Tag: Clinical-Nursing

ADHD Disorder Essay

ADHD Disorder Information Summary: Summarize information on ADHD disorder. Make sure to include the NINDS web address and any other web addresses of where you got your information. Make sure to type out the http address rather than using a link.

CCNS Course Learning Outcomes:

3. Identify the biological influences on behavior. ADHD Disorder Essay.

11. Write and speak clearly and logically in presentations and essays about topics related to psychology.

13. Analyze, evaluate, and apply written material related to the study of psychology.

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Psychology Department Student Learning Outcomes:

1. Recognize content as specified by the American Psychological Association (APA) Guidelines for the Undergraduate Psychology Major.

GT-SS3: Critical Thinking

Student Learning Outcomes (SLOs):

“Students should be able to:

1. Explain an Issue

a. Use information to describe a problem or issue and/or articulate a question related to the topic.

2. Utilize Context

a. Evaluate the relevance of context when presenting a position. ADHD Disorder Essay.

5. Understand Implications and Make Conclusions

a. Establish a conclusion that is tied to the range of information presented.

b. Reflect on implications and consequences of stated conclusion.”

ADHD Disorder Information Summary-What research is being done?

Several components of the NIH support research on developmental disorders such as ADHD. Research programs of the NINDS, the National Institute of Mental Health (NIMH), and the National Institute of Child Health and Human Development (NICHD) seek to address unanswered questions about the causes of ADHD, as well as to improve diagnosis and treatment. ADHD Disorder Essay.

Information from the National Library of Medicine’s MedlinePlus

Attention Deficit Hyperactivity Disorder

Bottom of Form

Definition

Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects 3-5 percent of all American children. It interferes with a person’s ability to stay on a task and to exercise age-appropriate inhibition (cognitive alone or both cognitive and behavioral). Some of the warning signs of ADHD include failure to listen to instructions, inability to organize oneself and school work, fidgeting with hands and feet, talking too much, leaving projects, chores and homework unfinished, and having trouble paying attention to and responding to details. There are several types of ADHD: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype, and a combined subtype. ADHD is usually diagnosed in childhood, although the condition can continue into the adult years. ADHD Disorder Essay.

 

Treatment

 

The usual course of treatment may include medications such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine), which are stimulants that decrease impulsivity and hyperactivity and increase attention. The U.S. Food and Drug Administration has approved the generic versions of Strattera (atomoxetine) to treat ADHD in pediatric and adult individuals. Most experts agree that treatment for ADHD should address multiple aspects of the individual’s functioning and should not be limited to the use of medications alone. Treatment should include structured classroom management, parent education (to address discipline and limit-setting), and tutoring and/or behavioral therapy for the child.

Prognosis

There is no “cure” for ADHD. Children with the disorder seldom outgrow it; however, some may find adaptive ways to accommodate the ADHD as they mature.

Clinical Trials

Throughout the U.S. and Worldwide

NINDS Clinical Trials

Patient Organizations

Attention Deficit Disorder Association (ADDA)

CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder

Child Neurology Foundation

Learning Disabilities Association of America

National Center for Learning Disabilities

Publications

 

Order NINDS Publications

ADHD Disorder Information Summary: Summarize information on ADHD disorder. Make sure to include the NINDS web address and any other web addresses of where you got your information. Make sure to type out the http address rather than using a link.

CCNS Course Learning Outcomes:

3. Identify the biological influences on behavior. ADHD Disorder Essay.

11. Write and speak clearly and logically in presentations and essays about topics related to psychology.

13. Analyze, evaluate, and apply written material related to the study of psychology.

Psychology Department Student Learning Outcomes:

1. Recognize content as specified by the American Psychological Association (APA) Guidelines for the Undergraduate Psychology Major.

GT-SS3: Critical Thinking

Student Learning Outcomes (SLOs):

“Students should be able to:

1. Explain an Issue

a. Use information to describe a problem or issue and/or articulate a question related to the topic.

2. Utilize Context

a. Evaluate the relevance of context when presenting a position.

5. Understand Implications and Make Conclusions

a. Establish a conclusion that is tied to the range of information presented.

b. Reflect on implications and consequences of stated conclusion.”

ADHD Disorder Information Summary-What research is being done?

Several components of the NIH support research on developmental disorders such as ADHD. Research programs of the NINDS, the National Institute of Mental Health (NIMH), and the National Institute of Child Health and Human Development (NICHD) seek to address unanswered questions about the causes of ADHD, as well as to improve diagnosis and treatment. ADHD Disorder Essay.

Information from the National Library of Medicine’s MedlinePlus

Attention Deficit Hyperactivity Disorder

Bottom of Form

Definition

Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that affects 3-5 percent of all American children. It interferes with a person’s ability to stay on a task and to exercise age-appropriate inhibition (cognitive alone or both cognitive and behavioral). Some of the warning signs of ADHD include failure to listen to instructions, inability to organize oneself and school work, fidgeting with hands and feet, talking too much, leaving projects, chores and homework unfinished, and having trouble paying attention to and responding to details. ADHD Disorder Essay. There are several types of ADHD: a predominantly inattentive subtype, a predominantly hyperactive-impulsive subtype, and a combined subtype. ADHD is usually diagnosed in childhood, although the condition can continue into the adult years. ADHD Disorder Essay.

 

Treatment

 

The usual course of treatment may include medications such as methylphenidate (Ritalin) or dextroamphetamine (Dexedrine), which are stimulants that decrease impulsivity and hyperactivity and increase attention. The U.S. Food and Drug Administration has approved the generic versions of Strattera (atomoxetine) to treat ADHD in pediatric and adult individuals. Most experts agree that treatment for ADHD should address multiple aspects of the individual’s functioning and should not be limited to the use of medications alone. Treatment should include structured classroom management, parent education (to address discipline and limit-setting), and tutoring and/or behavioral therapy for the child.

Prognosis

There is no “cure” for ADHD. Children with the disorder seldom outgrow it; however, some may find adaptive ways to accommodate the ADHD as they mature.

Clinical Trials

Throughout the U.S. and Worldwide

NINDS Clinical Trials

Patient Organizations

Attention Deficit Disorder Association (ADDA)

CHADD – Children and Adults with Attention-Deficit/Hyperactivity Disorder

Child Neurology Foundation

Learning Disabilities Association of America

National Center for Learning Disabilities

Publications

Order NINDS Publications. ADHD Disorder Essay.

Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay

In a formal paper of 800-900 words you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, ”Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM ”Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

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Explore the Campaign for Action webpage (you may need to research your state’s website independently if it is not active on this site): http://campaignforaction.org/states. Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

Review your state’s progress report by locating your state and clicking on one of the six progress icons for: education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage.

In a paper of 1,000-1,250 words:

1.Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, ”Future of Nursing: Leading Change, Advancing Health.”

2.Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

3.What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Summarize two initiatives spearheaded by your state’s action coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

A minimum of three scholarly references are required for this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide

In a formal paper of 800-900 words you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, ”Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM ”Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action? Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

Explore the Campaign for Action webpage (you may need to research your state’s website independently if it is not active on this site): http://campaignforaction.org/states

Review your state’s progress report by locating your state and clicking on one of the six progress icons for: education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage. Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

In a paper of 1,000-1,250 words:

1.Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, ”Future of Nursing: Leading Change, Advancing Health.”

2.Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development.

3.What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Summarize two initiatives spearheaded by your state’s action coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers? Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

A minimum of three scholarly references are required for this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide. Robert Wood Johnson Foundation Committee Future of Nursing and the Institute of Medicine IOM Research Report Essay.

Treatment of Personality Disorders nursing essay assignment discussion paper

Discussion: Treatment of Personality Disorders

Personality disorders occur in 10–20% of the population. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.

In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research. Treatment of Personality Disorders nursing essay assignment discussion paper.

Treatment of Personality Disorders nursing essay assignment discussion paper Learning Objectives

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Students will:

Analyze diagnostic criteria for personality disorders

Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders

Analyze clinical features of clients with personality disorders

Align clinical features with DSM-5 criteria

Compare differential diagnostic features of personality disorders

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

To prepare for this Treatment of Personality Disorders nursing essay assignment discussion paper:

By Day 5 of Week 2, your Instructor will have assigned you a personality disorder, which will be your focus for your initial post for this Discussion.

Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for your assigned personality disorder.

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

Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria. Treatment of Personality Disorders nursing essay assignment discussion paper.

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

By Day 6

Respond
 to at least 
two
 of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. What are their similarities and differences? How might you differentiate the two diagnoses? Treatment of Personality Disorders nursing essay assignment discussion paper.

Week 3: Personality Disorders

I cannot believe these people. Don’t they know who I am? I deserve better treatment than this. That hostess should have seated me immediately, but I had to wait for 10 minutes and then she put me at this table right by the kitchen. I see an empty table right in the middle where I should be. I am just going to get up and move there. I don’t care what the hostess says, rules don’t apply to me. Treatment of Personality Disorders nursing essay assignment discussion paper.

Personality disorders represent perhaps the most challenging disorders that the psychiatric mental health nurse practitioner will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask as disorder . Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the client to not only recognize the disorder, but to treat a disorder that clients often do not believe they have.

