Tag: Clinical-Nursing

  • NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers

    NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers

    NURS 6002 Foundations for Graduate Study: Welcome & Course Readings

    Welcome & Course ReadingsWelcome to your course guide

    NURS 6002 Course Readings

    Other Readings

    Welcome to your course guide

    Please find your required library readings below. If you have problems with the links below, please contact the Library. If you have APA questions about these materials, please contact the Writing Center.

    NURS 6002 Course Readings

    After clicking on a citation below, enter your myWalden user name and password at the prompt.

    Please Ask a Librarian if you have any questions about the links. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    Bahrieni, F., Azodi, P. Hajivandi, A. & Jahanpour, F. (2017). The effect of education in nurse’s moral sensitivity. Journal of Pharmaceutical Sciences and Research, 9(10), 1817–1821.

    Casey, D. & Egan, D. (2013). The use of professional portfolios for career enhancement. British Journal of Nursing, 15(11), 547–552.

    Glasper, A. (2016). Does cheating by students undermine the integrity of the nursing profession? British Journal of Nursing, 25(16), 932–933.

    Hoskins, K., Grady, C. & Ulrich, C. (2018). Ethics education in nursing: Instruction for future generations of nurses. OJIN: The Online Journal of Issues in Nursing, 23(1).

    Kauffman, H. (2015). A review of predictive factors of student success in and satisfaction with online learning. Research in Learning Technology, 23, 1–13. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    Smith, L. S. (2011). Showcase your talents with a career portfolio. Nursing, 41(7), 54–56.

    Thompson, T. L. (2011). Electronic portfolios for professional advancement. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 25(4), 169–170. doi:10.1097/NUR.0b013e318222a680

    Other Readings

    Optional or supplemental readings may or may not be available in the library. Find further information about optional readings here.

    If you have questions about your required course textbooks, please contact Student Support at support@waldenu.edu

    NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers

    A nurse is assessing the abdomen of a patient who is experiencing frequent bouts of diarrhea. The nurse first observes the contour of the abdomen, noting any masses, scars, or areas of distention. What action would the nurse perform next?

    A. Auscultate the abdomen using an orderly clockwise approach to all abdominal quadrants

    B. Percuss all quadrants of the abdomen in a systematic clockwise manner to identify masses, fluid, or air in the abdomen.

    C. Lightly palpate over the abdominal quadrants; first checking for any areas of pain or discomfort.

    D. Deeply palpate over the abdominal quadrants, noting muscular resistance, tenderness, organ enlargement, or masses. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A

    A nurse is administering a large-volume cleansing enema to a patient prior to surgery. Once the enema solution is introduced, the patient complains of severe cramping. What would be the appropriate nursing intervention in this situation.

    A. Elevate the head of the bed 30 degrees and reposition the rectal tube

    B. Place the patient in a supine position and modify the amount of solution

    C. Lower the solution container and check the temperature and flow rate

    D. Remove the rectal tube and notify the PCP

    C

    If the solution is too cold or the flow rate too fast, severe cramping may result.

    A nurse working in a hospital includes abdominal assessment as part of patient assessment. In which patients would a nurse expect to find decreased or absent bowel sounds after listening for 5 minutes? Select all that apply. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A. A patient diagnosed with peritonitis

    B. A patient who is on prolonged bedrest

    C. A patient who has diarrhea

    D. A patient who has gastroenteritis

    E. A patient who has an early bowel obstruction

    F. A patient who has paralytic ileus caused by surgery

    A, B, F

    Decreased or absent bowel sounds, evidenced by only after listening for 5 minutes, signify the absence of bowel motility, commonly associated with peritonitis, paralytic ileus, and/or prolonged immobility. Hyperactive bowel sounds indicate increased motility, commonly caused by diarrhea, gastroenteritis, or early bowel obstruction

    A nurse assesses the stool of patients who are experiencing GI problems. In which patients would diarrhea be a possible finding? Select all that apply. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A. A patient who is taking narcotics for pain

    B. A patient who is taking laxatives

    C. A patient who is taking diuretics

    D. A patient who is dehydrated

    E. A patient who is taking amoxicillin for an infection

    F. A patient taking OTC antacids

    B, E, F

    Diarrhea is a potential effect of treatment with amoxicillin clavulanate, laxatives, or OTC antacids. Narcotics, diuretics, and dehydration may lead to constipation.

