Tag: Clinical-Nursing

  • Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Week 2: Therapy for Pediatric Clients With Mood Disorders

    Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies.

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    Assignment: Assessing and Treating Pediatric Clients With Mood Disorders

    When pediatric clients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. 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 with mood disorders. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers .

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients

    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. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Required Readings

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

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Chapter 6, “Mood Disorders”

    Chapter 7, “Antidepressants”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following medications, click on the
    The Prescriber’s Guide, 5th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

     

    Review the following medications:

    amitriptyline

    bupropion

    citalopram

    clomipramine

    desipramine

    desvenlafaxine

    doxepin

    duloxetine

    escitalopram

    fluoxetine

    fluvoxamine

    imipramine

    ketamine

    mirtazapine

    nortriptyline

    paroxetine

    selegiline

    sertraline

    trazodone

    venlafaxine

    vilazodone

    vortioxetine

    Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

    Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171

    Note:
    Retrieved from Walden Library databases.

    Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.),
    IACAPAP e-Textbook of Child and Adolescent Mental Health.
    Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf

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

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education (2016e).
    Case study: An African American child suffering from depression
    [Interactive media file]. Baltimore, MD: Author. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

     

    Note:
    This case study will serve as the foundation for this week’s Assignment.

    Optional Resources

    El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review.
    European Child & Adolescent Psychiatry, 23
    (10), 973–992. doi:10.1007/s00787-014-0558-3

    Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal?
    Journal of Pediatrics and Child Health, 50
    (11), 847–854. doi:10.1111/jpc.12655

    Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now?
    Journal of Child & Adolescent Mental Health, 26
    (2), iii–v. doi:10.2989/17280583.2014.938497

    To prepare for this Assignment:

    Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    The Assignment

    Examine
     Case Study: An African American Child Suffering From Depression
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    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 “WK2Assgn+last name+first initial.(extension)” as the name.

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

    Click the 
    Week 2 Assignment 
    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 “WK2Assgn+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. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

    Grading Criteria

    To access your rubric:

    Week 2 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 2 Assignment

    Making Connections

    Now that you have:

    Assessed pediatric clients presenting with mood disorders

    Developed personalized plans of antidepressant therapy for pediatric clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers .

    Explored ethical and legal implications of prescribing antidepressant therapy to pediatric clients

    Next week, you will build on your assessment and treatment skills as you examine adult and geriatric clients presenting for antidepressant therapy. Assessing and Treating Pediatric Clients With Mood Disorders Essay Assignment Papers

  • NURS – 6630 Discussion: Foundational Neuroscience

    NURS – 6630 Discussion: Foundational
    Neuroscience

    Agonist-to-Antagonist Spectrum of Action

                According to Indian Health Service (IHS, 2020), an agonist is any drug that activates specific brain receptors, thus causing the full effect of the drug to take place (p. 1). A partial agonist is a drug that acts as an agonist but the degree of receptor activation is reduced. When a drug is classified as an antagonist, it means that the drug blocks the receptors so they are not able to bind to the agonist. In the realm of opioids, an example of an agonist is Heroin, the antagonist is Naloxone, and a partial agonist is Buprenorphine. To expand on this example, Heroin is an addictive agonistic substance. In the case of a Heroin overdose, Naloxone, an antagonist, can be used to reverse the binding and block receptors from binding with free-floating Heroin. Pharmacological treatment for Heroin addiction often includes the partial agonist, Buprenorphine. Buprenorphine allows partial binding to opioid receptors, thus reducing withdrawal symptoms and curving drug cravings (IHS, 2020, p. 2).

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    Compare and Contrast: Ion Gated Channels and G-couple-proteins

                Ion Gated Channels (IGCs) and G-protein-coupled receptors (GPCRs) are two classes of postsynaptic receptors. IGCs, also referred to as ligand-gated ion channels, have two domains. One domain functions to bind neurotransmitters (extracellular) and the other that forms the ion channel. GPCRs work via second messenger systems that are slower and rely on a variety of metabolic steps (Camprodon & Roffman, 2016, p. 47). GPCRs are also called metabotropic receptors. When the neurotransmitter binds to the metabotropic receptors, the G-proteins are activated. The G-proteins then separate from the receptor and directly interact with the ion channels or pair with effector proteins to control the ion channels via intracellular messengers (McEnery & Siegel, 2014, p. 552).

    Epigenetics and Pharmacological Action
     

    Epigenetics can be defined in many ways, but the basis is that gene function can be altered without changing the DNA and RNA code. This functional change in the gene can also be inherited (Camprodon & Roffman, 2016, p. 64). As a result, epigenetics can determine how a medication works and what illnesses an individual may develop. If a medication works on a specific gene, but that gene has an altered function, the drug’s efficacy may change. For example, individuals with altered dopamine formation and receptor binding may have an affinity towards drug addiction or a degree of natural tolerance (Saad et al., 2019, p. 1534).
     For non-addictive substances, this logic holds true as to why some medications work for one person, but not another individual. 

    Best Practice

    It is essential to gather a thorough medical and family history before prescribing medications. Currently, the clinic I work in considers the patient’s familial medication history when prescribing medications, as well as genetic testing for patients where multiple psychotropics drugs have failed to treat their symptoms. As previously stated, some genes that affect medication efficacy may be inherited. In knowing what medications have worked for close relatives in the patient’s family, the patient may find success in using the same medication because of epigenetics.

    Genetic Testing
    One of the reasons the genetic testing is performed is to assess if the patient has normal Methylenetetrahydrofolate reductase gene function and is able to convert Folate to L-Methyl-Folate (LMF). LMF is necessary for the production of serotonin, dopamine, and norepinephrine (Shelton, Manning, Barrentine, & Tipa, 2013, p. 2). If this is impaired, even with medication, the patient’s body is not appropriately producing enough of the LMF cofactor to produce the necessary neurotransmitters for a stable mood- hence drug-resistant depression. Medication prescribing is not “cookie-cutter.” Modern science gives prescribing providers greater insight into what is going on in the very foundation of their patient’s being, their DNA. Although some are skeptical of genetic testing for psychotropic medications, I have first-hand seen the benefits in my employer’s clinic by using this resource as a means of guided prescribing.

     

     

    References

    Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),

    Massachusetts General Hospital psychopharmacology and neurotherapeutics.  Elsevier.

    McEnery, M. W. & Siegel, R. E. (2014). Neurotransmitter Receptors. Encyclopedia of the Neurological Sciences, pp. 552-564. Retrieved from

    https://www.sciencedirect.com/science/article/pii/B9780123851574000440

    Indian Health Service. (2020). Pharmacological Treatment. U.S. Department of Health and Human Services.

    Retrieved from https://www.ihs.gov/opioids/recovery/pharmatreatment/

    Saad, M.H., Rumschlag, M., Guerra, M.H.m Savonen, C. L., Jaster, A. M., Olson, P. D., Alazizi, A., Luca, F., Pique-Regi, R.,

    Schmidt, C. J., & Bannon, M. J. (2019). Differentially expressed gene networks, biomarkers, long noncoding RNAs, and

    shared responses with cocaine identified in the midbrains of human opioid abusers. Scientific Reports, 9, pp. 1534.

    Retrieved from https://www.nature.com/articles/s41598-018-38209-8

    Shelton, R. C., Sloan Manning, J., Barrentine, L. W., & Tipa, E. V. (2013). Assessing Effects of l-Methylfolate in Depression Management:

    Results of a Real-World Patient Experience Trial. The primary care companion for CNS disorders, 15(4), pp. 1-11.

    Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869616/?report=printable

    Week 1: Introduction to Neuroscience

    Modern psychopharmacology is largely the story of chemical neurotransmission. To understand the actions of drugs on the brain, to grasp the impact of diseases on the central nervous system, and to interpret the behavioral consequences of psychiatric medicines, one must be fluent in the language and principles of neurotransmission. NURS – 6630 Discussion: Foundational Neuroscience .

    —Dr. Stephen M. Stahl in Stahl’s Essential Psychopharmacology

    By using a combination of psychotherapy and medication therapy, psychiatric mental health nurse practitioners are positioned to provide a very unique type of care to clients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat clients as you relate presenting symptoms to theoretical neuronal functioning.

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    This week, as you begin to study psychopharmacology, you explore foundational neuroscience. You examine the agonist-to-antagonist spectrum of action of psychopharmacologic agents, compare the actions of g couple proteins to ion gated channels, and consider the role of epigenetics in pharmacologic action.

    Note:
     In previous courses, the term “patient” was used to describe the person receiving medical care. In traditional medicine and nursing, this term is used to describe the person you do something to, and it often refers to a passive recipient of care and services. As you move into the realm of psychiatric mental health, a transition will occur. You will work with individuals who are active participants in their care, and these individuals are generally referred to as “clients” as opposed to “patients.” It is important to note that the term “client” is also favored in other mental health disciplines, such as psychiatry, psychology, and social work. NURS – 6630 Discussion: Foundational Neuroscience .

     

    Discussion:
    Foundational Neuroscience

    As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.

    Learning Objectives

    Students will:

    Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

    Compare the actions of g couple proteins to ion gated channels

    Analyze the role of epigenetics in pharmacologic action

    Analyze the impact of foundational neuroscience on the prescription of medications

    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. NURS – 6630 Discussion: Foundational Neuroscience

    Required Readings

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

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 1, “Chemical Neurotransmission”

    Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

    Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

    Document:
    Midterm Exam Study Guide (PDF). NURS – 6630 Discussion: Foundational Neuroscience

    Document:
    Final Exam Study Guide (PDF)

    Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
        

     

    Agonists are ligands that bind to receptors and alter or modify the state of the receptors in such a way it triggers a biological response, whereas antagonist are alpha or beta blocker ligands that refrain from or dampen a biological reaction but blocks the presenting receptors. A full agonist has the capability of producing maximal response of the target system. As the receptor stimulus invoked by an agonist maximizes its response capability as a full agonist in such system.

     

    Partial agonists bind to and activate the presenting receptors; however, they do not have the ability to induce maximal intrinsic activity capable of producing full agonists even at full receptor occupancy and high concentration because of their low maximal efficacy when compared to the maximal efficacy of full agonists. When these partial agonists compete for the same receptors with full agonists they act as antagonists. Unless the partial agonists bind to the receptors in some sort of irreversible manner, it could be potentially be displaced from the receptor by a sufficiently high concentration of full agonist. In view of this, the efficacy of the full agonist is not affected, but its potency is reduced. Conversely, inverse agonists bind to receptors and reduce fraction of them in an active conformation. It could potentially decrease the available fraction of active receptors by binding to receptors in their inactive state preferentially, thus reducing the total possible pool of receptors in the system. In other words, an inverse agonist’s oppositional activity could be significantly reduced by competitive neutral antagonists that also bind the receptors but do nothing with them once they are attached (Camprodon and Roffman, 2016).

     

    Compare and contrast the actions of g couple proteins and ion gated channels.

     

    Neurotransmitter
     receptors such as acetylcholine that are 
    ligand
    -gated ion channels have the tendency to mediate rapid postsynaptic responses while 
    G protein
     – coupled neurotransmitter receptors such as serotonin and dopamine have the tendency to mediate slow postsynaptic responses. More so, a G protein-coupled receptor consist of a single polypeptide that is threaded over membrane, while ion channels comprise of pores that open and close upon ligand binding.

     

    G protein coupled receptors interact with a variety of proteins for intracellular response, while ion channels regulate flow of ions.  Finally, G protein involves GTP (Guanosine Triphosphate) whereas ion channels do not involve GTP.

     

    Explain how the role of epigenetics may contribute to pharmacologic action.

     

    The drug metabolism, as a biochemical process, requires modification of pharmaceutical substances through specialized enzymatic systems. Epigenetic regulation of drug-metabolizing enzyme genes has been shown to be a significant mechanism of changes in the expression of those drug-metabolizing enzymes.  In other words, Drug absorption, distribution, metabolism, and excretion are critical processes to be considered when developing safe drugs. These identified processes are mediated by drug-metabolizing enzymes such as cytochrome P450 and transporters such as ATP-binding cassettes that are expressed in various tissues of the body such as the small intestine, liver, and kidney. These processes could potentially inhibit, limit, or enhance the systemic and target organ exposure to xenobiotics (Camprodon and Roffman, 2016). Drug-metabolizing enzymes such as cytochrome P450 isoforms are responsible for the metabolic elimination of drugs, and membrane transporters such as ATP-binding cassette transporters can affect drug absorption, distribution, and excretion processes. More so, the interplay of these drug-metabolizing enzymes and transporters could potentially determine the pharmacokinetic properties of a drug in areas of bioavailability, volume of distribution, and half-life, as well as understanding the regulation of drug-metabolizing enzymes and transporters are critical to the prediction of consequent pharmacological and toxicological effects.