This week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder. You also will complete the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam. Treatment of Personality Disorders nursing essay assignment discussion paper

 

Treatment of Personality Disorders nursing essay assignment discussion paper 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

American Nurses Association. (2014).
Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.)
. Washington, DC: Author. Treatment of Personality Disorders nursing essay assignment discussion paper.

Standard 12 “Leadership” (pages 76-77)

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 22, “Personality Disorders” (pp. 742–762)

Chapter 13, “Psychosomatic Medicine” (pp. 451–464)

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

Chapter 68, “Paranoid, Schizotypal, and Schizoid Personality Disorders”

Chapter 69, “Antisocial Personality Disorder”

Chapter 70, “Borderline Personality Disorder”

Chapter 71, “Histrionic Personality Disorder”

Chapter 72, “Narcissistic Personality Disorder”

Chapter 73, “Cluster C Personality Disorders

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

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Treatment of Personality Disorders nursing essay assignment discussion paper.

“Personality Disorders”

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

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders.
Psychiatry: Interpersonal & Biological Processes, 76
(1), 32–52. doi:10.1521/psyc.2013.76.1.32

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

Rees, C. S., & Pritchard, R. (2015).
Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52
(1), 45–55. doi:10.1037/a0035158

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

Required Media

Laureate Education. (2017a).
A woman with personality disorder
[Interactive media file]. Baltimore, MD: Author.

Kernberg, O. (n.d.).
Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg
, MD. [Video file]. Mill Valley, CA: Psychotherapy.net. Treatment of Personality Disorders nursing essay assignment discussion paper.

Note:
This video is approximately 94 minutes of length. You will access this article from Walden Library databases.

Discussion: Treatment of Personality Disorders

Personality disorders occur in 10–20% of the population. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others. Treatment of Personality Disorders nursing essay assignment discussion paper.

In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research.

Treatment of Personality Disorders nursing essay assignment discussion paper Learning Objectives

Students will:

Analyze diagnostic criteria for personality disorders

Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders

Analyze clinical features of clients with personality disorders

Align clinical features with DSM-5 criteria

Compare differential diagnostic features of personality disorders

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

To prepare for this Treatment of Personality Disorders nursing essay assignment discussion paper:

By Day 5 of Week 2, your Instructor will have assigned you a personality disorder, which will be your focus for your initial post for this Discussion.

Review the Learning Resources.

By Day 3

Post:

Explain the diagnostic criteria for your assigned personality disorder.

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

Describe clinical features from a client that led you to believe this client had this disorder. Align the clinical features with the DSM-5 criteria.

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

By Day 6

Respond
 to at least 
two
 of your colleagues by comparing the differential diagnostic features of the disorder you were assigned to the diagnostic features of the disorder your colleagues were assigned. What are their similarities and differences? How might you differentiate the two diagnoses?

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 1: Decision Tree

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

Treatment of Personality Disorders nursing essay assignment discussion paper 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

** Assigned in Week 3 and submitted in Week 4

Examine 
Case 1
: 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. Treatment of Personality Disorders nursing essay assignment discussion paper.

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. Treatment of Personality Disorders nursing essay assignment discussion paper.

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. Treatment of Personality Disorders nursing essay assignment discussion paper.

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 family.

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

By Day 7

Submit
 by Day 7 of Week 4.

Assignment 2: Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam

In Weeks 1 or 2 of this course, you received an e-mail from Fitzgerald Health Education Associates (FHEA) explaining how to access the Fitzgerald Health Education Associates (FHEA) PMHNP 150 University Exit Comprehensive Exam. Please follow the directions FHEA provided and complete the exam. You must complete the exam by Day 7 of Week 3 to receive a grade. Each exam is worth 100 points and 10% of your grade. The 3-hour exam is required and will provide you with an overall view of your preparedness for the certification exam. Treatment of Personality Disorders nursing essay assignment discussion paper.

Note:
 Your Instructor receives the results and will inform you when the results are available. Do not e-mail the Fitzgerald site.

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. Treatment of Personality Disorders nursing essay assignment discussion paper.

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

This week, you explored the many personality disorders and used the DSM-5 criteria for diagnosing individuals with specific personality disorders. You used the Decision Tree format to diagnose and treat a client with a personality disorder. You also completed the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam.

Next week, you will analyze clients presenting for treatment of substance-related and addictive disorders and evaluate effectiveness of therapeutic approaches for clients diagnosed with substance-related and addictive disorders. Treatment of Personality Disorders nursing essay assignment discussion paper.

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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

Assignment 1: “Captain of the Ship” Project – Depressive Disorder Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders

Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders

Identify medical management needs for clients with depression disorders

Identify community support resources for clients with depression disorders

Recommend follow-up plans for clients with depression disorders

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

To prepare for this Assignment 1: “Captain of the Ship” Project – Depressive Disorder:

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

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

Describe the HPI and clinical impression for the client.

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

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

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

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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

As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role.In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.

Assignment 1: “Captain of the Ship” Project – Depressive Disorder Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders

Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders

Identify medical management needs for clients with depression disorders

Identify community support resources for clients with depression disorders

Recommend follow-up plans for clients with depression disorders

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

To prepare for this Assignment:

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

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

Describe the HPI and clinical impression for the client.

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

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

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

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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

Week 2: Depressive Disorders

I have no one. My wife died suddenly 4 years ago and I know it was my fault. She had been complaining she was sick for a year, but the doctors kept saying it was nothing. When they finally found the cancer, it had spread throughout her body. I should have listened to her. She might have survived and I would not be alone. I seem to cry for no reason and my children don’t understand why I don’t want to go out of the house. This is where her memories are. Why would I want to leave? Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

The National Institutes of Mental Health acknowledges that depression is one of the most common mental disorders in the United States. It is associated with significant disability, fiscal impact, and considerable personal suffering. It may have significant impact on the individual, their family, and their social network. The PMHNP must be capable of providing comprehensive care for depressive disorders, including both psychotherapy and psychopharmacologic approaches.

This week, you will become “captain of the ship” as you take full responsibility for a client with a depressive disorder. You will recommend psychopharmacologic treatment and psychotherapy, identify medical management needs and community support, and recommend follow-up plans. You will also explore how to obtain a DEA license and the responsibilities for safe prescribing and prescription monitoring. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Photo Credit: Juanmonino/ E+ / Getty Images

Assignment 1: “Captain of the Ship” Project – Depressive Disorder
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 8, “Mood Disorders” (pp. 347–386)

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

Chapter 12, “Psychotherapy of Mood Disorders”

Chapter 14, “Pharmacological and Somatic Treatments for Major Depressive Disorder”

Note:
You will access this textbook from the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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

“Depressive Disorders”

Major Depressive Disorder

Persistent Depressive Disorder (dysthymia)

Premenstrual Dysphoric Disorder

Substance/Medication-Induced Depressive Disorder

Depressive Disorder Due to Another Medical Condition

Other Specified Depressive Disorder

Unspecified Depressive Disorder

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

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Note:
All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

 

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

Depression

Premenstrual dysphoric disorder

Seasonal affective disorder (MDD with Seasonal Variation)

agomelatine

amisulpride

amitriptyline

amoxapine

amphetamine (d)

amphetamine (d,l)

aripiprazole (adjunct)

asenapine

atomoxetine

bupropion

buspirone (adjunct)

citalopram

clomipramine

cyamemazine

desipramine

desvenlafaxine

dothiepin

paroxetine

phenelzine

protriptyline

quetiapine (adjunct)

reboxetine

selegiline

sertindole

sertraline

sulpiride

tianeptine

tranylcypromine

triiodothyronine

trazodone

trimipramine

venlafaxine

vilazodone

vortioxetine

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

citalopram

desvenlafaxine

escitalopram

fluoxetine

paroxetine

sertraline

venlafaxine

bupropion. Assignment 1: “Captain of the Ship” Project – Depressive Disorder

Grieve, S. M., Korgaonkar, M. S., Koslow, S. H., Gordon, E., Williams, L. M. (2013). Widespread reductions in gray matter volume in depression.
NeuroImage: Clinical, 3
, 332-339. doi:10.1016/j.nicl.2013.08.016

Note:
You will access this article from the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Lach, H. W., Chang, Y-P., & Edwards, D. (2010). Can older adults with dementia accurately report depression using brief forms? Reliability and validity of the Geriatric Depression Scale.
Journal of Gerontological Nursing, 36
(5), 30–37. doi:10.3928/00989134-20100303-01

Note:
You will access this article from the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Steffens, D. C., McQuoid, D. R., & Potter, G. G. (2014). Amnestic mild cognitive impairment and incident dementia and Alzheimer’s disease in geriatric depression.
International Psychogeriatrics, 26
(12), 2029–2036. doi:10.1017/S1041610214001446

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

Drug Enforcement Administration. (n.d.).
Drug schedules
. Retrieved June 14, 2016, from https://www.dea.gov/druginfo/ds.shtml

Required Media

Hagen, B. (Producer). (n.d.-b).
Managing depression
[Video file]. Mill Valley, CA: Psychotherapy.net.

