Tag: Clinical-Nursing

NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry

Week 11: Special Topics in Child and Adolescent Psychiatry

“Here we go again; another foster home. My father kicked me out when he saw me wearing Mom’s clothes. He did not understand that deep down, I know that I am a girl. My birth certificate may say male, but it is wrong. I feel so much better being myself… being a girl. Maybe this foster family will understand and accept me for who I am, or I am just going to run away again.”

Joseph/Josephine, age 16

In your practice as a PMHNP, you may see many children and adolescents who are faced with challenges that go beyond the standard DSM-5 diagnoses. Children in foster homes or who have been adopted may have emotional scars from previous abuse or neglect; adolescents experiencing issues with gender dysphoria may be faced with peer and family issues; and children involved in acts of terrorism may face reoccurring fear and mistrust. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

This week, you explore psychological issues that may arise in children faced with special circumstances and the assessment and treatment options specific to these special populations. You also take your final exam for the course.

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Learning Resources

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

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014).
Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry
(11th ed.). Philadelphia, PA: Wolters Kluwer. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Chapter 31, “Child Psychiatry” (pp. 1279–1323)

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

“Somatic Symptom and Related Disorders”

“Other Conditions That May Be a Focus of Clinical Attention”

“Assessment Measures”

“Cultural Formulation”

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

American Academy of Child & Adolescent Psychiatry (AACAP). (2011). Practice parameter for child and adolescent forensic evaluations.
Journal of the American Academy of Child & Adolescent Psychiatry
,
50
(12), 1299-1312. Retrieved from http://www.jaacap.com/article/S0890-8567(11)00883-5/pdf

American Academy of Child & Adolescent Psychiatry (AACAP). (2012c). Practice parameter on gay, lesbian, or bisexual sexual orientation, gender nonconformity, and gender discordance in children and adolescents.
Journal of the American Academy of Child & Adolescent Psychiatry
,
51
(9), 957–974. Retrieved from http://www.jaacap.com/article/S0890-8567(12)00500-X/pdf. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Lee, T., Fouras, G., & Brown, R. (2015). Practice parameter for the assessment and management of youth involved with the child welfare system.
Journal of the American Academy of Child & Adolescent Psychiatry
,
54
(6), 502–517. Retrieved from http://www.jaacap.com/article/S0890-8567(15)00148-3/pdf

Human Rights Campaign. (n.d.).
Growing up LGBT in America
. Retrieved June 8, 2017, from http://assets.hrc.org//files/assets/resources/Growing-Up-LGBT-in-America_Report.pdf?_ga=1.83582870.1279387255.1493224749. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Optional Resources

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

Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Disorders” (pp. 239–249)

Chapter 49, “Forensic Psychology” (pp. 636–647)

Discussion: Special Topics in Child and Adolescent Psychiatry

Many children face special issues that impact everyday life, whether it is within themselves, their families, or their environment. The PMHNP must be sensitive to these many issues that children and adolescents are faced with during important developmental years.

In this Discussion, you select a special population and analyze the psychological issues that the population faces. You also address the assessment and treatment needs of the population. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Learning Objectives

Students will:

Analyze psychological issues that may arise in children faced with special circumstances

Evaluate assessment measures used with children faced with special circumstances

Evaluate treatment options used with children faced with special circumstances

Analyze cultural influences on treatments (D)

To Prepare for the Discussion:

Review the Learning Resources.

Select one of the following topics for the Discussion:

Adoption

Foster care

Gender dysphoria

Forensic issues

Impact of terrorism on children

Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking
Submit
! NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

By Day 3

Post:

Write your selected disorder in the subject line of your Discussion post.

Explain the psychological issues that may result from your topic.

Describe the most effective assessment measure that could be used, and explain why you selected this.

Explain the treatment options available for children and adolescents involved with your selected disorder.

Explain how culture may influence treatment.

By Day 6

Respond
to at least
two
of your colleagues who selected a topic other than the topic you selected. Provide at least two additional treatment strategies that could be used with this client and at least one additional cultural influence that you think should be considered. Explain your responses. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 11 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 11 Discussion

Assignment: Final Exam

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

Learning Objectives

Students will:

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

This exam will cover the following topics:

Learning and motor disorders in childhood

Mood disorders

Early-onset schizophrenia

Feeding and eating disorders

Elimination disorders

Special topics in child adolescent psychiatry

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 75-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
. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry

Submission and Grading Information

Submit Your Exam by Day 7

To submit your Exam:

Week 11 Exam

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

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

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

This week, you explored psychological issues that may arise in children faced with special circumstances and the assessment and treatment options specific to these special populations. You also completed your final exam for the course. NURS 6660 Discussion: Special Topics in Child and Adolescent Psychiatry.