    A patient has a fecal impaction. The nurse correctly administers an oil-retention enema by:

    A. Administering a large volume of solution (500-1000 mL)

    B. Mixing milk and molasses in equal parts for an enema

    C. Instructing the patient to retain the enema for at least 30 minutes

    D. Administering the enema while the patient is sitting on the toilet

    C

    The usual amount of solution administered with a retention enema is 150-200 mL for enema for an adult. The milk and molasses mixture is a carminative enema that helps expel flatus. The patient should be instructed to lie on the left side of the bed as dictated by patient condition and comfort. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A nurse prepares to assist a patient with her newly created ileostomy. Which recommended patient teaching points would the nurse stress. Select all that apply.

    A. “When you inspect the stoma, it should be dark purple-blue.”

    B. “The size of the stoma will stabilize within 2 weeks.”

    C. “Keep the skin around the stoma site clean and moist.”

    D. “The stool from an ileostomy is normally liquid.”

    E. “You should eat dark green vegetables to control the odor of the stool.”

    F. “You may have a tendency to develop food blockages.”

    D, E, F

    The nurse should encourage the intake of dark green leafy vegetables because they contain chlorophyll, which helps deodorize the feces. Patients wth ileostomies need to be aware they may experience a tendency to develop food blockages, especially when high-fiber foods are consumed. The stoma should be dark pink to red and moist. Stoma size should stabilize within 4-6 weeks, and the skin around the stoma site should be kept clean and dry.

    A nurse is preparing a hospitalized patient for a colonoscopy. Which nursing action is the recommended preparation for this test?

    A. Have the patient follow a clear liquid diet 24-48 hours before the test.

    B. Have the patient take Dulcolax and ingest a gallon of bowel cleaner on day 1.

    C. Prepare the patient for the use of general anesthesia during the test.

    D. Explain that barium contrast mixture will be given to drink before the test.

    A

    Prep for a colonoscopy includes a clear liquid diet 24 to 48 hours before the test along with a 2-day bowel prep of a strong cathartic and Dulcolax on day 1 and enema on day 2 or a 1-day bowel prep that consists of ingestion of a gallon of bowel cleanser in a short period of time. Conscious sedation, not general anesthesia, will be given for a colonoscopy. Barium contrast mixture is given to drink before an upper GI and small-bowel series of tests.

    A nurse is performing digital removal of stool on a 74-year-old female patient with a fecal impaction. During the procedure the patient tells the nurse that she is feeling dizzy and nauseated, and then she vomits. What should be the nurse’s next action? NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A. Reassure the patient that this is a normal reaction to the procedure.

    B. Stop the procedure, prepare to administer CPR, and notify the physician.

    C. Stop the procedure, assess vital signs, and notify the physician.

    D. Stop the procedure, wait 5 minutes, and then resume the procedure.

    C

    When a patient complains of dizziness or lightheadedness, nausea, and vomiting during digital stool removal, the nurse should stop the procedure, assess heart rate and blood pressure, and notify the physician. The vagal nerve may have been stimulated.

    A nurse is scheduling tests for a patient who has been experiencing epigastric pain. The physician ordered the following tests: a. a barium enema, b. fecal occult blood test, and c. endoscopic studies, and D. upper GI series. What is the correct order in which the tests would normally be performed?

    A. c, b, d, a

    B. d, c, a, b

    C. a, b, d, c

    D. b, a, d, c

    D

    A fecal occult blood test should be done first to detect GI bleeding. Barium studies should be performed next to visualize GI structures and reveal inflammation, ulcers, tumors, strictures, and other lesions. A barium enema and routine radiography should precede an upper GI series because retained barium from an upper GI series could take several days to pass through the GI tract and cloud anatomic detail on the barium enema studies. Noninvasive procedures usually take precedence over invasive procedures, such as endoscopic studies, when sufficient diagnostic data can be obtained from them. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    A nurse is caring for a patient who has a NG tube in place for gastric decompression. Which nursing actions are appropriate when irrigating a NG tube connected to suction? Select all that apply.