 

Note:
The approximate length of this media piece is 24 minutes. You will access this video through the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Optional Resources

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

Chapter 15, “Brain Stimulation Treatments for Mood Disorders”

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

Ahern, E., & Semkovska, M. (2017). Cognitive functioning in the first-episode of major depressive disorder: A systematic review and meta-analysis.
Neuropsychology, 31
(1), 52–72. doi:10.1037/neu0000319

Note:
You will access this article from the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Anderson, N. D., Damianakis, T., Kröger, E., Wagner, L. M., Dawson, D. R., Binns, M. A., . . . Cook, S. L. (2014). The benefits associated with volunteering among seniors: A critical review and recommendations for future research.
Psychological Bulletin, 140
(6), 1505–1533. doi:10.1037/a0037610

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

Inoue, J., Hoshino, R., Nojima, H., Ishida, W., & Okamoto, N. (2016). Additional donepezil treatment for patients with geriatric depression who exhibit cognitive deficit during treatment for depression.
Psychogeriatrics, 16
(1), 54–61. doi:10.1111/psyg.12121. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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

Sachs-Ericsson, N., Corsentino, E., Moxley, J., Hames, J. L., Rushing, N. C., Sawyer, K., . . . Steffens, D. C. (2013). A longitudinal study of differences in late- and early-onset geriatric depression: Depressive symptoms and psychosocial, cognitive, and neurological functioning.
Aging & Mental Health, 17
(1), 1–11. doi:10.1080/13607863.2012.717253

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

Shallcross, A. J., Gross, J. J., Visvanathan, P. D., Kumar, N., Palfrey, A., Ford, B. Q., . . . Mauss, I. B. (2015). Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.
Journal of Consulting and Clinical Psychology, 83
(5), 964–975. doi:10.1037/ccp0000050

Note:
You will access this article from the Walden Library databases. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Wanklyn, S. G., Pukay-Martin, N. D., Belus, J. M., St. Cyr, K., Girard, T. A., & Monson, C. M. (2016). Trauma types as differential predictors of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and their comorbidity.
Canadian Journal of Behavioural Science / Revue Canadienne Des Sciences Du Comportement, 48
(4), 296–305. doi:10.1037/cbs0000056

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

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

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

In this Assignment 1: “Captain of the Ship” Project – Depressive Disorder, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.

Assignment 1: “Captain of the Ship” Project – Depressive Disorder Learning Objectives

Students will:

Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders

Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders

Identify medical management needs for clients with depression disorders

Identify community support resources for clients with depression disorders

Recommend follow-up plans for clients with depression disorders

To prepare for this Assignment 1: “Captain of the Ship” Project – Depressive Disorder:

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

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

Describe the HPI and clinical impression for the client.

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

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

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

Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.

Recommend a plan for follow-up intensity and frequency and collaboration with other providers. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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 “WK2Assgn1+last name+first initial.(extension)” as the name.

Click the 
Week 2 Assignment 1 Rubric 
to review the Grading Criteria for the Assignment.

Click the 
Week 2 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 “WK2Assgn1+last name+first initial.(extension)” and click 
Open
. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

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 2 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 2 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 2 Assignment 1

Assignment 2: Week 2 Practicum Journal: Safe Prescribing

There is probably no greater responsibility that the psychiatric mental health nurse practitioner assumes than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

In this Practicum Journal Assignment, you will explore the legalities associated with prescribing controlled substances, as well as what a DEA number is, how to obtain one, and, most importantly, how to prescribe controlled substances in your state.

Learning Objectives

Students will:

Analyze roles of the Drug Enforcement Administration

Analyze PMHNP responsibilities when issued a DEA number

Analyze DEA number application procedures

Analyze state requirements for safe prescribing and prescription monitoring

Analyze PMHNP responsibilities for safe prescribing and prescription monitoring

Analyze Schedule II-V drug levels

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

To prepare for this Practicum Journal:

Review the Learning Resources.

In 2-3 pages:

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

Explain your responsibilities when having a DEA number.

Assignment 1: “Captain of the Ship” Project – Depressive Disorder

Explain how you apply for a DEA number.

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

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

By Day 7

Submit
 by Day 7 of Week 4.

Making Connections

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

Next week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder. You also will complete the Fitzgerald University Exit Comprehensive Exam to determine your readiness for the certification exam. Assignment 1: “Captain of the Ship” Project – Depressive Disorder.

Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments

Discussion: Treatment of Psychiatric Emergencies in Children Versus Adults

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

In this week’s Discussion, you compare treatment of adult psychiatric emergency clients to child or adolescent psychiatric emergency clients.

ORDER A CUSTOM-WRITTEN PAPER NOW

Learning Objectives

Students will:

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

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

To Prepare
:

Review the Learning Resources concerning emergency psychiatric medicine. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

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

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
! Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

By Day 3

Post
:

Briefly describe the case you selected.

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

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

Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments

By Day 6

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

sample 1

Treatment of Psychiatric Emergencies in Children versus Adults

There are significant differences when dealing with children and adolescents versus adults, even though there are many approaches to emergencies that are similar. A psychiatric emergency is a disturbance of mood, behavior, or thought which may lead to harm to the individual or others if untreated (Sadock, Sadock, & Ruiz, 2014).  In both pediatric and adult psychiatric emergencies, the clinician must ensure the safety of everyone involved (Chun, Katz, Duffy, 2014). As clinicians, one has to be able to recognize a clinical emergency and respond with the level of expediency and urgency that the situation determines is clinically appropriate. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Briefly describe the case you selected

The patient is an 18years old Hispanic female presented with a suicide attempt by cutting her left wrist. Patient reports that she had arguments with her boyfriend throughout the week and was feeling severely depressed with suicidal ideation. Patient reports that she drove and cut her wrist in the car and her boyfriend rushed her to our hospital emergency room. She has a 7months old child without a support system except for the boyfriend that mistreats her. Patient has lost appetite, difficulty sleeping and feeling hopelessness and worthlessness. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

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

The treatment of adult psychiatric emergency is the same as adolescents, in which as clinician l will still do the assessment and evaluation by using assessment tools appropriate for the patients presented problems. The difference here is that for adults, there is no need for interviewing the guardians as you will do with children or adolescents. A violent adult requires a different approach than a child/adolescent. With an adult, we may require stronger people to restrain the patient to administer the medication. For suicidal patients, adults have more experience and are more knowledgeable about different plans for suicide.as such, for any suicidal ideation for an adult or a child should be taken seriously and treated differently. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

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

Ethically children and adolescent deserve respect for their autonomy rights. However, parents must consent to treatment and the health care provider treating the child should make every reasonable effort to obtain and document informed consent. ( American Academy of Pediatrics, 2015). Also as a Nurse Practioner its legal when working on a patient who presents with the severe risk for harm to self or others, confidentiality requirements no longer apply. The NP may disclose information gathered by patients to caregivers, and they may obtain information from others (friends, family, caregiver, school personnel, and counselors) without obtaining consent from the patient or guardians (Chun, Katz, and Duffy, 2014). Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

References:

American Academy of Pediatrics. (2015). Consent for emergency medical services for children and adolescents. Pediatrics, 128(2), 427-433. doi:10.1542/peds.2011-1166

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

Chun, T., Katz, E. &  Duffy. (2014). Pediatric mental health emergencies and special health care needs. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3792398. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

sample 2

The PMHNP should consider any situation in which an individual present with thoughts, feelings, and actions requiring immediate therapeutic intervention as a psychiatric emergency. The focus of this post is to describe the treatment of an adult patient who presented at the field training site with an emergency situation. 
 
The documentation includes the explanation of the different approaches the PMHNP should utilize and any legal or ethical issues to consider in treating the patient if she is child or adolescent. 
 Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Briefly Describe the Case you Selected

RI is a 45 years old African American female who came for an unscheduled visit to the clinic for psychiatric treatment with her nineteen years old daughter. She lives with her children and husband. She sat in a fetal position, holding her head and crying. Her daughter reports that her younger sister is violent and had knocked one of her teeth out. She also said that sister has gone to jail and lives with them now. Patient confirmed that her younger daughter has legal problems. The patient is anxious that her younger child living in the family is a safety issue for the rest of the family. She reported poor appetite and not drinking. When she spoke, she utters one word at a time in a low voice. 
 
She denies hallucination. She walked in independently with her facing the ground. She is guarded with her emotion; her voice is soft, has delayed speech, content is appropriate, denies SI, HI. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments. Judgment and insight are good. The patient hair is short, dyed with golden and pink color and shaped into a style. The mood is dysphoric, affect is blunted, memory and concentration are fair. When discussing her mode of transportation to the GW Emergency Department (GWED), she said that her husband would not answer the phone until around 11 am during break time. The patient is in support not to drive self to the hospital. Alert and oriented x 4. 
 
Diagnosis- Bipolar Disorder, current depression, severe; PTSD. The patient agreed to the recommendation to go to GWED for evaluation and possible inpatient hospitalization. Plan of Care includes referral to GWED for stabilization. Placing a call to the ER and giving the ED psychiatrist report.

Explain How you Would Treat the Client Differently if He or She Were a Child or Adolescent

As with adult evaluations, the child or adolescent’s safety should be established and ensured first before proceeding with an interview. In treating the child or adolescent in the with the same psychiatric symptoms, the writer will ask the parent to take the child or adolescent to the emergency department for treatment. 
 