Week 10: Feeding, Eating, and Elimination Disorders in Childhood

“I am so tired and frustrated. Jackson refuses to breastfeed, and bottle feeding is not much easier. He was the perfect baby when he was born, but now, 6 months later, he is only a few pounds heavier. He won’t take any more than 4 ounces of formula at a time and wakes up several times during the night. We started him on baby food early, but even then he only eats one or two bites before he starts kicking and crying. The pediatrician says there is nothing wrong physically as he is meeting all his milestones, but he just won’t eat.” Feeding, Eating, and Elimination Disorders in Childhood.

Jessica, age 32, mother of Jackson, age 6 months

Children and adolescents with feeding, eating, and elimination disorders may come to the attention of providers in a variety of settings. These disorders are disturbing to parents and may have significant morbidity for youth. It is not uncommon to hear of youth with eating disorders including anorexia and bulimia. It is less common to hear of pica and rumination disorder. Elimination disorders of enuresis and encopresis are troubling to children and parents and cause significant difficulty in daily functioning. Feeding, Eating, and Elimination Disorders in Childhood.

This week, you work with your group again to develop a Parent Guide for a feeding, eating, or elimination disorder. You also submit your cover letter, resume, and portfolio.

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Learning Resources

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

Required Readings

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

Chapter 28, “Psychotherapies” (pp. 901–907)

Chapter 31, “Child Psychiatry” (pp. 1205–1216)

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

“Feeding and Eating Disorders”

“Elimination Disorders”

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

Lock, J., & La Via, M. C. (2015). Practice parameter for the assessment and treatment of children and adolescents with eating disorders.
Journal of the American Academy of Child & Adolescent Psychiatry
,
54
(5), 412–425. Retrieved from http://www.jaacap.com/article/S0890-8567(15)00070-2/pdf

Stahl, S. M. (2014).
Prescriber’s Guide: Stahl’s Essential Psychopharmacology
(5th ed.). New York, NY: Cambridge University Press. Feeding, Eating, and Elimination Disorders in Childhood.

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

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. Feeding, Eating, and Elimination Disorders in Childhood.

Review the following medications:

Bulimia nervosa/binge eating

Bulimia nervosa/binge eating

Enuresis

fluoxetine

topiramate

zonisamide

imipramine

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

Optional Resources

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

Chapter 71, “Feeding and Eating Disorders” (pp. 1016–1034)

Discussion: Parent Guide

Feeding, eating, and elimination disorders can be difficult to detect and treat. Parents need education and information to determine if their infant, child, or adolescent may have these types of disorders. A Parent Guide can be a useful tool to help both the clinician and the parent in understanding the child or adolescent and providing behavioral strategies for helping families work with these disorders. For this Discussion, you will be assigned a feeding, eating, or elimination disorder. Feeding, Eating, and Elimination Disorders in Childhood.

In this Discussion, you work with your group again to develop a Parent Guide for your assigned feeding, eating, or elimination disorder.

Learning Objectives

Students will:

Analyze signs and symptoms of feeding, eating, and elimination disorders

Analyze pathophysiology of feeding, eating, and elimination disorders

Analyze diagnosis and treatment methods for feeding, eating, and elimination disorders

Create professional cover letters, resumes, and portfolios

To Prepare for this Assignment:

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

Review the resources concerning your assigned disorder.

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

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

Signs and symptoms

Pathophysiology

How the disorder is diagnosed

Treatment options

Provide a minimum of three academic references. Feeding, Eating, and Elimination Disorders in Childhood.

By Day 5

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

By Day 7

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

Submission and Grading Information

Accessing Group Discussions and Wikis

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

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

Creating a Wiki Page

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

Grading Criteria

To access your rubric:

Week 10 Parent Guide Discussion Rubric

To access your group discussion / wiki:

Parent Guide Groups

Post to Discussion by Day 5 and Respond by Day 7

To participate in this Discussion:

Parent Guide Groups – Week 10

Assignment 1: Practicum: Week 2 Cover Letter, Resume, and Portfolio

By Day 7

Submit
your cover letter, resume, and portfolio, which were assigned in Week 2.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK10Assgn1+last name+first initial.(extension)” as the name.

Click the
Week 10 Assignment 1 Rubric
to review the Grading Criteria for the Assignment.

Click the
Week 10 Assignment 1
link. You will also be able to “View Rubric” for grading criteria from this area. Feeding, Eating, and Elimination Disorders in Childhood.

Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK10Assgn1+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. Feeding, Eating, and Elimination Disorders in Childhood.

Grading Criteria

To access your rubric:

Week 10 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 1 draft and review the originality report. Feeding, Eating, and Elimination Disorders in Childhood.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 10 Assignment 1

Assignment 2: Practicum: Week 9 Decision Tree

By Day 7

Submit
your Assignment. Refer to Week 9 for additional guidance.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK10Assgn2+last name+first initial.(extension)” as the name.

Click the
Week 10 Assignment 2 Rubric
to review the Grading Criteria for the Assignment.