     

    Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

     

    As a mental health nurse practitioner, it is extremely critical to understand that the pharmacokinetic properties such as the distribution, absorption, metabolism, and excretion processes of any given medication to be prescribed to a patient. More so, these processes identified above are significantly influenced by the route of administration as well as the functionality of the body organs. For instance, understanding the absorption, metabolic and distribution processes of enteral medications will make the prescribing practitioner be well informed that such medication is best absorbed in the stomach and should be best administered orally. Understanding the pharmacological and toxicological consequence or effect of a drug regarding dosage makes a huge difference in the favorability of the patient’s treatment outcome and could be a defining factor between life and death.

     

     

     

    Reference:

    Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),
    Massachusetts General Hospital psychopharmacology and neurotherapeutics
     (pp. 1–19). Elsevier.

    Required Media

    Laureate Education (Producer). (2016i).
    Introduction to psychopharmacology
    [Video file]. Baltimore, MD: Author.

     

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

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

    Optional Resources

    Laureate Education (Producer). (2009).
    Pathopharmacology: Disorders of the nervous system: Exploring the human brain
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 15 minutes.

     

    Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.

     

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

    Laureate Education (Producer). (2012).
    Introduction to advanced pharmacology
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 8 minutes.

     

    In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.

     

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

     

    Agonists are drugs with both affinity (they bind to the target receptor) and intrinsic efficacy (they change receptor activity to produce a response (NCBI 2018). Antagonists have affinity but zero intrinsic efficacy and therefore they bind to the target receptor but do not produce a response. By occupying a fraction of the receptor population an antagonist reduces the probability of occupancy by an agonist. The presence of an antagonist will reduce receptor occupancy by an agonist with a corresponding reduction in response. By increasing the concentration of the agonist, the probability of receptor occupancy by the agonist increases, and thus the inhibitory/blocking effect of the antagonist can be surmounted (NCBI 2018). As intrinsic efficacy differs with drug structure, agonists can have different intrinsic efficacies and consequently be characterized as full or partial agonists. A full agonist typically produces the maximal response a system is capable of, whereas a partial agonist produces a submaximal response (NCBI 2018).

    G proteins are a family of proteins that act as molecular switches inside cells and are involved in transmitting signals from a variety of stimuli outside a cell to 
    its
     interior. G-protein-coupled receptors (GPCRs) mediate most of our physiological responses to hormones, neurotransmitters, and environmental stimulants, and so have great potential as therapeutic targets for a broad spectrum of diseases (NCBI 2009). GPCRs are the largest family of membrane proteins and mediate most cellular responses to hormones and neurotransmitters, as well as being responsible for vision, olfaction, and taste (NCBI 2009). G protein-coupled receptors (GPCRs) are involved in the control of every aspect of our behavior and physiology (Hamm 2001). More than half of all drugs target GPCRs and either activate or inactivate them. GPCRs have a common body plan with seven transmembrane helices (Hamm 2001).

    Ligand-gated ion channels (LGICs) are integral membrane proteins that contain a pore which allows the regulated flow of selected ions across the plasma membrane (Alexander et al,2017). Ligand-gated ion channels bind neurotransmitters and open in response to ligand binding. These channels control synaptic transmission between two neurons or between a neuron and a muscle. Ion channel function is modulated by interactions with other proteins (Alexander et al,2017).

    Epigenetics is a mechanism of gene control that can promote or repress the expression of genes without altering the genetic coding of an organism (NCBI 2011). It represents a system by which the gene expression of an individual can be altered without altering their genome’s sequence. Unlike genetic changes, epigenetic changes are reversible and do not change the DNA sequence, but it can change how the body reads a DNA sequence (NCBI 2011). The disease may be caused by direct changes in epigenetic marks, such as DNA methylation found to affect imprinted gene regulation. Studies have found that exposure to risk factors such as toxins, stress, and unhealthy diets are associated with epigenetic changes which are associated with mental health problems. Epigenetic drugs belong to a category of drugs used for the treatment of specific cancers. These drugs fall into two groups DNA methylation inhibitors and histone deacetylase inhibitors (NCBI 2011). A nurse practitioner should be careful when prescribing psychiatric medication for a patient who is diagnosed with cancer or has a strong family history of cancer.

     

    References

    Alexander, S. P., Peters, J. A., Kelly, E., Marrion, N. V., Faccenda, E., Harding, S. D., Pawson, A. J., Sharman, J. L., Southan, C., & Davies, J. A. (2017). THE CONCISE GUIDE TO PHARMACOLOGY 2017/18: Ligand-gated ion channels. 
    British Journal of Pharmacology
    , 
    174 Suppl 1
    , S130–S159.
    https://doi.org/10.1111/bph.13879

     

    Hamm, H. E. (2001). How activated receptors couple to G proteins. 
    Proceedings of the National Academy of Sciences of the United States of America
    , 
    98
    (9), 4819–4821.

    National center for biotechnology Information (NCBI 2018). Making sense of pharmacology: Inverse Agonism and functional selectivity. Retrieved from
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6165953/

    National center for biotechnology Information (NCBI 2009). The structure and function of G-protein-coupled receptors. Retrieved from
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3967846/

    National center for biotechnology Information (NCBI 2011). Epigenetics and Lifestyle. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752894/

     

    To prepare for this Discussion:

    Review this week’s Learning Resources.

    Reflect on concepts of foundational neuroscience. NURS –
    6630 Discussion: Foundational Neuroscience

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit! 
    NURS – 6630 Discussion: Foundational Neuroscience .

    By Day 3

    Post
     a response to each of the following
    :

    Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

    Compare and contrast the actions of g couple proteins and ion gated channels.

    Explain the role of epigenetics in pharmacologic action.

    Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action. NURS – 6630 Discussion: Foundational Neuroscience

    Read 
    a selection of your colleagues’ responses.

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    By Day 6

    Respond
     to two colleagues in one of the following ways:

    If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained. NURS – 6630 Discussion: Foundational Neuroscience

    If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

    Post
    by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 1 Discussion

    Making Connections

    Now that you have:

    Explored foundational neuroscience

    Examined how medications impact the central nervous system

    Next week, you will focus on how neuroscience can be applied to pediatric clients presenting with mood disorders. NURS – 6630 Discussion:
    Foundational Neuroscience

    Week 2 Discussion-Main Post

     

    This discussion will focus on the agonistic and antagonistic actions of psychotropic medications, ion channels, g coupled proteins, the role of epigenetics in pharmacologic action, and the efficiency in prescribing medication based on these factors. The understanding of these factors aids in determining the most effective course of treatment.

    In receptor antagonism, a medication to promote reuptake reduction, such as the selective serotonin reuptake inhibitor (SSRI) sertraline, fills the receptor site, thus preventing the post-synaptic reuptake of the neurotransmitter serotonin (Camprodon and Roffman, 2016). Receptor agonism occurs when the medication has an affinity for specific receptor sites, as in an opioid’s affinity for mu receptors (Camprodon and Roffman, 2016). On the other hand, naltrexone is an opioid antagonist, which, when administered, dominates the mu receptor sites, preventing opioid agonist action. (Camprodon and Roffman, 2016). In the middle is the partial agonist. For example, buprenorphine is a partial mu-opioid receptor used in managing withdrawal from opiates as partial agonism provides enough activation of the opiate receptor to minimalize withdrawal symptoms and not promote a “high” (Camprodon and Roffman, 2016). Lastly, an inverse agonist is a molecule that produces an agonist’s opposite effect (Weir, 2020). An inverse agonist is only useful if the receptor site is active without an agonist present (Weir, 2020). Even if an antagonist is present, which competes for the same receptor site as an inverse agonist, without an agonist present, the antagonist is completely ineffectual (Weir, 2020).

    Concerning coupled proteins, their role as a membrane receptor is intervening in the activity of neurotransmitters, various hormones and affecting heart contractility, sight, and inflammation (Calebiro and Grimes, 2020). In direct relation to g coupled proteins, ion channels are precisely affected by the action of g coupled proteins (Caleiro and Grimes, 2020).  Once an agonist binds to the plasma membrane, a g coupled protein is recruited, followed by alteration in an ion channel (Calebiro and Grimes, 2020).

    Another avenue in selecting a course of treatment involves epigenetics. For example, in anxiety disorders, research shows that dysfunctional gene expression resulting in the abnormal concentration of serotonin, GABA and norepinephrine, negatively impacts the body’s psychological and physiological state via increased and sustained cortisol levels (Peedicayil, 2020). To combat the effects of these dysfunctions, medication classes such as SSRIs inhibit the reuptake of serotonin, resulting in anxiolytic action (Peedicayil, 2020). In acute cases, immediate relief of symptoms is sought, which the benzodiazepine class is recommended (Peedicayil, 2020).

    Fortunately, pharmacogenetic testing is available to reveal how the patient processes certain medications, thus ensuring the most efficient medication is selected for treatment. Pharmacogenetic testing shows if a patient is a normal, fast, or slow metabolizer of a specific medication based on the individual’s biological variant of drug-metabolizing enzymes and transporters (Yu et al., 2017).

    Finally, as a psychiatric mental health nurse practitioner (PMHNP), these aspects of treatment must be considered to discover the best course of action. As a subjective opinion and prioritizing safety, if a PMHNP is contemplating starting a patient on a first-generation antipsychotic due to the patient’s failure to respond to safer and newer medications, pharmacogenetic testing is crucial. For example, a patient treated with haloperidol, which was personally witnessed, turned out to be a slow metabolizer of haloperidol after epigenetic testing results were released. These results explained why an initial 2.5 mg dose produced rapid extrapyramidal symptoms. With research showing that haloperidol most commonly produces extrapyramidal symptoms, extrapyramidal symptoms can develop rapidly, requiring emergency intervention (Boettger et al., 2015).

     

     

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    References

    Boettger, S., Jenewein, J., & Breitbart, W. (2015). Haloperidol, risperidone, olanzapine and aripiprazole in the management of delirium: A comparison of efficacy, safety, and side effects.
    Palliative & Supportive Care
    ,
    13
    (4), 1079–1085. https://doi.org/10.1017/S1478951514001059

    Calebiro, D., & Grimes, J. (2020). G Protein-Coupled Receptor Pharmacology at the Single-Molecule Level.
    Annual Review of Pharmacology and Toxicology
    ,
    60
    , 73–87. https://doi.org/10.1146/annurev-pharmtox-010919-023348

    Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.),
    Massachusetts General Hospital psychopharmacology and neurotherapeutics.
    Elsevier.

    Peedicayil J. (2020). The Potential Role of Epigenetic Drugs in the Treatment of Anxiety Disorders.
    Neuropsychiatric Disease and Treatment
    ,
    16
    , 597–606. doi: https://doi.org/10.2147/NDT.S242040

    Weir, C. J. (2020). Ion channels, receptors, agonists and antagonists.
    Anaesthesia & Intensive Care Medicine
    ,
    21
    (1), 62–68. https://doi.org/10.1016/j.mpaic.2019.10.022

    Yu, A. M., Ingelman-Sundberg, M., Cherrington, N. J., Aleksunes, L. M., Ulrich M. Zanger, U. M., Xie, W., Jeong, H., Morgan, E. M., Turnbaugh, P. J., Klaassen, C. D., Aadra P. Bhatt, A. P., Redinbo, M. R., Hao, P., Waxman, D. J., Wang, L., & Zhong, X. B. (2017). Regulation of drug metabolism and toxicity by multiple factors of genetics, epigenetics, lncRNAs, gut microbiota, and diseases: a meeting report of the 21st International Symposium on Microsomes and Drug Oxidations (MDO).
    Acta Pharmaceutica Sinica B
    ,
    7
    (2), 241–248. https://doi.org/10.1016/j.apsb.2016.12.006

  • Orlando’s Nursing Process Discipline Theory Essays

    Orlando’s Nursing Process Discipline Theory Essays

    The Dynamic Nurse-Patient Relationship , published in 1961 and written by
    Ida Jean Orlando
    , described Orlando’s Nursing Process Discipline Theory. The major dimensions of the model explain that the role of the nurse is to find out and meet the patient’s immediate needs for help. The patient’s presenting behavior might be a cry for help. However, the help the patient needs may not be what it appears to be. Because of this, nurses have to use their own perception, thoughts about perception, or the feeling engendered from their thoughts to explore the meaning of the patient’s behavior. This process helps nurses find out the nature of the patient’s distress and provide the help he or she needs. Orlando’s Nursing Process Discipline Theory Essays.