Sadock, Sadock, and Ruiz (2014) noted that hospitalization is necessary when a child who dissociates is self-destructive. In the USA, emergency departments provide care for individuals during acute mental health crises. Chun, Katz, and Duffy (2013) supported that criteria for immediate referral of children and adolescents for an inpatient psychiatric admission include severely hopeless, ongoing agitation, inability to engage in discussion around safety planning, and inadequate support system/ability to adequate monitoring and follow-up.
 Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Explain any Legal or Ethical Issues you Would Have to Consider When Working With a Child or Adolescent Emergency Case

The PMHNP faces ethical challenges when providing services to a minor. State laws governing consents for treatment and commitment procedures are not universal. Hem, Molewijk, and Pedersen (2014) argued it is ethically challenging for the health professionals to stop including the parents in the treatment, after consenting because their child turns sixteen and refuses for the providers to include the parents in the care. 
 
The provider at the same time was holding the parents accountable for the admission cost of treatment. The PMHNP should facilize self with the state laws in the areas of his or her practice. In Washington DC, if the parent refuses to send the child to the hospital, the PMHNP must insist and emergency petition (FD12) the patient. The receiving hospital should contact the parent to come and sign voluntary admission papers and notifies the child protective services if not in contact with the parents or they are refusing to come. 
 
Also, the Title 22A DCMR authorized the PMHNP to provide emergency mental health services after the receipt of “Emergency Opinion,” except if a religious belief is a basis for the refusal of treatment (DC Department of Mental Health, n.d.). Emergency opinion is a written opinion from the referral provider that delaying treatment due to unviable consent is likely to result in serious injury to the patient. In DC, also a person under 18-year-old who seeks or receives mental health services can lawfully consent to and make treatment decisions.
 

Summary

Minors and adults with mental health problems are increasingly being evaluated and treated by both the PMHNP outpatient clinics and emergency department. In the office setting, the level of care determines when to send patients to the emergency room.

References

Chun, T. H, Katz, E. R., & Duffy, S. J. (2013). Pediatric
 

 
mental health emergencies and special health care needs.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/24093903

DC Department of Mental Health. (n.d.). DMH rules-consent to treat.
 
 Retrieved
 

From https://dbh.dc.gov/sites/default/files/dc/sites/dmh/publication/attachments/DCR11245.pdf

Hem, M. H., Molewijk, B., & Pedersen, R. (2014). Ethical challenges in
 

connection with the use of coercion: A focus group study of health care personnel in mental health care.
 
BMC Medical Ethics
, 15. Retrieved from
 
https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2014-56498-001&site=eds-live&scope=site

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.

 

sample 3

 

Emergency psychiatric case

Rachel a 28-year-old Caucasian was brought to the facility presenting with tachycardia, hypertension, agitation which progressed to altered consciousness levels and difficulty in breathing. The parents had brought the drug bottle that they assumed must have been the cause of the presenting symptoms. Rachel had been diagnosed with Major Depressive Disorder six months ago. She had been in and out of the mental health institutions for the treatment of depression due to lack of drug adherence. Two weeks before being brought as an emergency case, Rachel had been discharged home from the mental facility and had a significant improvement. The father reports that Rachel started presenting with fatigue, sadness, having negative thoughts about life and inability to do anything constructive following her ex-boyfriend’s visit. Rachel reported being tied of men and she wished she could live without men around her. The following day Rachel took all of her tricyclic antidepressants which lead to emergency psychiatric care. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Difference in management

If Rachel was a child or an adolescent, the assessment could have been performed differently. The assessment of the child and adolescents differs with that of the adults. The children are unable to provide clear history basing on the age and the developmental stage (Kola, Kola, Petrela, and Zaimi, 2013). The assessment of child and adolescents involves inquiring of information from various sources such as the teachers, parents. The children usually show few warning signs towards suicide attempts as compared to the adults. The child specific screening tools should be used for the interviews following management of the life threatening symptoms. The assessment period should be shorter and the questions should be shorter depending with the child’s cognitive functions. Other than interviewing the child, the health care professional should also interview the child’s caregivers, parents, family and teachers (Jans, Taneli, and Warnke, 2015). In case the child had taken an overdose of medications, the antidote that is used for the adults is the same that will be used for the child with the difference in terms of dosage. The suicide attempts are common among the young adults and the health care professionals would manage Rachel as inpatient case. On the other hand, the child may be managed in the outpatient department following assessment of the family, social and environmental factors (Wolfe, Foxwell, Kennard, 2014). Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Ethical issues:

Maintaining confidentiality of the child’s information is of great importance just like that of the adults. The healthcare worker should therefore explain the various situations under which the confidentiality can be breached. The informed consent should also be signed when managing both the child and the adult. If the child has not met the age to consent to make his/her medical decisions, the parents can sign the informed consent. The parents and the child may refuse medical services. In this case, the nurse can intervene by managing the client’s condition if the laws and regulations of their state allows.

References

Jans, T., Taneli, Y., and Warnke, A. (2015). Suicide and self-harming behavior. In: Rey JM, editor. IACAPAP e-Textbook of Child and Adolescent mental health, Geneva. 
International Association for Child and Adolescent Psychiatry and Allied Professions ,
4: 1-34.

Kola, V., Kola, E., Petrela, E., and Zaimi, E. (2013). Trends of attempted suicide in Albarian children and adolescents. 
Archives of Psychiatry and Psychotherapy,
 4: 39-44. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Wolfe, K.L., Foxwell, A., Kennard, B. (2014). Identifying and treating risk factors for suicidal behaviors in youth. 
International Journal of behavioral consultation and therapy
, 9(6): 11-14.

 

sample 4

Psychiatric Emergencies

Just like medical emergencies, psychiatric emergency is an acute mental problems that need to be dealt with immediately to prevent more damages. Murtaza et al (2018), the American Psychiatric Association defines a psychiatric emergency as “an acute disturbance in thought, behavior, mood, or social relationship, which requires immediate intervention as described by the patient, family, or social unit”. The following are some of the mental problems that need immediate evaluation and treatments, suicidal behaviors, agitation, psychosis, mania, substance use, and anxiety. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

SELECTED CASE: For this discussion, I selected a case that I witnessed last semester during the course NURS 6650. This particular case involved a Black American male veteran that leave alone, came in through the Emergency room for suicide ideation. The patient came in by himself, stating that he had been having this thought for the past two days, that he is better off dead than living, and he planned to kill himself with his gun at home. But each time the thought come through his mind, he could not carry it out when he thinks about his aged mother, who need his help to survive. The patient past psychiatric history include, Major Depressive Disorder (MDD) and Alcohol dependence.

TREATMENT: Margret & Hilt (2018), there are no medications to primarily treat suicidality or self-harm behaviors. Even though, there is no medication approved yet for suicide ideation, the patient was admitted into the hospital for proper monitoring, due to the fact that the patient leave alone, with a gun in the house, which he had admitted to be the weapon he planned to kill himself with. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

CHILD OR ADOLESCENT TREATMENT: The treatment might be different if this patient happened to be child or adolescent that leave with his/her parents at home. First and foremost, there will be need to get the parents consent before an admission can even start. In case of a child or adolescent that leave with parents thorough evaluation of the stressors need to be done, by making sure the problem is not coming from the parents themselves. Margret and Hilt (2018), Emotional abuse and neglect: repeated patterns of behaviors by caregivers that convey worthlessness, unwantedness, or value placed only when meeting other’s needs. Neglect can be physical, emotional, medical, safety, and educational as determined comprehensively.

If after abuse has been rule out as the cause of the suicide and home is adjudge to be safe, then it will not be necessary to admit the patient. The patient can be managed as an outpatient care. Sadock et al (2014), when the child is brought to the emergency room, a detailed and spontaneous account of the injury should be obtained promptly from parents or other caregivers before secondary details and rationalizations cloud the information provided. It is paramount for the clinician to obtain necessary information from both the child and parents. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

LEGAL/ETHICAL ISSUES: The common legal/ethical issues to be considered when dealing with children and adolescents are Confidentiality and Parent consent. The clinician needs to be well abreast of the laws in his/her jurisdiction as it relate to children and adolescents. An Emancipation minor in some States does not need a parent consent for care, and clinician are not obligated to divulge his/her medical history to his/her parents without proper consent from the Emancipated minor. Murtaza et al (2018), a successful managed psychiatric emergency results in a solid physician-patient rapport and a concomitant improvement in the patient’s symptoms, as well as improved ability to report accurate history and participate in treatment planning. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

 

References:

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

Murtaza, S., Aoshima, A., Saunders, J., Shah, A.A., & Moukaddam, N. (2018). Treatment of psychiatric emergencies. Psychiatry Annals, 48(1), 28-35. Retrieved from the Walden University Library databases. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Margret, C.P., & Hilt, R. (2018). Evaluation and management pf psychiatric emergencies in children. Pediatric Annals, 47(8), 328-333. Retrieved from the Walden University Library databases.

Moukaddam, N. Shah, A., & Shah, A.A. (2018). Emergency psychiatric: How far have we come? Psychiatric Annals, 48(1), 63-68. Retrieved from the Walden University Library databases.