Click the
Week 10 Assignment 2
link. You will also be able to “View Rubric” for grading criteria from this area. Feeding, Eating, and Elimination Disorders in Childhood.

Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK10Assgn2+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. Feeding, Eating, and Elimination Disorders in Childhood.

Grading Criteria

To access your rubric:

Week 10 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment: Feeding, Eating, and Elimination Disorders in Childhood.

Week 10 Assignment 2

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

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

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

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Practicum Reminder

Time Logs

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

Making Connections

This week, you worked with your group again to develop a Parent Guide for a feeding, eating, or elimination disorder. You also submitted your cover letter, resume, and portfolio.

Next week, you explore psychological issues that may arise in children faced with special circumstances and the assessment and treatment options specific to these special populations. Feeding, Eating, and Elimination Disorders in Childhood.

Week 9: Early-Onset Schizophrenia

“I can’t believe he is speaking to me! I have always liked his music, but now here he is on TV speaking directly to me! When I started following him on social media, he must have seen my profile. I know he loves me. He cannot love that model I saw with him in the picture. She must be the person following me to school. I have not seen her, but I know she is there. She does not want me being with him, but I will be with him. He loves me as much as I love him.”

Kaitlyn, age 17

Early-onset schizophrenia is a rare and severe mental illness in which children interpret reality abnormally. There are a range of problems with cognitive functioning, behavior, and emotions. Perceptions may be distorted and children or their parents may report that they have difficulty distinguishing reality. This is a diagnosis that is difficult to confirm in the early stages.

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

Photo Credit: HAYKIRDI / iStock / Getty Images Plus

Learning Resources

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

Required Readings

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

Chapter 31, “Child Psychiatry” (pp. 1268–1283)

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

“Schizophrenia Spectrum and Other Psychotic Disorders”

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

McClellan, J., & Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia.
Journal of the American Academy of Child & Adolescent Psychiatry
,
52
(9), 976–990. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00112-3/pdf

Giles, L. L., & Martini, D. R. (2016). Challenges and promises of pediatric psychopharmacology.
Academic Pediatrics
,
16
(6), 508–518. doi:10.1016/j.acap.2016.03.011

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

Hargrave, T. M., & Arthur, M. E. (2015). Teaching child psychiatric assessment skills: Using pediatric mental health screening tools.
International Journal of Psychiatry in Medicine
,
50
(1), 60–72. Retrieved from http://search.proquest.com.ezp.waldenulibrary.org/docview/1702699596?accountid=14872

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

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

 

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

 

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:

Schizoaffective disorder

Schizophrenia

amisulpride

aripiprazole

asenapine

carbamazepine (adjunct)

chlorpromazine

clozapine

cyamemazine

flupenthixol

haloperidol

iloperidone

lamotrigine (adjunct)

l-methylfolate (adjunct)

loxapine

lurasidone

mesoridazine

molindone

olanzapine

paliperidone

perospirone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

sulpiride

thioridazine

thiothixene

trifluoperazine

valproate (divalproex) (adjunct)

ziprasidone

zotepine

zuclopenthixol

amisulpride

aripiprazole

asenapine

carbamazepine (adjunct)

chlorpromazine

clozapine

cyamemazine

flupenthixol

haloperidol

iloperidone

lamotrigine (adjunct)

l-methylfolate (adjunct)

loxapine

lurasidone

mesoridazine

molindone

olanzapine

paliperidone

perospirone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

sulpiride

thioridazine

thiothixene

trifluoperazine

valproate (divalproex) (adjunct)

ziprasidone

zotepine

zuclopenthixol

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

Required Media

Laureate Education (Producer). (2017b).
A young girl with strange behaviors
[Multimedia file]. Baltimore, MD: Author.

Optional Resources

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

Chapter 57, “Schizophrenia and Psychosis” (pp. 774–794)

Assignment 1: Early Onset Schizophrenia

Children and adolescents with schizophrenia have more difficulty functioning in academic or work settings, and significant impairment usually persists into adulthood. They may have speech or language disorders and in some cases borderline intellectual functioning. These individuals are more likely to complete suicide attempts or die from other accidental causes. Schizophrenia is characterized by positive and negative symptoms. Positive symptoms include hallucinations, delusions, and behavior disturbance. Negative symptoms include blunted affect and attention, apathy, and lack of motivation and social interest.

In this Assignment, you compare treatment plans for adults diagnosed with schizophrenia with treatment plans for children and adolescents diagnosed with schizophrenia. You also consider the legal and ethical issues involved in medicating children diagnosed with schizophrenia.

Learning Objectives

Students will:

Compare evidence-based treatment plans for adults versus children and adolescents diagnosed with schizophrenia

Analyze legal and ethical issues surrounding the forceful administration of medication to children diagnosed with schizophrenia

Analyze the role of the PMHNP in addressing issues related to the forceful administration of medication to children diagnosed with schizophrenia

To Prepare for this Assignment:

Review the Learning Resources concerning early-onset schizophrenia.