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    The concepts of the theory are: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement.

    The function of professional nursing is the organizing principle. This means finding out and meeting the patient’s immediate needs for help. According to Orlando, nursing is responsive to individuals who suffer, or who anticipate a sense of helplessness. It is focused on the process of care in an immediate experience, and is concerned with providing direct assistance to a patient in whatever setting they are found in for the purpose of avoiding, relieving, diminishing, or curing the sense of helplessness in the patient. The Nursing Process Discipline Theory labels the purpose of nursing to supply the help a patient needs for his or her needs to be met. That is, if the patient has an immediate need for help, and the nurse discovers and meets that need, the purpose of nursing has been achieved.

    Presenting behavior is the patient’s problematic situation. Through the presenting behavior, the nurse finds the patient’s immediate need for help. To do this, the nurse must first recognize the situation as problematic. Regardless of how the presenting behavior appears, it may represent a cry for help from the patient. The presenting behavior of the patient, which is considered the stimulus, causes an automatic internal response in the nurse, which in turn causes a response in the patient. Orlando’s Nursing Process Discipline Theory Essays.

    The immediate reaction is the internal response. The patient perceives objects with his or her five senses. These perceptions stimulate automatic thought, and each thought stimulates an automatic feeling, causing the patient to act. These three items are the patient’s immediate response. The immediate response reflects how the nurse experiences his or her participation in the nurse-patient relationship.

    The nursing process discipline is the investigation into the patient’s needs. Any observation shared and explored with the patient is immediately useful in ascertaining and meeting his or her need, or finding out he or she has no needs at that time. The nurse cannot assume that any aspect of his or her reaction to the patient is correct, helpful, or appropriate until he or she checks the validity of it by exploring it with the patient. The nurse initiates this exploration to determine how the patient is affected by what he or she says and does. Automatic reactions are ineffective because the nurse’s action is determined for reasons other than the meaning of the patient’s behavior or the patient’s immediate need for help. When the nurse doesn’t explore the patient’s reaction with him or her, it is reasonably certain that effective communication between nurse and patient stops.  Orlando’s Nursing Process Discipline Theory Essays.

    Improvement is the resolution to the patient’s situation. In the resolution, the nurse’s actions are not evaluated. Instead, the result of his or her actions are evaluated to determine whether his or her actions served to help the patient communicate his or her need for help and how it was met. In each contact, the nurse repeats a process of learning how he or she can help the patient. The nurse’s own individuality, as well as that of the patient, requires going through this each time the nurse is called upon to render service to those who need him or her.

    Orlando’s model of nursing makes the following assumptions:

    When patients are unable to cope with their needs on their own, they become distressed by feelings of helplessness.

    In its professional character, nursing adds to the distress of the patient.

    Patients are unique and individual in how they respond.

    Nursing offers mothering and nursing analogous to an adult who mothers and nurtures a child.

    The practice of nursing deals with people, environment, and health. Orlando’s Nursing Process Discipline Theory Essays

    Patients need help communicating their needs; they are uncomfortable and ambivalent about their dependency needs.

    People are able to be secretive or explicit about their needs, perceptions, thoughts, and feelings.

    The nurse-patient situation is dynamic; actions and reactions are influenced by both the nurse and the patient.

    People attach meanings to situations and actions that aren’t apparent to others.

    Patients enter into nursing care through medicine. Orlando’s Nursing Process Discipline Theory Essays

    The patient is unable to state the nature and meaning of his or her distress without the help of the nurse, or without him or her first having established a helpful relationship with the patient.

    Any observation shared and observed with the patient is immediately helpful in ascertaining and meeting his or her need, or finding out that he or she is not in need at that time. Orlando’s Nursing Process Discipline Theory Essays.

    Nurses are concerned with the needs the patient is unable to meet on his or her own.

    The nurse uses the standard
    nursing process
    in Orlando’s Nursing Process Discipline Theory, which follows: assessment, diagnosis, planning, implementation, and evaluation. The theory focuses on the interaction between the nurse and patient, perception validation, and the use of the nursing process to produce positive outcomes or patient improvement. Orlando’s key focus was the definition of the function of nursing. The model provides a framework for nursing, but the use of her theory does not exclude nurses from using other
    nursing theories
    while caring for patients. Orlando’s Nursing Process Discipline Theory Essays.

  • NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    Syllabus

    Student Support and Calendar Information

    So you have all key information available to you off-line, it is highly recommended that you print the following items for your reference:

    This Syllabus, including the Course Schedule that is linked on this page as a PDF

    Course Calendar

    Student Support

    Credit Hours

    11 weeks

    Walden University assigns credit hours based on the number and type of assignments that enable students to achieve the course learning objectives. In general, each semester credit equals about 42 hours of total student work and each quarter credit equals about 28 hours of total student work. This time requirement represents an approximate average for undergraduate work and the minimum expectations for graduate work. The number and kind of activities estimated to fulfill time requirements will vary by degree level and student learning style and by student familiarity with the delivery method and course content.

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    Course Description

    At times, psychotherapy is not enough to alleviate the emotional difficulties that some patients face. To that end, psychopharmacologic approaches are needed. Psychiatric mental health nurse practitioners (PMHNPs) must have a strong basis in psychopharmacology, extending from a prior education in pharmacology, to make appropriate medication choices for their patients. Learners in this course consider psychopharmacologic approaches to major mental health disorders including but not limited to major depressive disorders, bipolar disorder, anxiety disorders, as well as psychotic disorders. Learners explore key considerations associated with medication selection, monitoring of efficacy, and long-term management. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    Course Prerequisites

    PMHNP Program Core Coures & NURS-6521

    Course Outcomes

    By the end of this course, students will:

    Evaluate foundational neuroscience as it relates to caring for clients with psychiatric disorders across the lifespan

    Assess mechanisms of action of medications used to treat a variety of psychiatric conditions

    Compare evidence-based practices to select appropriate psychopharmacologic agents

    Synthesize pathophysiology and health assessment concepts in the psychopharmacologic treatment of psychiatric mental health disorders

    Evaluate ethical and legal implications of prescribing psychotropic medications across the lifespan

    Evaluate the efficacy and adverse reactions of psychotropic medications

    Recommend strategies to become a social change agent for individuals with psychiatric mental health issues

    Click on the following link to view the Outcomes/Alignment map for NURS 6630:

    Document:
    NURS 6630 Outcomes/Alignment (PDF)

    Course Materials

    Please visit the university bookstore via your Walden student portal to ensure you are obtaining the correct version of any course texts and/or materials noted in the following section. When you receive your materials, make sure that all required items are included.

    Course Texts

    These course texts are available through Stahl Online Resources 
    http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    This course text is available through the Walden Library:

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

    Note:
     If the print editions of these books are referenced here, electronic versions also may be available and may be acceptable for use in this course. If electronic versions are listed, no print versions are available.

    Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the course and may be found within each week. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

    Course Readings List

    The Course Readings List contains all of the required Walden Library resources for this course. Please click on the following link to access the list:

    NURS 6630 Course Readings List

    Media

    Assigned course media elements are found within the weekly Learning Resources pages and are available via a streaming media player or a hyperlink to the individual item.

    Grading Criteria and Total Components of a Grade

    Course grades will be based on participation (postings) and completion of assignments listed below.

    Note:
     All assignments must be completed to pass the course.

    Grading Scale

    Letter grades will be assigned as follows:

    90%–100% = A

    80%–89%   = B

    70%–79%   = C

    <70%   = F Please see below for the policy on Incomplete (I) grades. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Important Note:  This course contains weighted grading. Assignments are weighted differently depending on their type. The total points achieved for each assignment will be weighted based on the percentage values noted in the  Weighted Total (%) column of the table that follows.   Assignment Total Points Weighted Total (%) Discussions (5 Discussions, each worth 100 points) Weeks 1, 3, 7, 9 & 10 500 16% Decision Tree (9 Discussions, each worth 100 points) Weeks 2, 3, 4, 5, 6, 7, 8, 9 & 10 900 40% Midterm Week 6 75 22% Final Exam Week 11 75 22% Total 1,550 100% *  Each Discussion requires that you make one initial posting and  at least two  response postings to colleagues. See the Formative Evaluative Criteria for Discussion Board Assignments for posting details. Note:  All assignments must be completed in order to receive a grade for the course. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Dedicated Support for Course Media You may use the following e-mail address and toll-free number for any questions or concerns you have about media in the course. E-mail: mediasupport@waldenu.edu Phone:  1-877-238-2963 Course Assignments Online Discussion and Blog Assignment The exchange of ideas between colleagues engaged in scholarly inquiry is a key aspect of graduate-level learning and is a requisite activity in this course. Requirements : You are expected to participate  at least two  separate days a week in the weekly  Discussion  area. Discussion topics/questions are provided in the Discussion area. In addition, you are expected to respond to your fellow students’ postings. To count as participation, responses need to be thoughtful; that is, they must refer to the week’s readings, relevant issues in the news, information obtained from other sources, and/or ideas expressed in other class members’ postings. Where appropriate, you should use references to support your position. Most weeks have at least one Discussion question. The Discussion questions require a response to one other student’s posting; it should be no more than two paragraphs long. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology All Discussion postings need to be made in each week’s  Discussion  area of the course, unless otherwise stated. Please do not e-mail postings to the Instructor or other students. Refer to the  Discussion  area for specific instructions. Discussions will be graded according to the Discussion Rubric found in the  Course Information  area. Assignments and Projects An Assignment or Project often is a writing assignment submitted to the Instructor for evaluation. Complete Assignment or Project directions are in the  Assignments  or  Projects  areas, including how and where to submit the Assignment or Project and the due date. Please note that you should keep copies of your Assignments and Projects on your computer in case of any technical difficulties. Information on scholarly writing may be found in the APA manual and at the Walden Writing Center website. Please refer to the APA Guide or visit the Walden University Online Writing Center at http://writingcenter.waldenu.edu/ Walden University expects you to act with integrity and honesty in your academic courses. Refer to the  Guidelines and Policies  and  Academic Integrity  areas for more details. Check the  Course Information  area for any rubrics relating to the Assignments and Projects. All assignments must be completed to pass the course. Preferred Methods for Delivering Assignments Submitting Course Postings to the Weekly Discussion Areas Be sure that you post to the correct  Discussion  area each week. Do not e-mail postings to the Instructor. For all initial Discussion postings, make sure that the first sentence of your posting reads  Main Question Post . For your responses to others’ postings, make sure that the first sentence of your response reads  Response . These actions will ensure easily identifiable subject lines for your postings and responses. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Submitting Assignments and Projects Assignments and Projects are submitted according to the instructions in the  Assignments  or  Projects  areas and are named according to the week in which the Assignment or Project is submitted. Directions for naming each Assignment or Project are included in each week’s  Assignment  or  Project  area. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology E-mailing Your Instructor When e-mailing the Instructor, please use the following heading for your e-mail subject line:  last name + your first initial + course number  (e.g., RideSHUMN6815) so that your Instructor will recognize and read your e-mail. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology . Policies on Late Assignments Discussion and Assignment Postings No credit will be given for Discussion and Assignment postings made after the week in which they are due unless prior arrangements are made with the Instructor. Exceptions will be made only for those rare situations that legitimately prevent a student from posting on time. Points will be deducted from late postings. Assignments Assignments are due by  Day 7  of the week in which they are assigned unless otherwise noted. Failure to meet the deadline without prior approval will result in at least a 3-point deduction per day. Any Assignment submitted after  Day 4 of the week following that in which it is assigned will receive zero points. Projects Projects are due by  Day 7  of the week in which they are assigned unless otherwise noted. Failure to meet the deadline without prior approval will result in at least a 3-point deduction per day. Any Project submitted after  Day 4  of the week following that in which it is assigned will receive zero points. No Assignment or Project will be accepted after the last day of the quarter (Week 6, Day 7) unless prior approval is obtained. Students With Disabilities Students in this course who have a disability that might prevent them from fully demonstrating their abilities should contact the director of disability services at  disability@waldenu.edu  or at 1-800-925-3368, ext. 312-1205 and +1-612-925-3368 or  https://www.waldenu.edu/contact  for international toll-free numbers as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure full participation in the successful completion of course requirements. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Classroom Participation In accordance with U.S. Department of Education guidance regarding class participation, Walden University requires that all students submit at least one of their required Week 1 assignments (which includes posting to the Discussion Board) within each course(s) during the first 7 calendar days of class. For courses with two-week units, posting to the Discussion Board by Day 7 meets this requirement. The first calendar day of class is the official start date of the course as posted on your myWalden academic page. Assignments submitted prior to the official start date  will not  count toward your participation. Financial Aid cannot be released without class participation as defined above. Students who  are taking their first class with Walden  and do not submit at least one of their required Week 1 assignments (or at least one Discussion post) by the end of the 7th day will be administratively withdrawn from the university. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology . Students who have already taken and successfully completed  at least one  or more class(es) with Walden, and who  do not participate  within the first 7 days, will be dropped from that class. If you have any questions about your assignments, or you are unable to complete your assignments, please contact your Faculty Member. Checklist The weekly course checklist below outlines the assignments due for the course. For full assignment details and directions, refer to each week of the course. All assignments are due by 11:59 p.m. Mountain Time (MT) on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology To view the Course Calendar: Course Calendar To View a Printable Course Schedule For full assignment details and directions, refer to each week of the course. Click on the  NURS 6630 Course Schedule (PDF)  link to access the Course Schedule. Document: NURS 6630 Course Schedule (PDF) Checklist Module Assignment Title Week 1 Introduction to Neuroscience Discussion Foundational Neuroscience Week 2 Therapy for Pediatric Clients With Mood Disorders Assignment Assessing and Treating Pediatric Clients with Mood Disorders Week 3 Adult and Geriatric Antidepressant Therapy Discussion The Impact of Ethnicity on Antidepressant Therapy Assignment Assessing and Treating Adult and Geriatric Clients With Mood Disorders Week 4 Bipolar Therapy Assignment Assessing and Treating Clients with With Bipolar Disorder Week 5 Anxiolytic Therapy & PTSD Treatment Assignment Assessing and Treating Clients With Anxiety Disorders Week 6 Antipsychotic Therapy Assignment Assessing and Treating Clients With Psychosis and Schizophrenia Week 7 Therapy for Clients With Pain and Sleep/Wake Disorders Discussion Sleep/Wake Disorders Assignment Assessing and Treating Clients With Pain Week 8 Therapy for Clients With Impulsivity, Compulsivity, and Addiction Assignment Assessing and Treating Clients With Impulsivity, Compulsivity, and Addiction Week 9 Therapy for Clients with ADHD Discussion Presentations of ADHD Assignment Assessing and Treating Clients With ADHD Week 10 Therapy for Clients with Dementia Discussion Influencing Social Change Assignment Assessing and Treating Clients With Dementia Week 11 Therapy for Clients With Comorbid Conditions Final Exam Bibliography The bibliography contains the references for all learning materials in the course. For your convenience, a link has been provided to download and save the bibliography. NURS – 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology

  • Goal Attainment nursing theory essay – Imogene King

    Goal Attainment Nursing Theory Essay

    The Theory of Goal Attainment was developed by
    Imogene King
    in the early 1960s. It describes a dynamic, interpersonal relationship in which a patient grows and develops to attain certain life goals. The theory explains that factors which can affect the attainment of goals are roles, stress, space, and time. Goal Attainment Nursing Theory Essay.

    The model has three interacting systems: personal, interpersonal, and social. Each of these systems has its own set of concepts. The concepts for the personal system are perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are interaction, communication, transaction, role, and stress. The concepts for the social system are organization, authority, power, status, and decision-making.

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    The following propositions are made in the Theory of Goal Attainment:

    If perceptual interaction accuracy is present in nurse-patient interactions, transaction will occur.

    If the nurse and patient make transaction, the goal or goals will be achieved.

    If the goal or goals are achieved, satisfaction will occur.

    If transactions are made in nurse-patient interactions, growth and development will be enhanced.

    If role expectations and role performance as perceived by the nurse and patient are congruent, transaction will occur. Goal Attainment Nursing Theory Essay.

    If role conflict is experienced by either the nurse or the patient (or both), stress in the nurse-patient interaction will occur.

    If a nurse with special knowledge communicates appropriate information to the patient, mutual goal-setting and goal achievement will occur.

    There are also assumptions made in the model. They are:

    The focus of nursing is the care of the human being (patient).

    The goal of nursing is the health care of both individuals and groups.

    Human beings are open systems interacting with their environments constantly.

    The nurse and patient communicate information, set goals mutually, and then act to achieve those goals. This is also the basic assumption of the nursing process. Goal Attainment Nursing Theory Essay.

    Patients perceive the world as a complete person making transactions with individuals and things in the environment.

    Transaction represents a life situation in which the perceiver and the thing being perceived are encountered. It also represents a life situation in which a person enters the situation as an active participant. Each is changed in the process of these experiences.

    According to King, a human being refers to a social being who is rational and sentient. He or she has the ability to perceive, think, feel, choose, set goals, select means to achieve goals, and make decisions. He or she has three fundamental needs: the need for health information when it is needed and can be used; the need for care that seeks to prevent illness; and the need for care when he or she is unable to help him or herself. Goal Attainment Nursing Theory Essay.

    Health involves dynamic life experiences of a human being, which implies continuous adjustment to stressors in the internal and external environment through optimum use of resources to achieve maximum potential for daily living. Environment is the background for human interaction. It involves the internal and external environments. The internal environment transforms energy to enable a person to adjust to continuous external environment changes. The external environment involves formal and informal organizations. In this model, the nurse is part of the patient’s environment.

    The Goal Attainment Nursing Theory Essay defines nursing as “a process of action, reaction and interaction by which nurse and client share information about their perception in a nursing situation” and “a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.” In this definition, action is a sequence of behaviors involving mental and physical action, and reaction is included in the sequence of behaviors described in action. King states that the goal of a nurse is to help individuals to maintain their health so they can function in their roles. The domain of the nurse “includes promoting, maintaining, and restoring health, and caring for the sick, injured and dying.” The function of a professional nurse is “to interpret information in the nursing process to plan, implement, and evaluate nursing care.” Goal Attainment Nursing Theory Essay.

    King gives detailed information about the
    nursing process
    in her model of nursing. The steps of the nursing process are: assessment, nursing diagnosis, planning, implementations, and evaluation.

    The theory explains that assessment occurs during interaction. The nurse brings special knowledge and skills whereas the patient brings knowledge of him or her self, as well as the perception of problems of concern to the interaction. During the assessment, the nurse collects data regarding the patient including his or her growth and development, the perception of self, and current health status. Perception is the base for the collection and interpretation of data. Communication is required to verify the accuracy of the perception, as well as for interaction and translation.

    The nursing diagnosis is developed using the data collected in the assessment. In the process of attaining goals, the nurse identifies problems, concerns, and disturbances about which the patient is seeking help. Goal Attainment Nursing Theory Essay.

    After the diagnosis, the nurse and other health care team members create a
    care plan
    of interventions to solve the problems identified. The planning is represented by setting goals and making decisions about the means to achieve those goals. This part of transaction and the patient’s participation is encouraged in making decisions on the means to achieve the goals. Goal Attainment Nursing Theory Essay.

    The implementation phase of the nursing process is the actual activities done to achieve the goals. In this model of nursing, it is the continuation of transaction.

    Evaluation involves determining whether or not goals were achieved. The explanation of evaluation in King’s theory addresses meeting goals and the effectiveness of nursing care. Goal Attainment Nursing Theory Essay.

  • NURS_6640_Week4_Assignment1_Rubric

    NURS_6640_Week4_Assignment1_Rubric

    Excellent

    Good

    Fair

    Poor

    Quality of Work Submitted:

    The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.

    27 
    (27%)
     – 30 
    (30%)

    Assignment 
    exceeds
    expectations. All topics are addressed with a minimum of 75% containing 
    exceptional
    breadth and depth about 
    each
     of the assignment topics.

    24 
    (24%)
     – 26 
    (26%)

    Assignment meets expectations. All topics are addressed with a minimum of 50% containing 
    good
     breadth and depth about 
    each
     of the assignment topics.

    21 
    (21%)
     – 23 
    (23%)

    Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.

    0 
    (0%)
     – 20 
    (20%)

    Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

    Quality of Work Submitted:

    The purpose of the paper is clear.

    5 
    (5%)
     – 5 
    (5%)

    A clear and comprehensive purpose statement is provided which delineates all required criteria.

    4 
    (4%)
     – 4 
    (4%)

    Purpose of the assignment is stated, yet is brief and not descriptive.

    3.5 
    (3.5%)
     – 3.5 
    (3.5%)

    Purpose of the assignment is vague or off topic.

    0 
    (0%)
     – 3 
    (3%)

    No purpose statement was provided.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Understand and interpret the assignment’s key concepts.

    9 
    (9%)
     – 10 
    (10%)

    Demonstrates the ability to critically appraise and intellectually explore key concepts.

    8 
    (8%)
     – 8 
    (8%)

    Demonstrates a clear understanding of key concepts. NURS_6640_Week4_Assignment1_Rubric

    7 
    (7%)
     – 7 
    (7%)

    Shows some degree of understanding of key concepts.

    0 
    (0%)
     – 6 
    (6%)

    Shows a lack of understanding of key concepts, deviates from topics.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.

    18 
    (18%)
     – 20 
    (20%)

    Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.

    16 
    (16%)
     – 17 
    (17%)

    Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view. NURS_6640_Week4_Assignment1_Rubric

    14 
    (14%)
     – 15 
    (15%)

    Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.

    0 
    (0%)
     – 13 
    (13%)

    Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.

    18 
    (18%)
     – 20 
    (20%)

    Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.

    16 
    (16%)
     – 17 
    (17%)

    Summarizes information gleaned from sources to support major points, but does not synthesize. NURS_6640_Week4_Assignment1_Rubric

    14 
    (14%)
     – 15 
    (15%)

    Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.

    0 
    (0%)
     – 13 
    (13%)

    Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

    Written Expression and Formatting

    Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

    5 
    (5%)
     – 5 
    (5%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity

    4 
    (4%)
     – 4 
    (4%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.

    3.5 
    (3.5%)
     – 3.5 
    (3.5%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.

    0 
    (0%)
     – 3 
    (3%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time. Written Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. NURS_6640_Week4_Assignment1_Rubric 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) APA format errors. NURS_6640_Week4_Assignment1_Rubric 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100

  • Virginia Henderson Nursing Need Theory Essay Assignment Papers

    Virginia Henderson Nursing Need Theory Essay Assignment Papers

    Need Theory

    The Nursing Need Theory was developed by
    Virginia Henderson
    and was derived from her practice and education. Henderson’s goal was not to develop a theory of nursing, but rather to define the unique focus of nursing practice.
    The theory emphasizes the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed. Her emphasis on basic human needs as the central focus of nursing practice has led to further theory development regarding the needs of the patient and how nursing can assist in meeting those needs. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Henderson identifies three major assumptions in her model of nursing.
    The first is that “nurses care for a patient until a patient can care for him or herself,” though it is not stated explicitly. The second assumption states that nurses are willing to serve and that “nurses will devote themselves to the patient day and night.” Finally, the third assumption is that nurses should be educated at the college level in both sciences and arts.

    The four major concepts addressed in the theory are the individual, the environment, health, and nursing. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

    According to Henderson, individuals have basic needs that are components of health. They may require assistance to achieve health and independence, or assistance to achieve a peaceful death. For the individual, mind and body are inseparable and interrelated, and the individual considers the biological, psychological, sociological, and spiritual components. This theory presents the patient as a sum of parts with biophysical needs rather than as a type of client or consumer.

    The environment is made up of settings in which an individual learns unique patterns for living. All external conditions and influences that affect life and development. The environment also includes individuals in relation to families. The theory minimally discusses the impact of the community on the individual and family. Basic nursing care involves providing conditions in which the patient can independently perform the fourteen components explained in the model. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

    There are fourteen components based on human needs that make up nursing activities. These components are:

    Breathe normally. Eat and drink adequately.