 

sample 5

 

Treatment of Psychiatric Emergencies in Children Versus Adults

A psychiatric emergency encompasses psychotic episodes including agitation, aggression and violent behavior that accompany psychiatric, medical disorders or behaviors (Patel, Sethi, Barnes, Dix, Dratcu, Fox & Wilson-Jones, 2018). Both adult and child psychiatric emergency is a major concern for healthcare practitioner. Child and adolescent pose a significant burden approaching a projection of one among the five leading causes of disability by 2020 (Margret & Hilt, 2018). Verbal and non-verbal collaborative approaches are effective in treating psychiatric emergency in both populations (Pata el, Sethi, Barnes, Dix, R., Dratcu, Fox & Wilson-Jones, 2018). Practitioners must follow consensus guidelines and age-appropriate interventions in managing psychotic emergencies. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Psychiatric Emergency of a 36-year-old Adult Male

            
A 36-year-old Hispanic male was brought to the emergency department in the acute psychiatric hospital by a police officer due to aggression and explosive outburst. The patient was physically assaultive to his parents, threatening to kill them and kill himself. The parents called local police who filed a warrant on the patient, and he was checked into the hospital. At the intake, the patient became violent threatening to hit intake staff and refused to come to the unit. Code white (Psychiatric Emergency Code) was called. The staff and police restrained the patient, handcuffed and brought him to the unit. He was secluded in the unit, and emergency medication was administered to calm him down, induce sleep and decrease psychosis. Evidence shows that de-escalation and rapid tranquilization are the verbal and non-verbal collaborative measures that have yielded positive results in stabilizing patients during a psychiatric emergency (Patel, Sethi, Barnes, Dix, R., Dratcu, Fox & Wilson-Jones, 2018). Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

Treatment of Child and Adolescent Psychiatric Emergencies

Psychotic episodes in children and adolescent can be related to developmental age, adaptive abilities, drug-induced or comorbid conditions (Margret & Hilt, 2018). Children or exhibiting adolescent agitation or aggressive behavior should be approached in a calm and non-threatening manner by a nonjudgmental adult (Sadock, Sadock, & Ruiz, 2014). This case presents two levels of emergencies and decisions. A warrant may not have been filed in the patient if he is a child or adolescent, and the parents’ consent to treatment. The second level of decision is the patient’s emergency during admission. There is a high likelihood that children and adolescents can be harmed by physical restraint and medications, unlike an adult. The practitioner should be aware of all the reasons that may contribute to aggression during admissions such as separation anxiety or fear of stranger (Sadock, Sadock, & Ruiz, 2014). Verbal de-escalation could have been used to debrief and decrease the anxiety of the patient. The patient could be calmly approached by staff. Then if the patient is a child, the parents could be asked to accompany him to the unit. Right in the unit, the nurse could talk to the patient on 1:1 in the quiet room. Oriented to the unit/room, introduction to peers/staff and contingency contract can resolve the situation. Evidence-based information shows that environmental modification, verbal interventions such as the provision of calm milieu are the first-line efficacious approach in managing a psychiatric emergency in children and adolescents (Margret & Hilt, 2018).

Legal or Ethical Consideration during Child or Adolescent Emergency Case.

It is important for the practitioner to consider the developmental level, psychosocial and neurodevelopmental conditions that may contribute to a child or adolescent psychiatric emergency (Sheridan, Sheridan, Johnson, & Marshall, 2017). A thorough assessment is needed to rule out medical conditions and to direct appropriate intervention in the absence of psychiatric disorder (Sheridan, Sheridan, Johnson, & Marshall, 2017). Due to the fragility of children and adolescent the practitioner should strive to limit the use of physical or chemical restraints and make referrals to available specialized services such as psychotherapy to prevent psychiatric emergency and its burden (Sheridan, Sheridan, Johnson, & Marshall, 2017). Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

References

Margret, C. P., & Hilt, R. (2018). Evaluation and Management of Psychiatric Emergencies in Children. 
Pediatric Annals
, 
47
(8), e328–e333. https://doi-org.ezp.waldenulibrary.org/10.3928/19382359-20180709-01

Patel, M. X., Sethi, F. N., Barnes, T. R. E., Dix, R., Dratcu, L., Fox, B., … Wilson-Jones, C. (2018). Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation. 
Journal of Psychopharmacology, 
32(6), 601–640. https://doi-org.ezp.waldenulibrary.org/10.1177/0269881118776738. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

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.

Sheridan, J. S., Sheridan, D. C., Johnson, K. P., & Marshall, R. D. (2017). Can’t We Just Get Some Help? Providing Innovative Care to Children in Acute Psychiatric Crisis. 
Health & Social Work
, 
42
(3), 177–181. https://doi-org.ezp.waldenulibrary.org/10.1093/hsw/hlx025. Treatment of psychiatric emergencies in children versus adult sample essay discussion assignments.

A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

Child Behavior Check List

Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” 
(Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 )
. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

 
299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

Decision Point One

299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

Decision Point One

299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

RESULTS OF DECISION POINT ONE

 Client returns to clinic in four weeks

 You have selected Autism Spectrum Disorder along with co-occurring Social Anxiety Disorder. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

Decision Point Two

Based on your diagnosis and the parents’ concerns, you decided to begin Risperal 0.5 mg po BID

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 Upon her return to the clinic in 4 weeks, Katie’s parents feel that Katie is calmer, but no changes in her school performance have been noted. Additionally, her parents have noticed that she seems more “tired” than usual, and report that she seems to ‘space out’ more often. They further report that she has been falling asleep during her usual television shows.

Decision Point Three

Increase Risperdal to 1 mg po BID

Guidance to Student

The information provided in the scenario is not suggestive of the diagnostic criteria for autism spectrum disorder (ASD) or co-occurring social anxiety disorder. Even if it were, Risperdal is not routinely used to treat autism-spectrum disorder- in fact, there are no FDA approved drugs for treatment of this disorder. Antipsychotics are only used to treat violent or self-injurious behaviors in ASD, and in those cases, used off-label. Antipsychotics did slow Katie down, but also gave her a other side effects, and did nothing to treat the primary presenting problems of inattention.

While CBT has evidence of efficacy in both autism spectrum disorder and social anxiety disorder, and while video modeling and video-self modeling therapy has some evidence for efficacy in ASD, these therapies will not, in and of themselves, help Katie as she does not have ASD with co-occurring social anxiety disorder.

 

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Based on your diagnosis and the parents’ concerns, you decided to begin Risperal 0.5 mg po BID

Decision Point Two

Based on your diagnosis and the parents’ concerns, you decided to begin Celexa 20 mg po daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

 Katie’s parents feel that Katie is no calmer, and that there have been no changes in her school performance. Her parents are also concerned that Katie has been asking them “odd” questions such as “where do you go when you die?” and “when you die, do you get to see your pets that have died?” Her parents indicated that she had never had such questions before.

Decision Point Three

Increase Celexa to 40 mg PO daily

Guidance to Student

The information provided in the scenario is not suggestive of the diagnostic criteria for autism spectrum disorder (ASD) or co-occurring social anxiety disorder. Even if it were, Celexa is not routinely used to treat autism-spectrum disorder- in fact, there are no FDA approved drugs for treatment of this disorder. Antidepressants may be considered if the child has co-occurring depression and/or anxiety disorder, but only after careful consideration of risk/benefits associated with antidepressant therapy in a child. The Celexa did nothing to alter Katie’s behavior, and in fact, Katie developed what appeared to be some morbid thoughts, possibly suggesting a fascination with death. While there is insufficient information to suggest that she was entertaining suicidal ideation, her parents clearly indicated that she was not having these thoughts before the antidepressant therapy was initiated.

While CBT has some evidence for efficacy in ASD and social anxiety disorder, it will not help Katie as she does not have either of these diagnoses. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

 

Based on your diagnosis and the parents’ concerns, you decided to begin Celexa 20 mg po daily

Decision Point One

 
299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

RESULTS OF DECISION POINT ONE

 Client returns to clinic in four weeks

 You have selected Autism Spectrum Disorder along with co-occurring Social Anxiety Disorder. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

Decision Point Two

Based on your diagnosis and the parents’ concerns, you decided to begin Celexa 20 mg po daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 Katie’s parents feel that Katie is no calmer, and that there have been no changes in her school performance. Her parents are also concerned that Katie has been asking them “odd” questions such as “where do you go when you die?” and “when you die, do you get to see your pets that have died?” Her parents indicated that she had never had such questions before.

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Increase Celexa to 40 mg PO daily

Guidance to Student

The information provided in the scenario is not suggestive of the diagnostic criteria for autism spectrum disorder (ASD) or co-occurring social anxiety disorder. Even if it were, Celexa is not routinely used to treat autism-spectrum disorder- in fact, there are no FDA approved drugs for treatment of this disorder. Antidepressants may be considered if the child has co-occurring depression and/or anxiety disorder, but only after careful consideration of risk/benefits associated with antidepressant therapy in a child. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay. The Celexa did nothing to alter Katie’s behavior, and in fact, Katie developed what appeared to be some morbid thoughts, possibly suggesting a fascination with death. While there is insufficient information to suggest that she was entertaining suicidal ideation, her parents clearly indicated that she was not having these thoughts before the antidepressant therapy was initiated. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.While CBT has some evidence for efficacy in ASD and social anxiety disorder, it will not help Katie as she does not have either of these diagnoses.