The Assignment (2 pages):

Compare at least two evidence-based treatment plans for adults diagnosed with schizophrenia with evidence-based treatment plans for children and adolescents diagnosed with schizophrenia.

Explain the legal and ethical issues involved with forcing children diagnosed with schizophrenia to take medication for the disorder and how a PMHNP may address those issues.

Note:
The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at
http://writingcenter.waldenu.edu/57.htm
). All papers submitted must use this formatting.

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 “WK9Assgn1+last name+first initial.(extension)” as the name.

Click the
Week 9 Assignment 1 Rubric
to review the Grading Criteria for the Assignment.

Click the
Week 9 Assignment 1
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK9Assgn1+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 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 9 Assignment 1

Assignment 2: Practicum: Decision Tree

Childhood psychosis is extremely rare; however, children that present with psychosis must be carefully assessed and evaluated with appropriate interviewing of parent, child, and use of assessment tools.

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 early onset schizophrenia.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

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

The Assignment:

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

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?

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

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

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

Decision #2: Treatment Plan for Psychotherapy

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

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

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

Decision #3: Treatment Plan for Psychopharmacology

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

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

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

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

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

By Day 7 of Week 10

Submit your Assignment.

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

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

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

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

This week, you compared evidence-based treatment plans for adults with evidence-based treatment plans for children diagnosed with schizophrenia. You analyzed the legal and ethical issues involved with forcing patients with early-onset schizophrenia to take medications for the disorder. You also completed a Decision Tree concerning children with psychotic disorders.

Next week, you work with your group again to develop a Parent Guide for a feeding, eating, or elimination disorder.

NURS 6660 Discussion: Pediatric Bipolar Depression Disorder Debate

Week 8: Mood Disorders

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

Madison, age 16

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

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

Photo Credit: Corbis/VCG / Corbis / Getty Images

Learning Resources

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

Required Readings

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

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

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

“Bipolar and Related Disorders”

“Depressive Disorders”

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

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

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

 

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

 

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

Review the following medications:

Seasonal affective disorder

bupropion

Bipolar depression

Bipolar disorder

amoxapine

aripiprazole

armodafinil

asenapine

bupropion

carbamazepine

fluoxetine

iloperidone

lamotrigine

lithium

lurasidone

modafinil

olanzapine

olanzapine-fluoxetine combination

quetiapine

risperidone

sertindole

valproate (divalproex)

ziprasidone

alprazolam (adjunct)

amoxapine

aripiprazole

asenapine

bupropion

carbamazepine

chlorpromazine

clonazepam (adjunct)

cyamemazine

doxepin

fluoxetine

flupenthixol

fluphenazine

gabapentin (adjunct)

haloperidol

iloperidone

lamotrigine

levetiracetam

lithium

lorazepam (adjunct)

loxapine

lurasidone

molindone

olanzapine

olanzapine-fluoxetine combination

oxcarbazepine

paliperidone

perphenazine

pipothiazine

quetiapine

risperidone

sertindole

thiothixene

topiramate (adjunct)

trifluoperazine

valproate (divalproex)

ziprasidone

zonisamide

zotepine

zuclopenthixol

Bipolar maintenance

Depression

aripiprazole

asenapine

carbamazepine

iloperidone

lamotrigine

lithium

lurasidone

olanzapine

olanzapine-fluoxetine combination

quetiapine

risperidone (injectable)

sertindole

valproate (divalproex)

ziprasidone

agomelatine

amisulpride

amitriptyline

amoxapine

amphetamine (d)

amphetamine (d,l)

aripiprazole (adjunct)

asenapine

atomoxetine

bupropion

buspirone (adjunct)

citalopram

clomipramine

cyamemazine

desipramine

desvenlafaxine

dothiepin

doxepin

duloxetine

escitalopram

fluoxetine

flupenthixol

fluvoxamine

iloperidone

imipramine

isocarboxazid

ketamine

lisdexamfetamine

lithium (adjunct)

l-methylfolate (adjunct)

lofepramine

lurasidone

maprotiline

methylphenidate (d)

methylphenidate (d,l)

mianserin

milnacipran

mirtazapine

moclobemide

modafinil (adjunct)

nefazodone

nortriptyline

olanzapine

paroxetine

phenelzine

protriptyline

quetiapine (adjunct)

reboxetine

selegiline

sertindole

sertraline

sulpiride

tianeptine

tranylcypromine

triiodothyronine

trazodone

trimipramine

venlafaxine

vilazodone

vortioxetine

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

Optional Resources

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

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

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

Discussion: Pediatric Bipolar Depression Disorder Debate

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

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

Learning Objectives

Students will:

Evaluate diagnosis of pediatric bipolar depression disorder

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

To Prepare for the Discussion:

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

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

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

By Day 3

Post:

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

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

Support your position with evidence and examples.