    Eliminate body wastes.

    Move and maintain desirable postures.

    Sleep and rest.

    Select suitable clothing. That is, dress and undress appropriately.

    Maintain body temperature within normal range by adjusting clothing and modifying the environment.

    Keep the body clean and well groomed and protect the integument.

    Avoid dangers in the environment and avoid injuring others.

    Communicate with others in expressing emotions, needs, fears, or opinions.

    Worship according to one’s faith.

    Work in such a way that there is a sense of accomplishment.

    Play or participate in various forms of recreation
    .

    Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

    These components show a holistic approach to nursing that cover the physiological, psychological, spiritual, and social. The first nine components are physiological. The tenth and fourteenth are psychological. The eleventh component is spiritual and moral. The twelfth and thirteenth components are sociological, specifically addressing occupation and recreation.

    The theory’s definition of health is based on an individual’s ability to function independently
    as outlined in the fourteen components.
    Nurses need to stress the promotion of health and prevention, as well as the curing of diseases. According to Henderson’s model, good health is a challenge because it is affected by so many different factors, such as age, cultural background, emotional balance, and others. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

    Henderson’s definition of nursing states:
    “I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible.” The nurse is expected to carry out a physician’s therapeutic plan, but individualized care is result of the nurse’s creativity in planning for care. The nurse should be an independent practitioner able to make independent judgments as long as he or she is not diagnosing, prescribing treatment, or making a prognosis, since those activities are the function of the physician.

    Henderson explains in
    Nature of Nursing
    that the role of a nurse is “to get inside the patient’s skin and supplement his strength will or knowledge according to his needs.” The nurse has the responsibility to assess the needs of the patient, help him or her meet health needs, and provide an environment in which the patient can perform activity unaided. Virginia Henderson Nursing Need Theory Essay Assignment Papers.

  • NURS_6640_Week6_Assignment1_Rubric

    NURS_6640_Week6_Assignment1_Rubric

    Excellent

    Good

    Fair

    Poor

    Quality of Work Submitted:

    The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.

    27 
    (27%)
     – 30 
    (30%)

    Assignment 
    exceeds
    expectations. All topics are addressed with a minimum of 75% containing 
    exceptional
    breadth and depth about 
    each
     of the assignment topics.

    24 
    (24%)
     – 26 
    (26%)

    Assignment meets expectations. All topics are addressed with a minimum of 50% containing 
    good
     breadth and depth about 
    each
     of the assignment topics.

    21 
    (21%)
     – 23 
    (23%)

    Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed.

    0 
    (0%)
     – 20 
    (20%)

    Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

    Quality of Work Submitted:

    The purpose of the paper is clear.

    5 
    (5%)
     – 5 
    (5%)

    A clear and comprehensive purpose statement is provided which delineates all required criteria.

    4 
    (4%)
     – 4 
    (4%)

    Purpose of the assignment is stated, yet is brief and not descriptive.

    3.5 
    (3.5%)
     – 3.5 
    (3.5%)

    Purpose of the assignment is vague or off topic.

    0 
    (0%)
     – 3 
    (3%)

    No purpose statement was provided.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Understand and interpret the assignment’s key concepts.

    9 
    (9%)
     – 10 
    (10%)

    Demonstrates the ability to critically appraise and intellectually explore key concepts.

    8 
    (8%)
     – 8 
    (8%)

    Demonstrates a clear understanding of key concepts. NURS_6640_Week6_Assignment1_Rubric

    7 
    (7%)
     – 7 
    (7%)

    Shows some degree of understanding of key concepts.

    0 
    (0%)
     – 6 
    (6%)

    Shows a lack of understanding of key concepts, deviates from topics.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.

    18 
    (18%)
     – 20 
    (20%)

    Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view.

    16 
    (16%)
     – 17 
    (17%)

    Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view. NURS_6640_Week6_Assignment1_Rubric

    14 
    (14%)
     – 15 
    (15%)

    Minimally includes and integrates specific information from 2-3 resources to support major points and point of view.

    0 
    (0%)
     – 13 
    (13%)

    Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view.

    Assimilation and Synthesis of Ideas:

    The extent to which the work reflects the student’s ability to:Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.

    18 
    (18%)
     – 20 
    (20%)

    Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice.

    16 
    (16%)
     – 17 
    (17%)

    Summarizes information gleaned from sources to support major points, but does not synthesize. NURS_6640_Week6_Assignment1_Rubric

    14 
    (14%)
     – 15 
    (15%)

    Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped.

    0 
    (0%)
     – 13 
    (13%)

    Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

    Written Expression and Formatting

    Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

    5 
    (5%)
     – 5 
    (5%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity

    4 
    (4%)
     – 4 
    (4%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.

    3.5 
    (3.5%)
     – 3.5 
    (3.5%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time.

    0 
    (0%)
     – 3 
    (3%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time. Written Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation 5  (5%)  – 5  (5%) Uses correct grammar, spelling, and punctuation with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. 5  (5%)  – 5  (5%) Uses correct APA format with no errors. 4  (4%)  – 4  (4%) Contains a few (1-2) APA format errors. 3.5  (3.5%)  – 3.5  (3.5%) Contains several (3-4) APA format errors. 0  (0%)  – 3  (3%) Contains many (≥ 5) APA format errors. Total Points: 100 NURS_6640_Week6_Assignment1_Rubric

  • NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    Week 1: Introduction to Neuroscience

    Modern psychopharmacology is largely the story of chemical neurotransmission. To understand the actions of drugs on the brain, to grasp the impact of diseases on the central nervous system, and to interpret the behavioral consequences of psychiatric medicines, one must be fluent in the language and principles of neurotransmission.

    —Dr. Stephen M. Stahl in Stahl’s Essential Psychopharmacology

    By using a combination of psychotherapy and medication therapy, psychiatric mental health nurse practitioners are positioned to provide a very unique type of care to clients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat clients as you relate presenting symptoms to theoretical neuronal functioning.

    ORDER A PLAGIARISM-FREE PAPER HERE

    This week, as you begin to study psychopharmacology, you explore foundational neuroscience. You examine the agonist-to-antagonist spectrum of action of psychopharmacologic agents, compare the actions of g couple proteins to ion gated channels, and consider the role of epigenetics in pharmacologic action.

    Note:
     In previous courses, the term “patient” was used to describe the person receiving medical care. In traditional medicine and nursing, this term is used to describe the person you do something to, and it often refers to a passive recipient of care and services. As you move into the realm of psychiatric mental health, a transition will occur. You will work with individuals who are active participants in their care, and these individuals are generally referred to as “clients” as opposed to “patients.” It is important to note that the term “client” is also favored in other mental health disciplines, such as psychiatry, psychology, and social work.

    Photo Credit: [cgtoolbox]/[Vetta]/Getty Images

    Discussion: Foundational Neuroscience

    As a psychiatric mental health nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat clients, you must not only understand the pathophysiology of psychiatric disorders, but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Learning Objectives

    Students will:

    Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents

    Compare the actions of g couple proteins to ion gated channels

    Analyze the role of epigenetics in pharmacologic action

    Analyze the impact of foundational neuroscience on the prescription of medications

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 1, “Chemical Neurotransmission”

    Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”

    Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”

    Document: Midterm Exam Study Guide (PDF)

    Document: Final Exam Study Guide (PDF)

     

    Required Media

    Laureate Education (Producer). (2016i).
    Introduction to psychopharmacology
    [Video file]. Baltimore, MD: Author.

     

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

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

    Optional Resources

    Laureate Education (Producer). (2009).
    Pathopharmacology: Disorders of the nervous system: Exploring the human brain
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 15 minutes.

     

    Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

     

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

    Laureate Education (Producer). (2012).
    Introduction to advanced pharmacology
    [Video file]. Baltimore, MD: Author.

     

    Note:
    The approximate length of this media piece is 8 minutes.

     

    In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.

     

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

    To prepare for this Discussion:

    Review this week’s Learning Resources.

    Reflect on concepts of foundational neuroscience.

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    By Day 3

    Post
     a response to each of the following:

    Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents.

    Compare and contrast the actions of g couple proteins and ion gated channels.

    Explain the role of epigenetics in pharmacologic action.

    Explain how this information may impact the way you prescribe medications to clients. Include a specific example of a situation or case with a client in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

    Read 
    a selection of your colleagues’ responses.

    By Day 6

    Respond
     to two colleagues in one of the following ways:

    If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.

    If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 1 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 1 Discussion

     

    Making Connections

    Now that you have:

    Explored foundational neuroscience

    Examined how medications impact the central nervous system

    Next week, you will focus on how neuroscience can be applied to pediatric clients presenting with mood disorders.

     

     

    Week 2: Therapy for Pediatric Clients With Mood Disorders

    Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.

    This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies.

    Photo Credit: GettyLicense_185239711.jpg

    Assignment: Assessing and Treating Pediatric Clients With Mood Disorders

    When pediatric clients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. 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 with mood disorders.

    Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 6, “Mood Disorders”

    Chapter 7, “Antidepressants”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following medications, click on the
    The Prescriber’s Guide, 5th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

     

    Review the following medications:

    amitriptyline

    bupropion

    citalopram

    clomipramine

    desipramine

    desvenlafaxine

    doxepin

    duloxetine

    escitalopram

    fluoxetine

    fluvoxamine

    imipramine

    ketamine

    mirtazapine

    nortriptyline

    paroxetine

    selegiline

    sertraline

    trazodone

    venlafaxine

    vilazodone

    vortioxetine

    Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

     

    Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171

    Note:
    Retrieved from Walden Library databases.

    Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.),
    IACAPAP e-Textbook of Child and Adolescent Mental Health.
    Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf

     

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

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education (2016e).
    Case study: An African American child suffering from depression
    [Interactive media file]. Baltimore, MD: Author.

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    Optional Resources

    El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review.
    European Child & Adolescent Psychiatry, 23
    (10), 973–992. doi:10.1007/s00787-014-0558-3

    Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal?
    Journal of Pediatrics and Child Health, 50
    (11), 847–854. doi:10.1111/jpc.12655

    Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now?
    Journal of Child & Adolescent Mental Health, 26
    (2), iii–v. doi:10.2989/17280583.2014.938497. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    To prepare for this Assignment:

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

    The Assignment

    Examine
     Case Study: An African American Child Suffering From Depression
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    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? NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    Also include how ethical considerations might impact your treatment plan and communication with clients. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    By Day 7

    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 “WK2Assgn+last name+first initial.(extension)” as the name.

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

    Click the 
    Week 2 Assignment 
    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
    Find the document you saved as “WK2Assgn+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. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Grading Criteria

    To access your rubric:

    Week 2 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 2 Assignment

     

    Making Connections

    Now that you have:

    Assessed pediatric clients presenting with mood disorders

    Developed personalized plans of antidepressant therapy for pediatric clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy

    Explored ethical and legal implications of prescribing antidepressant therapy to pediatric clients. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Next week, you will build on your assessment and treatment skills as you examine adult and geriatric clients presenting for antidepressant therapy.

     

     

    Week 3: Adult and Geriatric Antidepressant Therapy

    The National Institute of Mental Health estimates that approximately 15.7 million adults in the United States have depression (NIMH, 2014), making depression one of the most common disorders you will treat in practice. Although this disorder is so prevalent, antidepressant therapy must be as unique as each individual you treat. There are dozens of antidepressant medications on the market, and you must be able to identify which medication or combinations of medications will result in the best outcomes for your clients.

    This week, as you study antidepressant therapies, you examine the assessment and treatment of clients with mood disorders. You also explore ethical and legal implications of these therapies. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Photo Credit: Comstock Images/Getty Images

    Discussion: The Impact of Ethnicity on Antidepressant Therapy

    Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy

    Analyze the impact of ethnicity on antidepressant therapy

    Evaluate efficacy of treatment plans

    Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 7, “Antidepressants”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

     

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

     

    Review the following medications:

    amitriptyline

    bupropion

    citalopram

    clomipramine

    desipramine

    desvenlafaxine

    doxepin

    duloxetine

    escitalopram

    fluoxetine

    fluvoxamine

    imipramine

    ketamine

    mirtazapine

    nortriptyline

    paroxetine

    selegiline

    sertraline

    trazodone

    venlafaxine

    vilazodone

    vortioxetine

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

    Note:
    Retrieved from Walden Library databases.

    Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 1: Study design.
    Journal of Psychosocial Nursing and Mental Health Services, 46
    (9), 21–24. doi:10.3928/02793695-20080901-06

    Note:
    Retrieved from Walden Library databases.

    Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 2: Study outcomes.
    Journal of Psychosocial Nursing and Mental Health Services, 46
    (19), 21–24. doi:10.3928/02793695-20081001-05

    Note:
    Retrieved from Walden Library databases.

    Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies.
    Clinical Pharmacology & Therapeutics, 84
    (3), 417–423. Retrieved from https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf

     

    To prepare for this Discussion:

    Note: 
    By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.

    Case 1: 
    Volume 1, Case #1: The man whose antidepressants stopped working

    Case 2: 
    Volume 1, Case #7: The case of physician do not heal thyself

    Case 3: 
    Volume 1, Case #29: The depressed man who thought he was out of options

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

    Review the posttest for the case study.

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit!

    By Day 3

    Post
     a response to the following:

    Provide the case number in the subject line of the Discussion thread.

    List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

    Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

    Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

    List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

    List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?

    If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

    Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Read 
    a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues who were assigned to a different case than you. For example, if you were assigned to Case Study 1, respond to one colleague assigned to Case Study 2 and one colleague assigned to Case Study 3. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings.

    If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.

    If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 3 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 3 Discussion

     

    Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

    Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    Note:
    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 6, “Mood Disorders”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

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

     

    Review the following medications:

    amitriptyline

    bupropion

    citalopram

    clomipramine

    desipramine

    desvenlafaxine

    doxepin

    duloxetine

    escitalopram

    fluoxetine

    fluvoxamine

    imipramine

    ketamine

    mirtazapine

    nortriptyline

    paroxetine

    selegiline

    sertraline

    trazodone

    venlafaxine

    vilazodone

    vortioxetine

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

    Note:
    Retrieved from Walden Library databases.

    Montgomery, S. A., & Asberg, M. (1979).
    A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134
    , 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf

     

    Required Media

    Laureate Education. (2016g).
    Case study: An elderly Hispanic man with major depressive disorder
    [Interactive media file]. Baltimore, MD: Author.

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    To prepare for this Assignment:

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

    The Assignment

    Examine 
    Case Study: An Elderly Hispanic Man With Major Depressive Disorder
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    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 “WK3Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 3 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 3 Assignment 
    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
    Find the document you saved as “WK3Assgn+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 3 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 3 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 3 Assignment

     

    Making Connections

    Now that you have:

    Assessed adult and geriatric clients presenting with mood disorders

    Developed personalized plans of antidepressant therapy for adult and geriatric clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy

    Explored ethical and legal implications of prescribing antidepressant therapy to adult and geriatric clients

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for bipolar therapy.

     

     

    Week 4: Bipolar Therapy

    Jay, an 18-year-old high school senior, presents with symptoms of difficulty sleeping and feeling sad, which results in an initial diagnosis of depression. His mother later reports, however, that Jay exhibits symptoms of irritability and risk-taking behaviors. (His little brother reported to his mother that they were driving over 90 miles an hour on the highway.) After further evaluation, Jay’s psychiatric mental health nurse practitioner diagnosed him with bipolar disorder.

    Cases like this are not uncommon with bipolar disorder, as initial assessments rarely provides all the information needed. In your role, as a psychiatric mental health nurse practitioner, you must develop strategies for properly assessing and diagnosing these clients because treatments for bipolar disorder are significantly different than treatments for depression or other mood disorders. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    This week, as you examine bipolar therapies, you explore the assessment and treatment of clients with bipolar disorder. You also consider ethical and legal implications of these therapies.

    Photo Credit: [Vanessa Galeote]/[Hemera / Getty Images Plus]/Getty Images

    Assignment: Assessing and Treating Clients with With Bipolar Disorder

    Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of bipolar therapy for clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 6, “Mood Disorders”

    Chapter 8, “Mood Stabilizers”

    Stahl, S. M., & Ball, S. (2009b).
    Stahl’s illustrated mood stabilizers.
    New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Illustrated Guides
    tab and then the
    Mood Stabilizers
    tab.

    Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”

    Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”

    Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder?
    CNS Drugs, 27
    (5), 331-333. doi:10.1007/s40263-013-0060-3

    Note:
    Retrieved from Walden Library databases.

    Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems.
    European Journal of Clinical Pharmacology, 71
    (7), 835-841. doi:10.1007/s00228-015-1855-6

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education. (2016f).
    Case study: An Asian American woman with bipolar disorder
    [Interactive media file]. Baltimore, MD: Author

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    Optional Resources

    Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial.
    Acta Medica Iranica, 52
    (10), 734-739.

    Retrieved from http://acta.tums.ac.ir/index.php/acta

     

    To prepare for this Assignment:

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

    The Assignment

    Examine Case Study: An Asian American Woman With Bipolar Disorder.
     You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Submission and Grading Information

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

    Save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.

    Click on the Assignment Rubric to review the Grading Criteria for the Assignment.

    Click on the 
    Week 4 Assignment
    Next, from the Attach File area, click on the 
    Browse My Computer
    button. Find the document you saved as “WK4Assgn+last name+first initial.(extension)” and click on 
    Open
    .

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

    Grading Criteria

    To access your rubric:

    Week 4 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 4 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with bipolar disorder

    Developed personalized plans of bipolar therapy for clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy

    Explored ethical and legal implications of prescribing bipolar therapy to clients

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for anxiolytic therapy and PTSD treatment.

     

     

    Week 5: Anxiolytic Therapy & PTSD Treatment

    “I’m no longer at the mercy of my PTSD, and I would not be here today had I not had the proper diagnosis and treatment. It’s never too late to seek help.”

    —P.K. Philips, PTSD patient

    For individuals suffering from posttraumatic stress disorder (PTSD) and other anxiety disorders, everyday life can be a constant challenge. Clients requiring anxiolytic therapy may present with anxiousness, depression, substance abuse issues, and even physical symptoms related to cardiovascular, respiratory, and gastrointestinal ailments. As a psychiatric mental health nurse practitioner, you must be prepared to address the many needs of individuals seeking treatment for PTSD and other anxiety disorders.

    This week, as you study anxiolytic therapies and PTSD treatments, you examine the assessment and treatment of clients with PTSD and other anxiety disorders. You also explore ethical and legal implications of these therapies.

    Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images

    Assignment: Assessing and Treating Clients With Anxiety Disorders. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of anxiolytic therapy for clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing anxiolytic therapy to clients across the lifespan

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 9, “Anxiety Disorder and Anxiolytics”

    Stahl, S. M., & Grady, M. (2010).
    Stahl’s illustrated anxiety, stress, and PTSD
    . New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Illustrated Guides
    tab and then the
    Anxiety, Stress, and PTSD
    tab.

    Chapter 4, “First-Line Medications for PTSD”

    Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”

    Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder.
    Depression and Anxiety, 29
    (4), 328–-339. doi:10.1002/da.21913. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Note:
    Retrieved from Walden Library databases.

    Hamilton, M. (1959). Hamilton Anxiety Rating Scale.
    Psyctests
    , doi:10.1037/t02824-0

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education. (2016b).
    Case study: A middle-aged Caucasian man with anxiety
    [Interactive media file]. Baltimore, MD: Author.

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    Optional Resources

    Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review.
    Biomed Research International
    , 2014. doi:10.1155/2014/537306

    To prepare for this Assignment:

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

    The Assignment

    Examine Case Study: A Middle-Aged Caucasian Man With Anxiety.
     You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Submission and Grading Information

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

    Save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.

    Click on the Assignment Rubric to review the Grading Criteria for the Assignment.

    Click on the 
    Week 5 Assignment
    Next, from the Attach File area, click on the 
    Browse My Computer
    button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click on 
    Open
    .

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

    Grading Criteria

    To access your rubric:

    Week 5 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 5 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 5 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with PTSD and other anxiety disorders

    Developed personalized plans of anxiolytic therapy for clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring anxiolytic therapy

    Explored ethical and legal implications of prescribing anxiolytic therapy to clients

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for antipsychotic therapy.

     

     

    Week 6: Antipsychotic Therapy

    According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients.

    This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.

    Photo Credit: Ingram Publishing/Getty Images

    Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia

    Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized plans of antipsychotic therapy for clients

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 4, “Psychosis and Schizophrenia”

    Chapter 5, “Antipsychotic Agents”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    amisulpride

    aripiprazole

    asenapine

    chlorpromazine

    clozapine

    flupenthixol

    fluphenazine

    haloperidol

    iloperidone

    loxapine

    lurasidone

    olanzapine

    paliperidone

    perphenazine

    quetiapine

    risperidone

    sulpiride

    thioridazine

    thiothixene

    trifluoperazine

    ziprasidone

    Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians.
    CNS Drugs, 23
    (8), 649-659. doi:10.2165/00023210-200923080-00002

    Note:
    Retrieved from Walden Library databases.

    Document: Midterm Exam Study Guide (PDF)

     

    Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.

    Note:
    Retrieved from Walden Library databases.

    Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

    Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

     

    Required Media

    Laureate Education. (2016j).
    Case study: Pakistani woman with delusional thought processes
    [Interactive media file]. Baltimore, MD: Author

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    Optional Resources

    Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study.
    Clinical Schizophrenia & Related Psychoses, 5
    (3), 124-134. doi:10.3371/CSRP.5.3.2

    Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems.
    American Journal of Health-System Pharmacy, 71
    (9), 728-738. doi:10.2146/ajhp130471

    Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach.
    The Psychiatric Quarterly, 86
    (1), 107-121. doi:10.1007/s11126-014-9326-2

    To prepare for this Assignment:

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

    The Assignment

    Examine Case Study: Pakistani Woman with Delusional Thought Processes.
     You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note:
     Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Submission and Grading Information

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

    Save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.

    Click on the Assignment Rubric to review the Grading Criteria for the Assignment.

    Click on the 
    Week 6 Assignment
    Next, from the Attach File area, click on the 
    Browse My Computer
    button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click on 
    Open
    .

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

    Grading Criteria

    To access your rubric:

    Week 6 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 6 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 6 Assignment

     

    Midterm Exam

    Learning Objectives

    Students will:

    Assess psychopharmacologic approaches to treatment for clients across the lifespan

    This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for clients across the lifespan:

    Introduction to neuroscience

    Therapy for pediatric patients with mood disorders

    Adult and geriatric antidepressant therapy

    Bipolar therapy

    Anxiolytic therapy

    Antipsychotic therapy

    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.

    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 Midterm Exam by Day 7

    To submit your Midterm Exam:

    Week 6 Midterm Exam

     

    Making Connections

    Now that you have:

    Assessed clients presenting with psychosis and schizophrenia

    Developed personalized plans of antipsychotic therapy for clients

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    Explored ethical and legal implications of prescribing antipsychotic therapy to clients

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for therapy for pain and sleep/wake disorders.

     

    Week 7: Therapy for Clients With Pain and Sleep/Wake Disorders

    From negative changes in mood to problems concentrating, pain and sleep/wake disorders can have a tremendous impact on clients’ lives. When clients suffer from these disorders, they often seek medical care with the intent of receiving medications to manage symptoms. However, many of the medications used to treat pain and sleep/wake disorders may be addictive, making thorough client assessments and close follow-up care essential. To prescribe appropriate therapies with client safety in mind, you must understand not only the pathophysiology of these disorders, but also the pharmacologic agents used to treat them.

    This week, as you study therapies for individuals with pain and sleep/wake disorders, you examine the assessment and treatment of clients with these disorders. You also explore ethical and legal implications of these therapies.

    Photo Credit: [riskms]/[iStock / Getty Images Plus]/Getty Images

    Discussion: Sleep/Wake Disorders

    It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with sleep/wake disorders

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for sleep/wake disorders

    Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy

    Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake disorders

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    For insomnia

    alprazolam

    amitriptyline

    amoxapine

    clomipramine

    clonazepam

    desipramine

    diazepam

    doxepin

    flunitrazepam

    flurazepam

    hydroxyzine

    imipramine

    lorazepam

    nortriptyline

    ramelteon

    temazepam

    trazodone

    triazolam

    trimipramine

    zaleplon

    zolpidem

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

    Note:
    Retrieved from Walden Library databases.

    Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines.
    British Journal of Psychiatry
    , 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16

     

    To prepare for this Discussion:

    Note:
     By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the 
    Case Studies
     tab on the Stahl Online website and select the appropriate volume and case number.

    Case 1:
     Volume 2, Case #16: The woman who liked late-night TV

    Case 2:
     Volume 2, Case #11: The figment of a man who looked upon the lady

    Case 3:
     Volume 1, Case #5: The sleepy woman with anxiety

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

    Review the patient’s past and current medications. Refer to Stahl’s 
    Prescriber’s Guide
    and consider medications you might select for this patient.

    Review the posttest for the case study.

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit
    !

    By Day 3

    Post
     a response to the following:

    Provide the case number in the subject line of the Discussion.

    List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

    Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

    Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

    List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

    List two pharmacologic agents and their dosing that would be appropriate for the patient’s sleep/wake therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

    If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

    Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues who were assigned to a different case than you. For example, if you were assigned to Case Study 1, respond to one colleague assigned to Case Study 2 and one colleague assigned to Case Study 3. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 7 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 7 Discussion

     

    Assignment: Assessing and Treating Clients With Pain

    Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with pain

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for pain

    Evaluate efficacy of treatment plans for clients presenting for pain therapy

    Analyze ethical and legal implications related to prescribing therapy for clients with pain

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 10, “Chronic Pain and Its Treatment”

    Stahl, S. M., & Ball, S. (2009a).
    Stahl’s illustrated chronic pain and fibromyalgia.
    New York, NY: Cambridge University Press.

     

    To access the following chapter, click on the
    Illustrated Guides
    tab and then the
    Chronic Pain and Fibromyalgia
    tab.

    Chapter 5, “Pain Drugs”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

     

    Review the following medications:

    For insomnia

    amitriptyline

    amoxapine

    carbamazepine

    clomipramine

    clonidine (adjunct)

    desipramine

    dothiepin

    doxepin

    duloxetine

    gabapentin

    imipramine

    lamotrigine

    levetiracetam

    lofepramine

    maprotiline

    memantine

    milnacipran

    nortriptyline

    pregabalin

    tiagabine

    topiramate

    trimipramine

    valproate (divalproex)

    zonisamide

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

    Note:
    Retrieved from Walden Library databases.

    National Institute of Neurological Disorders and Stroke. (2016).
    Pain: Hope through research
    . Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#3084_2

     

    Required Media

    Laureate Education (2016a).
    Case study: A Caucasian man with hip pain
    [Interactive media file]. Baltimore, MD: Author

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    To prepare for this Assignment:

    Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.

    The Assignment

    Examine 
    Case Study: A Caucasian Man With Hip Pain.
     You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    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? NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

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

    Note: 
    Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.

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

    Click the 
    Week 7 Assignment 
    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
    Find the document you saved as “WK7Assgn+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 Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 7 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with pain and sleep/wake disorders

    Developed personalized plans of therapy for clients with pain and sleep/wake disorders

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for pain and sleep/wake disorders

    Explored ethical and legal implications of prescribing therapy to clients with pain and sleep/wake disorders

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for therapy for impulsivity, compulsivity, and addiction.

     

     

    Week 8: Therapy for Clients With Impulsivity, Compulsivity, and Addiction

    Impulsivity and compulsivity have a wide range of clinical presentations and often overlap with many other psychiatric disorders. Some individuals act without forethought and have difficulty saying “no” to certain things such as using illicit drugs or spending money, whereas other individuals engage in compulsive behaviors with undesirable consequences. In some cases, these impulsive and compulsive behaviors also fuel issues with addiction. To effectively assess and treat clients, you must understand how these disorders differ, as well as how their symptoms impact clients and their families.

    This week, as you examine therapies for individuals with impulsivity, compulsivity, and addiction, you explore the assessment and treatment of clients with these disorders. You also consider ethical and legal implications of these therapies.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Photo Credit: [Apolinar B. Fonseca]/[Moment]/Getty Images

    Assignment: Assessing and Treating Clients With Impulsivity, Compulsivity, and Addiction

    Impulsivity, compulsivity, and addiction are challenging disorders for clients across the lifespan. These disorders often manifest as negative behaviors, resulting in adverse outcomes for clients. In your role as the psychiatric mental health nurse practitioner, you have the opportunity to help clients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with impulsivity, compulsivity, and addiction

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for impulsivity, compulsivity, and addiction

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing therapy for clients with impulsivity, compulsivity, and addiction

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 14, “Impulsivity, Compulsivity, and Addiction”

    Stahl, S. M., & Grady, M. (2012).
    Stahl’s illustrated substance use and impulsive disorder
    New York, NY: Cambridge University Press.

     

    To access the following chapter, click on the
    Illustrated Guides
    tab and then the
    Substance Use and Impulsive Disorders
    tab.

    Chapter 10, “Disorders of Impulsivity and Compulsivity”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    For insomnia

    For obsessive-compulsive disorder

    Citalopram

    clomipramine

    escitalopram

    fluoxetine

    fluvoxamine

    paroxetine

    sertraline

    venlafaxine

    vilazodone

     

    For alcohol withdrawal

    chlordiazepoxide

    clonidine

    clorazepate

    diazepam

    lorazepam

    oxazepam

     

    For bulimia nervosa and binge eating

    fluoxetine

    topiramate

    zonisamide

    For alcohol abstinence

    acamprosate

    disulfiram

     

    For alcohol dependence

    nalmefene

    naltrexone

     

    For opioid dependence

    buprenorphine

    naltrexone

    For nicotine addiction

    bupropion

    varenicline

     

    Book Excerpt:
    Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders.
    Treatment Improvement Protocol Series, No. 32
    . Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64350/

    Chapter 1, “Substance Use Among Adolescents”

    Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”

    Chapter 7, “Youths with Distinctive Treatment Needs”

    University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control in adulthood, study finds. Retrieved from https://www.sciencedaily.com/releases/2016/01/160120201324.htm

    Note:
    Retrieved from Walden Library databases.

    Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling.
    British Journal of Clinical Pharmacology, 77
    (2), 375–381. doi:10.1111/j.1365-2125.2012.04457.x

    Note:
    Retrieved from Walden Library databases.

    Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges.
    Journal of Gerontological Nursing, 42
    (4), 10–15. doi:10.3928/00989134-20160314-04

    Note:
    Retrieved from Walden Library databases.

    Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature.
    Journal of Dual Diagnosis, 8
    (1), 74–84. doi:10.1080/15504263.2012.648439

    Note:
    Retrieved from Walden Library databases.

    Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., & … Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents.
    Comprehensive Psychiatry, 55
    (6), 1337–1341. doi:10.1016/j.comppsych.2014.04.018

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education (2016c).
    Case study: A Puerto Rican woman with comorbid addiction
    [Interactive media file]. Baltimore, MD: Author

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    To prepare for this Assignment:

    Review this week’s Learning Resources. Consider how to assess and treat adolescent clients requiring therapy for impulsivity, compulsivity, and addiction.

    The Assignment

    Examine 
    Case Study: A Puerto Rican Woman With Comorbid Addiction
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    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.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK8Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 8 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 8 Assignment 
    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
    Find the document you saved as “WK8Assgn+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 8 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 8 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 8 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with impulsivity, compulsivity, and addiction

    Developed personalized plans of therapy for clients with impulsivity, compulsivity, and addiction

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for impulsivity, compulsivity, and addiction

    Explored ethical and legal implications of prescribing therapy to clients with impulsivity, compulsivity, and addiction

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for therapy for ADHD.

     

     

    Week 9: Therapy for Clients with ADHD

    Tyler, a 9-year-old third grader, had always been an energetic child with a short attention span. For years, his mother attributed his behaviors to him being “all boy” and assumed it would improve as he grew older. Instead, daily tasks like chores and homework became increasingly overwhelming for Tyler, resulting in disruptive behaviors at home and school. After being evaluated by his healthcare provider, Tyler was diagnosed with and treated for attention deficit hyperactivity disorder (ADHD).

    ADHD is a prevalent disorder for clients across the lifespan, as more than 6 million children (CDC, 2016) and 8 million adults (ADAA, 2016) have been diagnosed with the disorder. Like Tyler, individuals of all ages find that symptoms of ADHD can make life challenging. However, when properly diagnosed and treated, clients often respond well to therapies and have positive health outcomes.

    This week, as you study ADHD therapies, you examine the assessment and treatment of clients with ADHD. You also explore ethical and legal implications of these therapies.

    Photo Credit: [kristian sekulic]/[E+]/Getty Images

    Discussion: Presentations of ADHD

    Although ADHD is often associated with children, this disorder is diagnosed in clients across the lifespan. While many individuals are properly diagnosed and treated during childhood, some individuals who have ADHD only present with subsyndromal evidence of the disorder. These individuals are often undiagnosed until they reach adulthood and struggle to cope with competing demands of running a household, caring for children, and maintaining employment. For this Discussion, you consider how you might assess and treat individuals presenting with ADHD.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with ADHD

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for ADHD

    Evaluate efficacy of treatment plans

    Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

    Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

    Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”

    Stahl, S. M., & Mignon, L. (2012).
    Stahl’s illustrated attention deficit hyperactivity disorder.
    New York, NY: Cambridge University Press.

     

    To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab.

    Chapter 4, “ADHD Treatments”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    For ADHD

    armodafinil

    amphetamine (d)

    amphetamine (d,l)

    atomoxetine

    bupropion

    chlorpromazine

    clonidine

    guanfacine

    haloperidol

    lisdexamfetamine

    methylphenidate (d)

    methylphenidate (d,l)

    modafinil

    reboxetine

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

    Note:
    Retrieved from Walden Library databases.

    Optional Resources

    Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245–268. doi:10.2165/11599630-000000000-00000

    Psychiatric Times. (2016). A 5-question quiz on ADHD. Retrieved from http://www.psychiatrictimes.com/adhd/5-question-quiz-adhd?GUID=AA46068B-C6FF-4020-8933-087041A0B140&rememberme=1&ts=22072016

     

    To prepare for this Discussion:

    Note:
     By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the 
    Case Studies
     tab on the Stahl Online website and select the appropriate volume and case number.

    Case 1:
     Volume 1, Case #13: The 8-year-old girl who was naughty

    Case 2:
     Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter

    Case 3:
     Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder

    Review this week’s Learning Resources and reflect on the insights they provide.

    Go to the Stahl Online website and examine the case study you were assigned.

    Take the pretest for the case study.

    Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

    Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

    Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

    Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

    Review the patient’s past and current medications. Refer to Stahl’s 
    Prescriber’s Guide
    and consider medications you might select for this patient.

    Review the posttest for the case study.

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit
    !

    By Day 3

    Post
     a response to the following:

    Provide the case number in the subject line of the Discussion.

    List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

    Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

    Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

    List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

    List two pharmacologic agents and their dosing that would be appropriate for the patient’s ADHD therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

    If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

    Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least 
    two
     of your colleagues who were assigned to a different case than you. For example, if you were assigned to Case Study 1, respond to one colleague assigned to Case Study 2 and one colleague assigned to Case Study 3. Explain how you might apply knowledge gained from your colleagues’ case studies to you own practice in clinical settings.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 9 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 9 Discussion

     

    Assignment: Assessing and Treating Clients With ADHD

    Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. They may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric mental health nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for clients across the lifespan. For this Assignment, you consider how you might assess and treat clients presenting with ADHD.

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with ADHD

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for ADHD

    Evaluate efficacy of treatment plans

    Evaluate ethical and legal implications related to prescribing therapy for clients with ADHD

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

    Note: 
    Review all materials from the Discussion.

    Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity.
    Journal of Abnormal Child Psychology, 26
    , 279-291.

    Note:
    Retrieved from Walden Library databases.

    Required Media

    Laureate Education (2016d).
    Case study: A young Caucasian girl with ADHD
    [Interactive media file]. Baltimore, MD: Author

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    To prepare for this Assignment:

    This case study will serve as the foundation for this week’s Assignment.

    The Assignment

    Examine 
    Case Study: A Young Caucasian Girl With ADHD
     You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

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

    Note: 
    Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    Submission and Grading Information

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

    Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 9 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 9 Assignment 
    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
    Find the document you saved as “WK7Assgn+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 9 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 9 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 9 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with ADHD

    Developed personalized plans of therapy for clients with ADHD

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for ADHD

    Explored ethical and legal implications of prescribing therapy to clients with ADHD

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for therapy for impulsivity, compulsivity, and addiction.