    NURS 6003 Foundations for Graduate Study: Welcome & Course Readings

    Print Page Report a broken link

    Welcome & Course ReadingsWelcome to your course guide

    NURS 6003 Course Readings

    Other Readings

    Welcome to your course guide

    Please find your required library readings below. If you have problems with the links below, please contact the Library. If you have APA questions about these materials, please contact the Writing Center. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    NURS 6003 Course Readings

    After clicking on a citation below, enter your myWalden user name and password at the prompt.

    Please Ask a Librarian if you have any questions about the links.

    Boykins, A., & Gilmore, M. (2012). Ethical decision making in online graduate nursing education and implications for professional practice. Online Journal of Health Ethics, 8(1), 1–18. https://doi.org/10.18785/ojhe.0801.04

    Casey, D. & Egan, D. (2013). The use of professional portfolios for career enhancement. British Journal of Nursing, 15(11), 547–552. doi:10.12968/bjcn.2010.15.11.79625

    Glasper, A. (2016). Does cheating by students undermine the integrity of the nursing profession? British Journal of Nursing, 25(16), 932–933. doi:10.12968/bjon.2016.25.16.932

    Kaufffman, H. (2015). A review of predictive factors of student success in and satisfaction with online learning. Research in Learning Technology, 23, 1–13.

    Norris, T., Herrin-Griffith, D., Mckeon, L., & Webb, S. (2012). Using portfolios to introduce the clinical nurse leader to the job market. The Journal of Nursing Administration, 42(1), 47–51. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

    Smith, L. S. (2011). Showcase your talents with a career portfolio. Nursing, 41(7), 54–56. doi:10.1097/01.NURSE.0000398641.62631.8e.

    Thompson, T. L. (2011). Electronic portfolios for professional advancement. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 25(4), 169–170.

    Other Readings

    Optional or supplemental readings may or may not be available in the library. Find further information about optional readings here.

    If you have questions about your required course textbooks, please contact Student Support at support@waldenu.edu. NURS 6002 and 6003 Foundations for Graduate Study nursing essay assignment papers.

  • Financial Proposal: Allocation of Resources

    Financial Proposal: Allocation of Resources

    Complete the following components below:

    Develop a strategy to request additional resources.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Justify an allocation of resources, with examples in details that may include:

    Staff

    Hours Per Patient Day (HPPD)

    Full-Time Equivalents (FTE)

    Skill Mix (How do you determine the amount of staff you already have and how many more you may need?

    Develop a communication plan with information about the concepts of costs to share with staff.

    Develop a plan to interpret cost accounting.

    Justify value-based purchasing. (describe why value-based purchasing is important and justify value-based purchasing)

    *Should be APA formatted

    *Cite 5 scholarly peer-reviewed articles. Financial Proposal: Allocation of Resources.

  • Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment

    Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment

    NURS 6630 Week 3 Assignment: Geriatric Depression Therapy

    Introduction

    Depression in the elderly altogether influences patients, families, and groups. Familiarity with inclining and hastening variables can help recognize patients needing screening with instruments, for example, the Geriatric Depression Scale (American Psychiatric Association, 2013). After analysis, consistent development and dynamic drug administration are essential to augment treatment and reduction. Determination of a stimulant solution ought to be founded on the best reaction profile and the most reduced danger of medication collaboration. On the off chance that abatement is not accomplished, then extra medicines, including different medications and psychotherapy, might be considered (Flint & Rifat, 2013). In instances of serious, insane, or recalcitrant depression in the elderly, electroconvulsive treatment is prescribed. This paper considers a case of a 31-year-old Hispanic man with severe depression and the treatment options available. The treatment decisions made are evaluated and the outcomes compared to facilitate greater understanding of geriatric depression therapy. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.