By Day 6

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

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion

Assignment: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

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

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

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

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

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

Looking Ahead 1

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

Looking Ahead 2

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

NURS 6660 Discussion: Pediatric Bipolar Depression Disorder Debate

Learning and Motor Disorders in Childhood

Week 7: Learning and Motor Disorders in Childhood

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

Samuel, age 9

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

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

Photo Credit: PT Images

Learning Resources

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

Required Readings

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

Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)

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

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

“Neurodevelopmental Disorders”

“Specific Learning Disorder”

“Motor Disorders”

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

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

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

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

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

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

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

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

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

 

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

 

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

Review the following medications:

Tourette syndrome

Pervasive developmental disorders

clonidine

haloperidol

pimozide

guanfacine

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

Optional Resources

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

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

Discussion: Parent Guide

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

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

Learning Objectives

Students will:

Analyze signs and symptoms of learning and motor disorders in childhood

Analyze pathophysiology of learning and motor disorders in childhood

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

Evaluate Parent Guides

To Prepare for this Discussion:

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

Review the resources concerning your assigned disorder.

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

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

Signs and symptoms

Pathophysiology

How the disorder is diagnosed

Treatment options

Provide a minimum of three academic references.

By Day 5

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

By Day 7

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

Submission and Grading Information

Accessing Group Discussions and Wikis

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

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

Creating a Wiki Page

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

Grading Criteria

To access your rubric:

Week 7 Parent Guide Discussion Rubric

To access your group discussion / wiki:

Parent Guide Groups

Post to Discussion by Day 5 and Respond by Day 7

To participate in this Discussion:

Parent Guide Groups – Week 7

Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment

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

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

Scenario for Week 7 Case:

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

Learning Objectives

Students will:

Evaluate clients for voluntary commitment

Evaluate clients for involuntary commitment based on state laws

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

Recommend actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

Review the Learning Resources concerning voluntary and involuntary commitment.

Read the Week 7 Scenario in your Learning Resources.

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

The Assignment (2–3 pages):

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

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

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

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

If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

By Day 7

Submit
your Assignment.

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.

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

Click the
Week 7 Assignment 1
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click
Open
.

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

Click on the
Submit
button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

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

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 1

Assignment 2: Practicum: Week 5 Decision Tree

By Day 7

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

Submission and Grading Information

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

Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.

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

Click the
Week 7 Assignment 2
link. You will also be able to “View Rubric” for grading criteria from this area.

Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click
Open
.

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

Click on the
Submit
button to complete your submission.

Grading Criteria

To access your rubric:

Week 7 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

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

Submit Your Assignment by Day 7

To submit your Assignment:

Week 7 Assignment 2

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

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

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

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Practicum Reminder

Time Logs

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

Making Connections

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

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

Learning and Motor Disorders in Childhood

psychiatric health paper

Experiences on the psychiatric floor provided essential knowledge on the importance of treating patients with dignity. Health care delivery became significant on the psychiatric floor owing to the nature of various patients. It was essential to note that many patients required nursing assistance and critical care was important to ensure patients did not harm each other or themselves. In the psychiatric floor, my resilience and patience was tested, as this was the hardest experience to master. However, I feel that there was growth in the way I deal with patients, other medical professionals and family. psychiatric health paper.

The psychiatric department calls for collaboration between professionals in the medical world, and the nurse plays a critical role. The doctors and psychiatrists visit with the patient during specific hours of the day. However, nurses give full day care to the patients, especially those that pose a threat to themselves. Moreover, their family and friends often misunderstand some patients in the psychiatric floor. The nurse, however, has an opportunity to understand the patient and guide their family through the bonding process; furthermore, the nurses are important companions for psychiatric patients, especially those within the facility for a long time.

The role of technology in managing psychiatric health is important. The experience taught me that there is a big opportunity to apply technology in psychiatric care. For example, equipment can allow institutions to track patient’s location and ensure their safety. Furthermore, leadership plays a significant role in running the psychiatric floor. A leader with a vision drives the department towards continuous improvement but a leader without drive will only offer bare minimum care to the patients. It is essential for leaders in the psychiatric wards to unite and coordinate all professionals involved in the life of the patients. Proper leadership and management results to desirable patient outcomes. psychiatric health paper.

The experience in psychiatric ward created a shift in patient care perspective. It introduced me to the importance of good leadership, sound ethics and top-notch healthcare methods. A psychiatric department calls for dedications from all healthcare providers and requires collaboration to produce results. psychiatric health paper

Musculoskeletal

Case study

Part 1: Presentation

Patient admission

A 22-year-old female was admitted to the emergency

department after being involved in a motorcycle

accident. On presentation she was unable to weight

bear and there was slight knee effusion without

ecchymosis or deformity. On physical examination,

she was keeping her knee in slight flexion and knee

range of motion was painful and grossly restricted.