Augment with CBT

Reconsider Diagnosis

Based on your diagnosis and the parents’ concerns, you decided to begin Olanzapine 5 mg po daily.

 

Decision Point One

 
315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

RESULTS OF DECISION POINT ONE

 Client returns to clinic in four weeks

 You have selected 315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

Decision Point Two

Begin Donepezil 10 mg po daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 Katie’s parents feel that Katie is no different. She has had no changes in school performance, but has been having trouble falling asleep at night

 Additionally, Katie has reported having “scary dreams” to her parents and has been feeling “stomach sick”

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Explain that the side effects will abate with time and increase to 15 mg orally daily. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

Augment with Trazodone 50 mg po at HS.

Reconsider Diagnosis

315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

 
314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

Decision Point One

 
314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

RESULTS OF DECISION POINT ONE

 Client returns to clinic in four weeks

 You selected Attention deficit hyperactivity disorder, predominantly inattentive presentation. Based on this choice, outline the remainder of the diagnostic evaluation that you will conduct on this child and their parents. Be sure to include standardized assessment instruments that you would administer

Decision Point Two

Begin Wellbutrin 75 mg orally daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 Katie’s parent report that the teacher has indicated that Katie seems to be paying more attention during class. They have also noticed that Katie is able to attend more closely to her homework. However, her parents are somewhat concerned that Katie has been asking them “odd” questions such as “where do you go when you die?” and “when you die, do you get to see your pets that have died?” Her parents indicated that she had never had such questions before. A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay.

Decision Point Three

BASED ON THE ABOVE INFORMATION, SELECT YOUR NEXT ACTION. BE CERTAIN TO DISCUSS THE RATIONALE FOR YOUR DECISION.

Assure the parents that the questions Katie are asking are age-appropriate and increase dose of Wellbutrin to 150 mg daily

Implement psychodynamic therapy

Change drug to Concerta 18 mg orally daily in the morning A young girl with difficulties in school – Child Abuse Case study – Katie ADHD Essay

NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions

Describe a scenario in which there was a conflict between nurses working in your current or previous work environment. What was the primary cause of the conflict? What conflict resolution strategies would you employ to manage this conflict and promote civility in the workplace and why?

 

Compare and contrast servant leadership with another leadership style or theory such as transformational leadership. What are the primary characteristics of each? What appeals to you about them and what strengths and drawbacks do you see with each in terms of influencing organizational culture as a nurse leader? NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

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Discuss organizational factors that can drive the change within a health care organization. Also, discuss the ethical, social, legal, economic, or political implication of the change within an organization and on the profession of nursing. Integrate a specific example of organizational change you have witnessed in your response.

 

You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?

 

Imagine you are working in an outpatient specialty office. Your nursing director has informed you that due to “accountable care” your office might be penalized by having too many diabetic patients that are above the hemoglobin A1C (HBA1C) goal of 8. The national benchmark is that only 20% of your population should be above 8 and your office shows 40%. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Your physicians have also been informed by their management of the same issue.

Develop a plan using enhanced communications with patients to reach the benchmark goal. What might you do if you had the resources to accomplish this? You should consider all the technology you might be able to use such as a patient portal, wireless home monitor, texting, and secure messaging for example. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

 

What challenges do current reimbursement models pose for nurse leaders in their obligations to promote quality, cost effective patient What strategies can effective nurse leaders use to overcome those challenges? Discuss any specific examples you may have witnessed a leader implement in the practice environment in your response.

 

Review the Graduate QSEN Competencies. Focusing on the areas of Quality Improvement (QI), Safety, and Informatics, summarize the essential knowledge, skills and attitudes that an advanced registered nurse should possess to competently promote the use of health care data and information to improve care in the clinical setting. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Discuss two specific ways information and technology can improve clinical practice, administration, education, or research in your response.

 

 

Discuss a key event in the evolution of nursing informatics and the characteristics of nursing informatics as a specialty. In what ways do the roles of informatics nurses and nurse leaders intersect?

 

What are the primary challenges related to interoperability and the exchange of health information in the practice environment and how might these impact patients’ access to the best care? NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Discuss a particular challenge with clinical provide order entry (CPOE) in your response.

 

 

Discuss the benefits and drawback of clinical decision support systems, including the challenges of avoiding alert fatigue. Considering your interactions with patients and systems in the clinical environment, what best practices related to human factors and user-centered design would you recommend to designers of such systems?

 

Discuss an example of a personal health, mobile heath, or telehealth-related application that you think can improve patient care. What are some of the primary challenges with integrating data from a mobile device or application with data within an EHR? Do you think most patients are comfortable with sharing their personal data in the clinical environment? Supposing the sharing of such information is beneficial for their health, what can be done to help patients overcome their reticence?

 

 

Review HIPAA, protected health information (PHI), and requirements for privacy and confidentiality in EHRs. Discuss one ethical and one legal issue related to the use of EHRs that directly impact advanced registered nursing practice. Discuss possible consequences for compromising patient data and measures you can implement in your own practice to protect patient privacy and confidentiality. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

 

What quality standards or performance measures guide your role or specialty as an advanced registered nurse? Using these standards, discuss how informatics can be used to improve quality of care. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions. Make sure to discuss meaningful use and incorporate the topic materials, such as the American Health Information Management Association (AHIMA) and Information Governance websites in your response.

 

 

There are several project management methodologies available to nurse leaders for supporting the implementation of quality and performance improvement initiatives in the practice environment. Two well-known ones are Lean and Six Sigma. Compare and contrast two project management methodologies you think are promising in the health care environment. Discuss their relative benefits and drawbacks and discuss why you think they can be successful for implementing quality improvement initiatives. NUR-514: Organizational Leadership and Informatics Essay Assignment Discussions.

Safe Prescribing DEA PMHNP essay assignment example

Assignment : Safe Prescribing

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

2. Explain your responsibilities when having a DEA number.

3. Explain how you apply for a DEA number.

4. Explain MARYLAND state’s requirements for a safe prescribing and prescription monitoring program. Explain your responsibility as a PMHNP to follow these requirements. Safe Prescribing DEA PMHNP essay assignment example.

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

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Safe Prescribing

The Food and Drug Administration oversees the Drug Enforcement Administration. Drug Enforcement Administration (DEA) was founded in 1973 for the enforcement of controlled substances. The DEA protect the safety of the public within the United States. They help to make sure that drugs are not misused for an illicit purpose. In the US there are over 6 million prescription drug abusers (DEA, n.d.). Controlled substances are categorized into five schedules which are schedule I, II, III IV and V.   Schedule I have the highest potential for abuse and as the schedule number gets higher the potential for abuse gets lower. Safe Prescribing DEA PMHNP essay assignment example.

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

A nurse practitioner that is board certified and caring for patient must be licensed and DEA certified to prescribe control substance. The DEA work with practitioners to prevent drugs diversion for an illicit purpose. The DEA work with state professional licensing boards, local and state law enforcement authorities to guarantee controlled substances are prescribed, administered and distributed for authentic medical reasons, according to the federal and state laws. Safe Prescribing DEA PMHNP essay assignment example.

The DEA can investigate practitioner at any time if there is any suspicion of violations of federal or state law. At any time, there is a violation, the state board withdraws the practitioner license, and the DEA will make sure that the practitioner voluntarily surrenders their DEA registration. A lack of compliance requires corrective action, for example, administrative action or in extraordinary cases, civil, or criminal act. These actions are taken to stop the practitioner the ability to divert or abusing controlled substances and protect the health and safety of the public. Safe Prescribing DEA PMHNP essay assignment example.

T
he PMNHP responsibilities when having a DEA number

As a practitioner, it is important to proper prescribe, administer, and distribute controlled substances because can affect patients’ health and the safety of the public. Practitioners must prescribe substance-controlled medication as authorized by the state in which they practice. Safe Prescribing DEA PMHNP essay assignment example. The practitioner acts only within the scope of employment in the institution where they work. The practitioner prescribes medication under the employer registration and is assigns a specific internal code as authorized by their employer (DEA, n.d.).

As a practitioner, it is essential to keep all prescription blanks in a safe place. It is crucial to writing out the exact amount of prescription to prevent altercations of the prescription order. Prescription blanks should not be used as notes. It is significant to assist the pharmacist when they call to verify the prescription order. It is important not to sign a blank prescription pad in advance and use a tamper-resistant prescription pad. Safe Prescribing DEA PMHNP essay assignment example. The practitioner should be careful not to be manipulated by drug-abuser. Drugs diversion may result in drug overdose, drug- related emergency room visits, drug addictions and death. All suspicious prescription activities should be reported to the nearest DEA office immediately.

                                          Explain how you apply for a DEA number

A practitioner is required by their state and DEA to apply for a DEA number by registering using DEA form 224. It can be done online or hard copy or mailed. The phone is 1-800-882-9539, and the online websites are www.DEAdiversion.usdoj.gov. and cost about $700 (DEA, n.d.).