    Decision Point One

    Selected Decision

    Begin Zoloft 25 mg orally daily

    Reason for Selection

    Zoloft is one of the most effective drugs for treatment of severe depression in adults. The patient had a score of 51 when the PMHNP administered MADRS, this is an indication of severe depression. Considering the available antidepressants in this case, phenelzine is recommended for use in areas where other drugs have failed (Stahl, 2014b). Effexor XL on the other hand can be used but has many potential side effects considering the patients history and lifestyle. Thus, Zoloft emerges as the best option. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Expected Results

    The action of Zoloft should be evident within the first two weeks as this is the pharmaceutical expectation from the experiments completed with the drug. By the time the patient comes for checkup after two weeks, he should report ability to sleep at night. The level of concentration should also undergo a boost on administering this drug (Liu, Anderson, Mittmann, Axcell & Shear, 2015). It is also expected that the patient will be motivated to the normal activities and even relate well with people. The patient’s feeling of being an outsider due to the past treatment should start waning off.

    Differences between Expected Results and Actual Results

    When the patient revisited after four weeks and reported a decrease of 25% in the symptoms. This is in the direction of the expectations. However, another outcome was not anticipated, the patient was experiencing erectile dysfunction (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). This is a side effect of the drug that was not expected when the treatment plan was made. Zoloft has a number of potential side effects and erectile dysfunction is one of them though not very common. The rest of the outcomes reflected the expected trend even though the rate was a bit lower than anticipated. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.

    NURS 6630 Week 3 Assignment Decision Point Two

    Selected Decision

    Add augmenting agent such as Wellbutrin IR 150 mg in morning

    Reason for Selection

    The client was experiencing a decrease in the depression symptoms because of administering Zoloft but the same drug had led to erectile dysfunction. It is a good idea to maintain Zoloft for reducing depression and combine it with another antidepressant with abilities to abate erectile dysfunction. Wellbutrin is such an antidepressant that can be used to help the patient’s erection function normally while on depression therapy (Flint & Rifat, 2013). Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment. In this case, the focus is not to treat the side effect of Zoloft as this is not advisable, but it is to introduce an antidepressant and slowly withdraw Zoloft and thereby correcting erectile dysfunction.

    Expected Results

    When Wellbutrin is introduced as augmenting agent, the patient should experience much reduced symptoms. This is because both Zoloft and Wellbutrin will be working to reduce depression and thus the combined effect should be bigger (Flint & Rifat, 2013). In addition, the patient should start having normal erection as a result of the working of Wellbutrin. This should even make the patient better and more motivated.

    Differences between Expected Results and Actual Results – Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment

    The patient visited again after four weeks and he stated that the depressive symptoms had even reduced further. He also informed that the erection dysfunction had been abated. These two outcomes were expected as the therapy was being administered. Nevertheless, different other outcomes from the ones anticipated arose (Gaboda, Lucas, Siegel, Kalay & Crystal, 2014). The patient was feeling jittery and nervous. Either of the two drugs could influence this; Zoloft and Wellbutrin as both are known to cause feelings of anxiety in some cases. Sometimes the feeling of jittery is caused by the kind of dosage of the two drugs. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.

    Decision Point Three

    Selected Decision

    Change Wellbutrin to XL 150 mg orally in AM

    Reason for Selection

    The patient is experiencing jitteriness as the only problem with the current therapy. The effect of medication is as intended and so it is not proper to change just because of the side effect. Jitteriness may be caused by the immediate release of Wellbutrin. Trying to change the administration of Wellbutrin may be the solution to jitteriness. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment. Administering Wellbutrin in its extended release form can help to reduce depression and remove jitteriness. It is not proper to introduce a new drug to treat the side effects of another before trying to modify the dosage of the original drug.

    Expected Results

    Administration Wellbutrin in its extended release form is anticipated to treat jitteriness if in fact the problem is the immediate release of Wellbutrin. It is also expected that the patient will continue experiencing an improved rate of depression reduction (Liu, Anderson, Mittmann, Axcell & Shear, 2015). The ceasing of jitteriness should allow the patient to have confidence in the therapy and are motivated to continue using the medication. The concentration ability of the patient should increase tremendously. The patient should also not have problems with sleeping at night.