Further detailed physical examination could not be

performed due to intentional guarding, pain and

muscle spasm. X-rays and computed tomography

(CT) scans were performed.

Note: At this time you only have access to the X-rays.

Patient presentation (Task 1)

The elbow dislocation and the hand fractures are

obvious to observe, however you are not sure about

the knee. You ask the attending physician to help

clarify it for you.

The elbow dislocation and the hand fractures are

obvious to observe, however you are not sure about

the knee. You ask the attending physician to help

clarify it for you.

(Click here for the interactive version of the markedup

x-rays that the physician made for you. Once you

have done that return to this page)

You return to the physician a couple of minutes later,

after having studied the X-ray over a cup of coffee.

You are ready you say, and you feel confident identify

the landmarks. Give you a big smile the physician

wipes the pen marks off and asks you a question.

(This has been recorded and saved below for as long as the internet

survives).

Physician: So you are feeling confident are you. Let’s test you out then.

Can you point to the lateral

condyle, the medial condyle, and the intercondyle

eminance?

(Click here for an interactive version of the X-ray so

you can point out the correct features for the

physician. Once you have done that return to this

page)

Patient presentation (Task 2)

The physician seeing that you have correctly identify

the appropriate landmarks on the normal knee bones

holds up the two X-rays and gets you to compare

them (below).

Fig. 1. Knee radiographs of the patient before and

after the accident. Left image is an X-ray from a

previous admission (courtesy of Mr Andrew Murphy,

Radiopaedia.org), where no issues were observed.

Right image is an X-ray of the knee at the time of

admission following the accident (courtesy of Gerry

Gardney, Radiopaedia.org)

As part of your “training” with the physician you are

asked to answer the following three questions.

Which bone of the knee do you think was fractured

in the motorcycle accident?

How would you describe the location of the fracture

(Hint: Use directional terms)

Do you think there might be other structures within

the knee joint that could have been affected by the

accident and if so, why?

Part 2: Family arrives

Questions from the family

The immediate family of the patient have arrived and

the consulting surgeon has explained the injury to

them, however he was brief and used a lot of medical

terminology. (It has been recorded below for clarity)

Surgeon: Your daughter has suffered a lateral

tibial plateau fracture. This will require surgery

and most likely some screws. She has also

sustained an elbow joint dislocation, and

multiple fractures to her phalanges.

The patient and the family all node and say “right, ok,

cool”. And before the surgeon can explain what it all

means he is called away to consult on a critical patient

who just arrived by helicopter. As he leaves the

patients keeps repeating the word cool. (e.g “Cool cool

cool cool cool cooooool.”)

Once the surgeon has left the patients mother turns to

you and states:

Mother: I have no idea what that doctor said. I

don’t know what a lateral blah blah blah is. Can

you please explain what has happened to my

daughter’s leg?

Practical Assessment Task –

Part 1

Write a script for how you would explain the injury to the patient and

the mother.

Remember to use terms that they would understand, but also make sure

you explain

the medical terms the doctor used.

Rehabilitation

Following surgery the patient has

been transferred to the ward where

she will continue to receive treatment

relating to her motorcycle accident.

Due to the significant damage that

was sustained by her left knee she

has been informed that it will take

time to recover the majority of her

range of movement, and that it may

not fully return.

She is also told that while her knee is

recovering, she will not be able to

move her leg or foot much, and that

when she starts physiotherapy she

may experience tightness and a

severe limit to her range of motion.

Time passes

The patient is to be released from

hospital today and will be going

home to continue her rehabilitation.

You help her pack her things ready to

leave, then are called away by the

nurse unit manager.

You are brought into a meeting and

notice one very important person

whom you have only met on a

handful of occasions (usually staff

end of year celebrations), the chief

nursing officer. They indicate for you

to take a seat and then introduce you

to two other people behind the table.

The chief medical officer and the

executive director operations.

They inform you that they would like

you to become part of a new team of

health staff that will assist with

intensive home-care for

physiotherapy patients. More is

discussed during the meeting, but as

you leave they make sure to impress

the importance of what you need to

do next.

Chief nursing officer:

Remember, before you start

with the first patient next week

you need to make sure you

understand their situation. This

will require you to familiarise

yourself with the case. The chief

physiotherapist has asked that

you present to him a short

summary of the muscles you

believe would be affected and

the reasoning for your decisions

before the end of this week .

You nod, and thank them for

choosing you.

Chief nursing office: Also

remember that this is a new

appointment and the first time

this type of team has been put

together and we want it to

work. You have been identified

by your nursing unit manager

as the prime candidate for this

position, don’t let them down.

Have a good weekend.

Practical Assessment Task –

Part 2

Based on the case you will need to create a document that

outlines the muscles you believe would be affected directly

by the damage to the knee and also provide your reasoning

as to why they are affected. (You may use diagrams or

drawings to help you explain your reasoning).