An active license for the state of practice is required. The online registration consists of six-part which are Personal/ business information, Activity, state license, background information, payment, and confirmation. It is crucial to know that the application fees are not refundable. Safe Prescribing DEA PMHNP essay assignment example. For online application take note of the registration ID number and call after three business days to verify if the application has been approved.

Anybody who purposely or intentionally furnishes false or deceitful data in the form is liable to a term of detainment of not over four years, and a fine under Title 18 of not more than $250,000, or both (DEA, n.d.).

Explain your state’s requirements for a safe prescribing and prescription monitoring

     program. Explain your responsibility as a PMHNP to follow these requirements.

All practitioner in Maryland must be registered with Prescription Drug Monitoring Program. It helps the state to monitor prevent diversion of substance medication. As a practitioner is mandatory to follow the requirement of the state to prevent any civil or criminal charge or suspension of license. A nurse practitioner must comply with the state law of Health Occupations Article, §12-505, Annotated Code of Maryland, record the order of the prescription drug on the patient’s chart, permit the division of drug control to enter and review the practitioner office at any time. Safe Prescribing DEA PMHNP essay assignment example. A practitioner is required to stamp all schedule III, IV, V prescription with the letter “C’ in a red link (MBON, 2017). Only starter dosages or samples medication without charges, furnish the patient with a written prescription order. A practitioner should maintain two separate records one for schedule II medication and the other for other prescription and keep records for five years. The practitioner can prepare and distribute a starter dosage of any drug they want as authorized and record it in the patient chart. Safe Prescribing DEA PMHNP essay assignment example.

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

The Schedule II drug levels have a high possibility for abuse which may lead to severe physical or psychological dependence. There is no federal time limit to numbers of drugs prescribed. Safe Prescribing DEA PMHNP essay assignment example. An oral order can be given in an emergency situation. Examples of Schedule II narcotics are hydromorphone, oxycodone and methylphenidate (Gabay, 2013).

Schedule III-Substances have a lesser potential for abuse than schedule I or II with moderate physical and psychological dependence. Example is buprenorphine (Gabay, 2013).

  Schedule IV- is a controlled substance with a little potential for abuse than schedule I, II and III. Example is Tramadol, Ambien and clonazepam
(Gabay, 2013).

   Schedule V as the lowest potential for abuse of all and it contain limited number of certain narcotics. Example Lyrica and Robitussin AC
(Gabay, 2013). Safe Prescribing DEA PMHNP essay assignment example.

 

References

Drug Enforcement Administration (n.d.). Drug Scheduling. Retrieved on September 23, 2018.https://www.dea.gov/drug-scheduling

Gabay, M. (2013). Federal Controlled Substances Act: Controlled Substances Prescriptions. Hospital Pharmacy, 48(8), 644–645. Retrieved on September 23, 2018   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847977/. Safe Prescribing DEA PMHNP essay assignment example.

Maryland Board of Nursing (2017). Division of State Documents. Retrieved on September 23, 2018.
https://mbon.maryland.gov/Pages/advanced-practice-index.aspx

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

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. Safe Prescribing DEA PMHNP essay assignment example.

Antisocial Personality Disorder essay research case study example

Assignment : Antisocial Personality Disorder

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

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders

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

Antisocial Personality Disorder essay research case study example

THE CASE STUDY

Antisocial Personality Disorder

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BACKGROUND

SUBJECTIVE

Rhonda is a 32-year-old Hispanic female who presents to your office for her initial appointment. When you ask what brought her to your office, she states: “I’m at the end of my rope, I don’t know what else to do.” She then bursts into tears. Rhonda explains that she has very few friends left, and everyone seems to have “abandoned” her. Rhonda explains that she goes out of her way to help other people, and to be nice to them, but this does not seem to help.

Rhonda then stands up and begins to pace around your office at times using wild hand gestures to explain the circumstances that led up to her making the appointment with you. She describes the recent breakup with her boyfriend as traumatic and explains “when we first met, he was the best guy in the world. He treated me really well. But he just became a complete monster! Even though he broke off the relationship with me, I was glad to see it end. I hate his guts!” Antisocial Personality Disorder essay research case study example.

Rhonda explains that her current financial situation is also precarious. She states that she recently purchased an automobile, and is not certain how she is going to pay for it. She states that she had a car that was repossessed last year at that time, and that she borrowed some money from a friend to help pay for the car; the friend later turned around and accused her of theft. “It was my friend’s fault. She told me she would loan me the money and then backed out. I only took the money because she said she would loan it to me … people just can’t go back on their word like that when other people are counting on them.”

Rhonda reports that she was “always in trouble” as a kid. She states that people were always picking on her, to which she adds: “the other kids my age were just stupid. Antisocial Personality Disorder essay research case study example. They didn’t know how to have fun.” She says “I have always been impulsive, but it’s fun. Sometimes people can be such prudes … you only go around life once, so you have to make the best of it.”

OBJECTIVE

Rhonda is currently single. She has no children. Educationally, she had completed two semesters toward her bachelor of arts degree in fine arts. Rhonda currently works as a waitress at a local restaurant. She has held this job for about 2 weeks. Prior to this, Rhonda worked as a housekeeper for a local hotel chain. She states that she was fired from this job because her coworkers were jealous of her and “planted” evidence of her stealing from hotel patrons. She was also arrested for cashing checks under an alias, for which she spent 120 days in jail. Antisocial Personality Disorder essay research case study example.

Rhonda has a history of multiple incarcerations for offences ranging from larceny to possession of controlled substances to possession of an illegal firearm. She was also arrested several times for fighting and on at least one occasion, used a baseball bat to beat up a girl who she thought was trying to “set her up” with the police.

MENTAL STATUS EXAM

Rhonda is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. She reports her mood as “terrible!” Affect is labile and seems to change rapidly with the subject being discussed. Her eye contact is normal, but at times, she appears to stare at you. Rhonda is oriented to person, place, and time. She denies visual/auditory hallucinations, no overt paranoia or delusional thought processes noted. Rhonda denies any suicidal or homicidal ideation. Antisocial Personality Disorder essay research case study example.

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Decision Point One

1. Diagnosis: Antisocial Personality Disorder

Decision Point Two

2.Refer to psychologist for psychological testing

RESULTS OF DECISION POINT TWO

– Client returns to clinic in four weeks

– The psychologist’s report indicates that a comprehensive psychological battery was performed for the purposes of diagnostic clarification. The end result suggested that Rhonda has traits of multiple personality disorders, but scores highest in antisocial personality traits, suggesting antisocial personality disorder. Antisocial Personality Disorder essay research case study example.

-When Rhonda returns to the office, you review the psychologist’s report with her. Rhonda seems upset, but also states “well, that’s why I am here, to get better … what do I need to do?”

Decision Point Three

3. Refer to group-based cognitive behavior therapy

Guidance to Student

Referral to a psychologist was appropriate for the purposes of diagnostic clarification. Psychological tests can help tease out the actual personality disorder that Rhonda has. In this case, Rhonda’s symptoms are most consistent with antisocial personality disorder, but as you can see, she has signs/symptoms of other personality disorders.

Of the available choices, group-based cognitive behavior therapy may be useful in treating individuals with this personality disorder, but all “improvement” in signs/symptoms should be met with great skepticism. Antisocial Personality Disorder essay research case study example.

Dialectical behavior therapy is ineffective in people with APD.

Beginning Latuda is not appropriate, as there are currently no FDA-approved medications to treat APD. Also, prescribing medications to someone with antisocial personality disorder could lead to misuse or diversion. Antisocial Personality Disorder essay research case study example.

The Assignment:

.

At each Decision Point, stop to complete the following:

Decision #1: Antisocial Personality Disorder

Which Decision did you select?

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

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Antisocial Personality Disorder essay research case study example.

o 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

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

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

o 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

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

o What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources. Antisocial Personality Disorder essay research case study example.

o 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. Antisocial Personality Disorder essay research case study example.

Antisocial Personality Disorder essay

Antisocial personality disorder (ASPD) is a powerlessness to fit in with the social standards that customarily govern numerous parts of a person’s behavior (Sadock, Sadock & Ruiz, 2014). A person with ASPD are often called sociopathy, is a psychological condition in which a person reliably demonstrates no respect for good and bad and disregards the rights and feelings of others. Individuals with the above disorder tend to estrange, unstable, aggressive, control or treat others cruelly or with hard aloofness. They demonstrate no blame or regret for their conduct. Ms. Rhonda is a 32year old Hispanic with no children. In the scenario She presently works at local restaurant as a waitress and in college with two semesters left from graduation. She is alert and oriented × 4. She is well spoken, speech is clear, normal eye contact, goal directed, and spontaneous. She verbalized having a terrible mood. She appears to change discussed subject quickly with a labile affect. She denies any auditory or visual hallucinations, homicidal or suicidal ideation (Laureate Education, 2017a). Antisocial Personality Disorder essay research case study example.

She is manipulating, exploiting impulsive, others and violated the right of others. She is also irresponsible with her work and finances. According to the American Psychiatric Association (2013), there are four diagnostic criteria for ASPD: Individual with ASPD violate others rights deceitful, impulsive, irritability, aggressiveness, irresponsible, and lack remorse with an onset before 15 years. They must be 18 years old to be diagnoses with ASPD.