     

     

    Week 10: Therapy for Clients with Dementia

    In so many countries, to be old is shameful; to be mentally ill as well as old is doubly shameful. In so many countries, people with elderly relatives who are also mentally ill are ashamed and try to hide what they see as a disgrace on the family.

    —Dr. Nori Graham, psychiatrist and honorary vice president of Alzheimer’s Disease International

    In this quote, Dr. Graham is expressing her observations and experiences in her work with numerous international organizations. Many patients and their families experience feelings of anxiety and shame upon receiving a diagnosis of dementia. Lynda Hogg, an Alzheimer’s patient, shares her feelings that “some people don’t want to be associated with someone with an illness affecting the brain” (Alzheimer’s Disease International, 2012). As a psychiatric mental health nurse practitioner providing care to clients presenting with dementia, it is critically important to consider the impact of these disorders on clients, caregivers, and their families. A thorough understanding of the health implications of these disorders, as well as each client’s personal concerns, will aid you in making effective treatment and management decisions.

    This week, you explore strategies to become a social change agent for psychiatric mental health. Then, as you examine the assessment and treatment of clients with dementia, you also consider related ethical and legal implications.

    Photo Credit: [Maskot]/[Maskot]/Getty Images

    Discussion: Influencing Social Change

    Individuals with psychiatric mental health disorders are frequently stigmatized not only by society as a whole, but also by their friends, family, and sometimes healthcare providers. In your role, however, you have the opportunity to become a social change agent for these individuals. For this Discussion, consider how you might make a positive impact for your clients and advocate for social change within your own community.

    Learning Objectives

    Students will:

    Apply strategies to become a social change agent for psychiatric mental health

    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

    Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades.
    The British Journal of Psychiatry, 203
    (2), 146–151. Retrieved from http://bjp.rcpsych.org/content/203/2/146.full

     

    Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia.
    American Family Physician, 85
    (1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

    Note
    : Retrieved from from the Walden Library databases.

    Dingfelder, S. F. (2009). Stigma: Alive and well.
    American Psychological Association, 40
    (6), 56. Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx

     

    Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary.
    Culture, Medicine and Psychiatry, 36
    (1), 78–79. doi:10.1007/s11013-012-9248-0

     

    Note
    : Retrieved from from the Walden Library databases.

    Price, L. H. (2010). Violence in America: Is psychopharmacology the answer?
    Brown University Psychopharmacology Update, 21
    (5), 5. Retrieved from http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532

    Note
    : Retrieved from from the Walden Library databases.

    Optional Resources

    Bennett, T. (2015). Changing the way society understands mental health.
    National Alliance on Mental Illness
    . Retrieved from http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health

    Mechanic, D. (2007). Mental health services then and now.
    Health Affairs, 26
    (6), 1548–1550. Retrieved from https://web.archive.org/web/20170605094514/http://content.healthaffairs.org/content/26/6/1548.full

     

    Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.”
    New Republic, 210
    (7), 34–38.

    To prepare for this Discussion:

    Reflect on how you might influence social change for psychiatric mental health.

    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 on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on 
    Submit
    !

    By Day 3

    Post
     an explanation of how you, as a nurse practitioner, might become a social change agent for psychiatric mental health. Include how you might advocate for change within your own community.

    Read
     a selection of your colleagues’ responses.

    By Day 6

    Respond
     to at least two of your colleagues by providing additional insights or alternative perspectives.

    Submission and Grading Information

    Grading Criteria

    To access your rubric:

    Week 10 Discussion Rubric

     

    Post by Day 3 and Respond by Day 6

    To participate in this Discussion:

    Week 10 Discussion

     

    Assignment: Assessing and Treating Clients With Dementia. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

    The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.

    Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp

     

    Learning Objectives

    Students will:

    Assess client factors and history to develop personalized therapy plans for clients with dementia

    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for dementia

    Evaluate efficacy of treatment plans

    Analyze ethical and legal implications related to prescribing therapy for clients with dementia

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2013).
    Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
    (4th ed.). New York, NY: Cambridge University Press.

     

    To access the following chapter, click on the
    Essential Psychopharmacology, 4th ed
    tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

     

    Chapter 13, “Dementia and Its Treatment”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    For insomnia

    donepezil

    galantamine

    memantine

    rivastigmine

    Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia.
    American Family Physician, 85
    (1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html

     

    Note
    : Retrieved from from the Walden Library databases.

    Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis.
    Neuropsychopharmacology, 35
    , 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf

     

    Required Media

    Laureate Education. (2016h).
    Case study: An elderly Iranian man with Alzheimer’s disease
    [Interactive media file]. Baltimore, MD: Author.

     

    Note: This case study will serve as the foundation for this week’s Assignment.

     

    To prepare for this Assignment:

    Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.

    The Assignment

    Examine 
    Case Study: An Elderly Iranian Man With Alzheimer’s Disease
    . You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point stop to complete the following:

    Decision #1

    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

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

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

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    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.

    Note
    : Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

    By Day 7

    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 “WK10Assgn+last name+first initial.(extension)” as the name.

    Click the 
    Week 10 Assignment Rubric 
    to review the Grading Criteria for the Assignment.

    Click the 
    Week 10 Assignment 
    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
    Find the document you saved as “WK10Assgn+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 10 Assignment Rubric

     

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 10 Assignment draft and review the originality report.

     

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 10 Assignment

     

    Making Connections

    Now that you have:

    Assessed clients presenting with dementia

    Developed personalized plans of therapy for clients with dementia

    Examined factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring therapy for dementia

    Explored ethical and legal implications of prescribing therapy to clients with dementia

    Next week, you will build on your assessment and treatment skills as you examine clients presenting for therapy for comorbid conditions. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Week 11: Therapy for Clients With Comorbid Conditions

    As a psychiatric mental health nurse practitioner, you will frequently work with clients who have comorbid conditions. For instance, you may treat a 19-year-old male with Down syndrome and increasing violent behaviors; a middle-aged female with schizophrenia, diabetes, and poor renal function; or an older adult with a mental disorder, stage I Alzheimer’s disease, and chronic obstructive pulmonary disease (COPD). In cases like these, you must draw from foundational knowledge of pathophysiology and collaborate with other healthcare providers to ensure optimal safely and efficacy of psychopharmacological therapies for clients.

    This week, as you study therapy for patients with comorbid conditions, you examine psychopharmacologic approaches to treatment for clients across the lifespan. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Photo Credit: Ingram Publishing/Getty Images

    Final Exam

    This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for clients across the lifespan:

    Therapy for Clients with Pain and Sleep/Wake Disorders

    Therapy for Clients with Impulsivity, Compulsivity, and Addiction

    Therapy for Clients with ADHD

    Therapy for Clients with Dementia

    Therapy for Clients with Comorbid Conditions

    Learning Objectives

    Students will:

    Assess psychopharmacologic approaches to treatment for clients across the lifespan

    Learning Resources

    Note:
     To access this week’s required library resources, please click on the link to the Course Readings List, found in the 
    Course Materials
     section of your Syllabus.

    Required Readings

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

     

    Stahl, S. M. (2014a).
    Stahl’s illustrated violence: Neural circuits, genetics and treatment
    . New York, NY: Cambridge University Press.

     

    To access the following chapter, click on the
    Illustrated Guides
    tab and then the
    Violence
    tab.

     

    Chapter 3, “Treatment of Violence and Aggression”

    Stahl, S. M. (2014b).
    The prescriber’s guide
    (5th ed.). New York, NY: Cambridge University Press.

     

    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:

    For Alzheimer’s disease

    donepezil

    galantamine

    memantine

    rivastigmine

    For Parkinson’s disease with dementia

    rivastigmine

    Crocker, A. G., Prokić, A., Morin, D., & Reyes, A. (2014). Intellectual disability and co-occurring mental health and physical disorders in aggressive behaviour.
    Journal of Intellectual Disability Research, 58
    (11), 1032–1044. doi:10.1111/jir.12080. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Note
    : Retrieved from from the Walden Library databases.

    Erickson, S. C., Le, L., Zakharyan, A., Stockl, K. M., Harada, A. M., Borson, S., & … Curtis, B. (2012). New-onset treatment-dependent diabetes mellitus and hyperlipidemia associated with atypical antipsychotic use in older adults without schizophrenia or bipolar disorder.
    Journal of the American Geriatrics Society, 60
    (3), 474–479. doi:10.1111/j.1532-5415.2011.03842.x

     

    Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse.
    Human Psychopharmacology, 30
    (3), 164–172. doi:10.1002/hup.2467

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Note
    : Retrieved from from the Walden Library databases.

    Malhotra, A. K., Zhang, J., & Lencz, T. (2012). Pharmacogenetics in psychiatry: Translating research into clinical practice.
    Molecular Psychiatry, 17
    (8), 760–769. doi:10.1038/mp.2011.146

     

    Note
    : Retrieved from from the Walden Library databases.

    Substance Abuse and Mental Health Services Administration. (2013). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol.
    Treatment Improvement Protocol (TIP)
    Series 42. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-3992/SMA13-3992.pdf

    Document: Final Exam Study Guide (PDF)

     

    Optional Resources

    Stahl, S. M. (2014a).
    Stahl’s illustrated violence: Neural circuits, genetics and treatment
    . New York, NY: Cambridge University Press.

     

    To access the following chapters, click on the
    Illustrated Guides
    tab and then the
    Violence
    tab.

     

    Chapter 1, “Which Individuals Will Become Violent or Aggressive?”

    Chapter 2, “Neurobiology and Genetics of Violence and Aggression”

    Final Exam:

    This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for clients across the lifespan: NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology.

    Therapy for Clients with Pain and Sleep/Wake Disorders

    Therapy for Clients with Impulsivity, Compulsivity, and Addiction

    Therapy for Clients with ADHD

    Therapy for Clients with Dementia

    Therapy for Clients with Comorbid Conditions

    By Day 7

    Complete the Final 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.

    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
    .

    Submit Your Final Exam by Day 7. NURS 6630 – Discussion Posts, Assignments and Exams – Psychopharmacologic Approaches to Treatment of Psychopathology

  • NURS_6640_Week3_Assignment2_Rubric

    NURS_6640_Week3_Assignment2_Rubric

    Satisfactory

    Unsatisfactory

    Quality of Work Submitted: The extent of which work meets the assignned criteria and work reflects graduate level critical and analytic thinking.

    26 
    (26%)
     – 30 
    (30%)

    Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics.

    0 
    (0%)
     – 25 
    (25%)

    Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed.

    Quality of Work Submitted: The purpose of the paper is clear.

    4 
    (4%)
     – 5 
    (5%)

    Purpose of the assignment is stated, yet is brief and not descriptive.

    0 
    (0%)
     – 3 
    (3%)

    No purpose statement was provided.

    Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

    Understand and interpret the assignment’s key concepts.

    8 
    (8%)
     – 10 
    (10%)

    Demonstrates a clear understanding of key concepts.

    0 
    (0%)
     – 7 
    (7%)

    Shows a lack of understanding of key concepts, deviates from topics.

    Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

    Apply and integrate material in course rsources (i.e. video, required readings, and textook) and credible outside resources.

    16 
    (16%)
     – 20 
    (20%)

    Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view.

    0 
    (0%)
     – 15 
    (15%)

    Includes and integrates specific information from 0 to 1 resource to support major points and point of view. NURS_6640_Week3_Assignment2_Rubric

    Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to:

    Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.

    16 
    (16%)
     – 20 
    (20%)

    Summarizes information gleaned from sources to support major points, but does not synthesize.

    0 
    (0%)
     – 15 
    (15%)

    Rarely or does not interpret, apply, and synthesize concepts, and/or strategies.

    Written Expression and Formatting

    Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.

    4 
    (4%)
     – 5 
    (5%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time.

    0 
    (0%)
     – 3 
    (3%)

    Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time. “Written Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation” 3  (3%)  – 5  (5%) Contains a few (1-2) grammar, spelling, and punctuation errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. “Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.” 3  (3%)  – 5  (5%) Contains a few (1-2) APA format errors. 0  (0%)  – 2  (2%) Contains many (≥ 5) APA format errors. Total Points: 100 NURS_6640_Week3_Assignment2_Rubric