Hint: Looking at the muscles that attach to the

affected area would be a good place to start.

Part 4 – Rehabilitation

The patient has been undertaking physical therapy for a

period of time, however her progression has plateaued. The

physical therapist reports to the health team that the patient

is able to walk, but requires a cane in order to walk any

significant distance. In fact, one of the tests used to assess

the patient’s walking ability was the 6-minute walk test. The

results from the test showed the patient was only able to

walk 45m.

Further tests are discussed at the meeting and the therapist

concludes her report:

Physical Therapist: The patient experiences

dorsiflexion weakness in her left foot, a result of atrophy

of the tibialis anterior muscles that occurred during the

post-operative period. I suggest that we trial the use of

functional electrical stimulation to strengthen the muscle.

This should aid in helping the patient move past the

progression plateau.

The team agrees that this is a good direction for the patient’s

rehabilitation. At the meeting it is also determined that at

her next visit the PT will discuss the option with the patient.

It is also decided that you will have training relating to

transcutaneous electrical nerve stimulation, and the

functional electrical stimulation protocol.

You spend a day with other nurses learning about the basics

of the TENS units, and experimenting with different

settings. You particularly find it fascinating that you were

able to induce a tetanic contraction in your lab partner’s

hand by increasing the frequency of stimulation

continuously higher.

Part 5 – Questions from

the patient

The patient has been undergoing the

FES trial for a couple of weeks now

and is able to now apply the

electrodes herself, and also program

the unit to deliver the appropriate

treatment protocol. While you are

visiting she asks you a couple of

questions.

Patient: Ummm… I feel silly

asking this but I just want to

double check that I understand

what this machine is doing and

how it is supposed to be helping

me.

You look at the patient and smile.

You: Don’t feel silly. Please ask

any questions you have.

Patient: Well if I understand

correctly the electrodes

stimulate electrical sensors in

my muscle, where I place the

electrodes… the tibia muscle…

or something. But, the

electricity is detected by sensors

in my muscle and then my

muscle sends a signal to my

brain that tells my brain to send

a signal back down to my

muscle telling it to contract. Is

that right?

But before you can answer the

patient continues.

Patient: Then because my

muscle contracts it means that it

learns how to contract again,

you know, because it didn’t

know how to contract before. So

it learns and once it has learnt

how to contract again, then I

will be able to walk properly

because at the moment every

time I try to walk my foot just

droops.

She takes a deep breath and

continues quickly on.

Patient: So what I’m saying is

the machine electrocutes my leg,

which causes my brain to tell

my muscle how to contract and

then it will get better walking

and I’ll be able to walk.

It is your turn to speak.

Your task is to write a script explaining to the patient what is

actually happening between the machine and her muscles.

You should also make sure to kindly explain where she is

incorrect about how the machine works. You should also

explain which muscle is affected, and why it is important in

walking. (Hint: remember what the PT said in her report

about the patient. It would also be good to explain what

dorsiflexion weakness is and why it is a problem for

walking). Musculoskeletal Case study

Criteria Exemplary Mastering Developing Emerging Not attempted

Knowledge

(Scientific)

The patient’s situation

has been clearly,

appropriately, and

systematically

described. The

differences between

normal and abnormal

skeletal structures

have been

methodically

comprehensively

contrasted.

A comprehensive

description of the

patient’s condition is

evident, with

differences between

normal and abnormal

skeletal structures

being sufficiently

discussed. Has

demonstrated sound

understanding of the

underlying scientific

knowledge relating to

the case.

An appropriate

description of the

patient’s condition has

been provided, but is

limited in information.

The differences

between normal and

abnormal skeletal

structures have been

adequately described.

The patient’s situation

has been awkwardly

and/or poorly

explained. Discussion

on the differences

between normal and

abnormal skeletal

structures in this case

study is vague and

limited.

Not attempted or no

clear demonstration of

the criteria

Knowledge

(Terminology)

All anatomical and

medical terminology

has been

comprehensively,

accurately, and

appropriately

explained in part 1,

and applied in part 2 &

3.

Accurate, appropriate,

and clear explanations

have been provided for

the majority of terms

in part 1, and has been

applied accurately and

appropriately in the

majority of parts 2 and

3

There is a clear

attempt to provide

suitable explanations

of the specialised

terminology used in

part 1 and

explanations are

mainly limited in

describing or defining

the terms. There is a

clear attempt to apply

terminology correctly

in parts 2 & 3.

There is an attempt to

explain some terms,

however very few

terms have been

explained to a

satisfactory standard.

Explanations are

confusing and/or

ineffective in

describing the terms.

There is little

appropriate use of

terminology in parts 2

& 3.

Not attempted or no

clear demonstration of

the criteria

Communication

The assessment

demonstrates a clear,

effective, and

comprehensive

approach to presenting

the information. There

is a logical and

professional approach

that demonstrates a

skilful approach in

patient interaction,

scientific

communication, and

The assessment shows

clear examples of a

professional approach

to the situation, and

clearly demonstrates

an appropriate plan for

delivering the

information.