                                                     Differential Diagnosis

It is important to determine which started first, if the patient started abusing drugs before their antisocial behavior began may have behavior caused from the impacts of their drug addiction. Antisocial Personality Disorder essay research case study example.

                                                        Expected Result

Ms. Rhonda showed behavior indicative of ASPD. She is deceitful with friends. She stated that she has “always been impulsive” which she finds funny (Laureate Education, 2017a). She is consistently irresponsible (her current financial situation risky/ awful). She does not know her car note will be paid for. She stated that her last car was repossessed last year because of her friends, who promised to loan her money but later backed out. Antisocial Personality Disorder essay research case study example. She expresses that she was terminated from a job because her colleagues were envious of her and “planted” proof of her stealing from hotel patrons. She was arrested for cashing checks using fake name, for which she was imprison for 120 days (lack remorse).

Rhonda has a background of various detainments for offenses running from possession of an unlawful gun to stealing to possession of controlled substances. Antisocial Personality Disorder essay research case study example. She was arrested a few times for combating and on somewhere around one event, utilized a baseball bat to thrash a young lady who she thought was attempting to “set her up” with the police (lack remorse) (Laureate Education, 2017a).

              Difference Between Expected Result and the Achieved Result

There is no difference between the expected result and achieved result since Ms. Rhonda exhibited signs and symptoms indicative of ASPD.

                                                      Decision Point Two

                                      Refer to psychologist for psychological testing

The explanation behind this choice is because diagnosing ASPD is based on psychological evaluation. Patient will be referred to psychologist for psychological testing this will enable the psychologist to even more likely comprehend the patient and her behavior. psychological testing is a procedure of critical thinking in which the psychologist attempts and decide the main components of a patient’s mental or mental health problems, Intellectual Functioning IQ, personality, behavioral or some other component. It is additionally a procedure that aides distinguish a person strength and weakness (Laureate Education, 2017a). Antisocial Personality Disorder essay research case study example.

Expected Result with this Decision

There is no different between expected result and the actual result because the psychologist report shows that a thorough psychological battery was performed for the motivations behind diagnostic elucidation. The psychological report stated that although Rhonda had other qualities of multiple personality disorder. She scored highest in antisocial personality disorder test indicating that she has ASPD.

                     Difference between what you expected to achieve with Decision #2

Rhonda was referred to psychologist so that she can get the best treatment need for her symptoms.  Rhonda has a lots of other personality disorder symptoms. The psychological tests will enable persuade to out the actual personality disorder that Rhonda possess
.
Rhonda’s indications are most predictable with reserved ASPD, however as should be obvious, she has signs/side effects of other identity issue (Laureate Education, 2017a).

                                                        Decision Point Three

                                Refer to group-based cognitive behavior therapy

Reason for Decision

There is at present no FDA-approve medication for the treatment of ASPD so prescribing medication to the patient may result to diversion or abuse. Antisocial Personality Disorder essay research case study example. Psychotherapy is effective in the treatment of ASPD. Group-based cognitive behavior has proven to be effective with ASPD.CBT uses cognitive restructuring, exposure, behavior modification, psychoeducation, and skills education.

                                            Expected Result with this Decision.

Group-based cognitive behavior has proven to be effective with ASPD. Cognitive behavioral relapse prevention theory is linked with successful correctional treatment programs (Davidson, 2008). It focuses on challenging dysfunctional beliefs and teaches the patient tactics, exercises and behavioral experiments to acquire more socially acceptable behavior. It deals with the premise that antisocial behavior is learned, motivated and strengthened within the person and within the environment factors. Antisocial Personality Disorder essay research case study example. There a few cognitive behavioral strategies can be used to acknowledge new cognitive and behavioral techniques to break the sequences of antisocial behavior (Davidson, 2008).

      Difference between Expected Result and the Achieved Result with Decision

The expected result and achieved result are the same. Ms. Rhonda returned to the clinic showing empathy, compassion, remorseful for her action and demonstrating acceptable social behavior.

                                                      Ethical
Considerations

People with ASPD are responsible for an extreme amount of social discomfort, crime, and violence and pose a critical burden to society causing distress to others, to a great extent because of the violations they commit and their antisocial behavior.  Working with ASPD patients can be challenging. ASPD is a mental disorder and requires clinicians to give proper consideration and treatment nonjudgmental (De Brito & Hodgins, 2009). Antisocial Personality Disorder essay research case study example.

 

                                                        References

Davidson K.M. (2008). Cognitive therapy for personality disorders: a guide for clinicians. Second Edition.  Routledge: Hove

De Brito S, Hodgins S (2009) Antisocial personality disorder. In: McMurran M, Howard R, editors. Personality, Personality Disorder and Risk of Violence: An Evidence-Based Approach. West Sussex, UK: John Wiley and Sons. Antisocial Personality Disorder essay research case study example.

Framingham, J. (2016). Types of Psychological Testing.
Psych Central
. Retrieved on September 23, 2018, from https://psychcentral.com/lib/types-of-psychological-testing/

Laureate Education. (2017a). A woman with personality disorder [Interactive media file] Baltimore, MD: Author.

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. Antisocial Personality Disorder essay research case study example.

Maryland Nursing Certification Plan Essay Example

Assignment: Certification Plan

1. Describe the PMHNP practice environment for MARLAND state, highlighting restrictions or limitations for practice.

2. Compare the PMHNP practice environment in MARYLAND State with a neighboring state or a state in which you would like to practice.

3. Describe a professional and/or clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process. Maryland Nursing Certification Plan Essay Example.

4. Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc

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Certification Plan                                                                                                   

Nurse Practitioner is advance practiced registered nurse with higher education to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose illness and disease, prescribe medication and articulate treatment plans. According to the American Association of Nurse Practitioners, a nurse practitioner has a masters or doctoral level education. To practice professional licensure and certification are required in every state (AANP, 2018). They deliver care to patients in need of primary, acute, chronic, and specialty care. In some states, they can independently manage patient care and educate patients and families about illnesses. Maryland Nursing Certification Plan Essay Example.

PMHNP Practice Environment in Maryland – Maryland Nursing Certification Plan Essay Example

Licensure laws vary contingent on the state. The Maryland Board of Nursing approves the licensure of nurse practitioners who graduates from an accredited school. To practice as an NP, the NP student must sit for certification after graduating from an accredited school with one of the national credentialing associations (NPAM, 2018). As indicated by Maryland Scope of Practice (2018), preceding full practice authority can be given in Maryland, an NP must have a coordinated shared relationship for 18 months with an NP or a Doctor with a full practice authority. They have a limitation for prescribing schedule II-V controlled element, which can only be done with certification.  NP’s in Maryland has a limitation as medical staff membership. The State law doesn’t indicate Maryland’s necessities for medical staff composition.

                             PMHNP practice environment in neighboring states

The state of Virginia and the District of Columbia law have stricter laws than the state of Maryland because in the District of Columbia NPs’ cannot sign disable person placard forms and death certificates while in Virginia NPs’ cannot practice independently. They need a joint agreement with a physician to practice. The state law did not outline if NPs’ can be a primary care provider (Barton Associates, 2018).

   Professional and/or Clinical practice issue a new PMNHP will need to consider and address with the certification, licensure, credentialing, or relocation process.Maryland Nursing Certification Plan Essay Example.

One of the issues a new NP may be in the part of credentialing which is unique in relation to certification. The credentialing process incorporates the validation of education, licensure, reference checks, and accreditation. In the process of relocation an NPs may be faced with restriction of practice despite the fact they have the same educational qualification base on the state of practice for example DC, Maryland and Virginia all have different scope of practice.

Checklist for Passing the National Certification Exam

It is crucial to work towards graduating from the NP program and then proceed with getting certification. The school which the NP student graduate from sending an official transcript to the American Academy of Nurse Practitioners (AANP), or the American Nurses Credentialing Center (ANCC). The student after confirming that the AANP or ANCC have received their transcript can now register for the NP certification exam. Maryland Nursing Certification Plan Essay Example. The student is sent a candidate’s eligibility to Test notice is sent to, and candidates are expected to review the candidate handbook for the exam for relevant information about the application process, testing content, and testing procedures. The student is expected to test during an a120-day window

My plan is after my final exams in school. I will take time out from my job and read my purple book and practice Board vitals and Pocket prep questions. My aims are to read and understand the purple book and go for a review class with Barkley & Associates.

 

References

American Association of Nurse Practitioners. (2018). Nurse Practitioner Credibility. Retrieved from https://www.aanp.org/membership/107-all-about-nps/what-s-an-np-accordion/570-why-nps-are-important. Maryland Nursing Certification Plan Essay Example.

Barton Associates, (2018). Nurse Practitioner Scope of Practice Laws. Retrieved from https://www.bartonassociates.com/locum-tenens-resources/nurse-practitioner-scope-of-practice-laws/ Maryland Scope of Practice (2018).

Maryland Scope of Practice Policy: State Profile. Retrieved from http://scopeofpracticepolicy.org/states/md/. Maryland Nursing Certification Plan Essay Example.

Nurse Practitioner Association in Maryland. (2018). What is a Nurse Practitioner? Retrieved from https://www.npamonline.org/page/4