Information is

presented in a

systematic, logical

order.

Information is

presented in a clear,

consistent manner.

There is an obvious

logical approach to the

order in which

information is

presented. Some

information is not

effectively presented.

The assessment lacks

effective, clear, and

appropriate

communication

throughout. There is

no clear indication of a

logical approach to

delivering the

information.

Not attempted or no

clear demonstration of

the criteria

A marking rubric has been provided to assist you in creating your assessment.

written

communication.

Musculoskeletal Case study

Nursing in surgery essay

Nursing in the surgical floor is critical in providing patients with care before, during and after surgery. Additionally, the role of a surgical nurse also involves providing support to other healthcare practitioners like surgeons and aestheticians. Serving as charge nurse in the surgical floor comes with various responsibilities that require excellent leadership and management. A charge nurse must assign duties to nurses on the surgical floor to ensure efficiency in the department. Furthermore, the charge nurse plays a critical supervisory role to ensure that nurses perform their duties optimally. Lack of guidance from the charge nurse can cause chaos within the surgical department especially when patient care becomes compromised. Nursing in surgery essay.

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            Nursing in surgery requires professional collaboration among various healthcare professionals to achieve a common goal. Therefore, nurses often work with other professionals and assist during surgery. The charge nurse plays a pivotal role in ensuring that the collaboration is efficient and works in the best interest of the patient. When conflict arises within the surgical team, the charge nurse plays a critical role in meditation and conflict resolution. Furthermore, nurses look up to the charge nurse to manage teams and promote cohesion in the work. Nursing in surgery essay .

Healthcare provision is essential in surgery, especially during and after surgery. Particularly, the recovery stage after surgery requires input from nurses. Care provided to patients post-surgery must meet high standards of healthcare to promote quick recovery. The charge nurse has the responsibility to ensure that nurses provide adequate post-surgery healthcare to all patients. The charge nurse is the custodian for all nursing practices in their department. Therefore, they must supervise nurses to ensure they employ best practices in their work; take due care and put enough effort to ensure patients recover. Furthermore, the charge nurse should recognize the skills possessed by other nurses and suggest areas that require additional training to improve performance. Nursing in surgery essay.

Experience during the exercise showed that the charge nurse plays an important role in leadership, management and coordination. The nurse is a mediator that brings together all professionals collaborating in the surgical process. Furthermore, they provide leadership to the nursing team in the hospital. Nursing in surgery essay.

Byvalson Medication Paper

The Medication Paper Final Draft “Byvalson” paper must be a minimum of seven pages, not including your title or reference pages. You should include at least five recent references (published within the last five years), and the paper must be presented in APA format (see rough draft requirements in week 6). Byvalson Medication Paper

The paper must include the following content information:

Manufacturing company

Brand name

Indication

First in class, or not first in class

Common side effects profile

Known contradictions

Make sure you explain the special considerations that your chosen drug has on the unique populations/client groups listed below. Special considerations should include absorption, clearance/elimination, distribution, metabolism half-life, loading dose, route of drug administration, and steady state. Byvalson Medication Paper.

Pediatric Patients

Pediatric patients are not little adults. There are special pharmacokinetic and pharmacodynamics variations in this patient group. Their reaction to medication can be very unpredictable. Accurate dosing is the key due to their limited body mass.

Geriatric Patients

Geriatric patients have altered pharmacokinetic and pharmacodynamics responses to medication. The process of aging and disease will change how the body responds to drug therapy. Memory limitations and increased sensitivity to drug therapy may cause unique problems with this population. Byvalson Medication Paper.

Patients With Renal Dysfunction

Many medications are excreted through the renal glands or metabolized and excreted renally. Dosage adjustment is the key in this population. Many agents may cause nephrotoxicity.

Patients With Liver Dysfunction

Liver disease produces alterations in the physiology of the drugs’ pharmacokinetics in the body. Special attention should be given to all drugs used in this client population. Byvalson Medication Paper.

Obese Patients

Obese patients have alterations in their pharmacokinetic and pharmacodynamic response to medication. Many comorbidities and altered nutritional status can be seen as responses to taking these medications. Accurate dosing is paramount.

Pregnancy/Lactation

Pregnancy and lactation can be challenging. Concerns of effects to the unborn fetus must be considered. Will treating the mother harm the unborn fetus or nursing infant? Byvalson Medication Paper

Professional Capstone and Practicum course

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

New practice approaches

Intraprofessional collaboration

Health care delivery and clinical systems

Ethical considerations in health care

Population health concerns. Professional Capstone and Practicum course.

The role of technology in improving health care outcomes

Health policy

Leadership and economic models

Health disparities

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course. Professional Capstone and Practicum course