    Differences between Expected Results and Actual Results

    The decision seems to be in agreement with the standard way of dealing with side effects of therapy administered to a patient (Laureate Education, 2016g). It was recommended that a drug can be modified in the way it is administered in an attempt to handle the side effects rather than introduce another drug to treat the side effect (Liu, Anderson, Mittmann, Axcell & Shear, 2015). This is because every drug has side effects and so treating one may be just as good as introducing another.

    Impact of Ethical Considerations on Treatment Plan

    Ant-depression therapy in adults has many complications that accompany any medication plan adopted. It involves taking risks, as there are many side effects of the drugs used in this therapy. Some drugs cause patients to have suicidal tendencies (Flint, 2012). Based on the doctor’s evaluation of the patient, some drugs may not be included in the therapy of certain patients. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment. In this case, some drugs may not be used especially those that induce suicidal tendencies as this patient is not interacting with people and that make is risky.

    Conclusion

    Depression in the elderly is a noteworthy, normal, and developing issue that requires treatment. It has genuine ramifications for the patient, family, and group. Recognizable proof took after by a careful evaluation can help manage the determination of a proper upper prescription. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.  There are a few variables to consider when choosing, altering, and changing antidepressants in the elderly. Together, these techniques can help advance the sheltered utilization of antidepressants in the elderly (Flint & Rifat, 2013). Other than medicines, different treatments for wretchedness that may be considered incorporate different types of psychotherapy and neurostimulation, with electroconvulsive treatment as yet being the highest quality level for extreme or crazy discouragement. Geriatric Depression Therapy – NURS 6630 Decision Tree Essay Assignment.

  • NURS 514: Organizational Leadership Discussions and Essay Assignment

    NURS 514: Organizational Leadership Discussions and Essay Assignment

    NURS 514: Organizational Leadership: Topic 1 DQ1

    Discuss the shift to value-based health care and its impact on the roles and responsibilities of advanced registered nurses. What major evolving trends in the health care policy and delivery systems will affect your practice in the next 3-5 years, and how do you think advanced registered nurse leaders will continue to influence the direction of health care

    ORDER A PLAGIARISM-FREE PAPER HERE

    NURS 514: Organizational Leadership: Topic 1, DQ2

    From your experience, how can developing strong interprofessional relationships increase collaboration and benefit patient outcomes or organizational initiatives into today’s dynamic health care environment? What are some ways you can form an interprofessional team and collaborate with other advanced registered nurse roles in support of organizational initiatives or improved patient outcomes? Make sure to incorporate the Interprofessional Education Collaborative (IPEC) competencies in your response. NURS 514: Organizational Leadership Discussions and Essay Assignment.

    NURS 514: Organizational Leadership Topic 2 DQ 1

    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?

    NURS 514: Organizational Leadership Topic 2 DQ2.

    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? NURS 514: Organizational Leadership Discussions and Essay Assignment.

    NURS 514: Organizational Leadership Topic 3 DQ 1

    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

    ORDER NOW FOR A CUSTOMIZED ACADEMIC PAPER

    NURS 514: Organizational Leadership Topic 3 DQ 2

    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. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee

     

    1

    Unsatisfactory

    0.00%

    2

    Less than Satisfactory

    80.00%

    3

    Satisfactory

    88.00%

    4

    Good

    92.00%

    5

    Excellent

    100.00%

    100.0 %Conte

     NURS 514: Organizational Leadership Discussions and Essay Assignment

    5.0 %Driving Forces of EHRS

    A description of the driving forces that related to need for implementing EHRs is not included.

    A description of the driving forces that related to need for implementing EHRs is incomplete or incorrect.

    A description of the driving forces that related to need for implementing EHRs is included, but lacks supporting detail.

    A description of the driving forces that related to need for implementing EHRs is completed and includes supporting detail.

    A description of the driving forces that related to need for implementing EHRs is extremely thorough and includes substantial details.

    5.0 %Key Interprofessional Stakeholders

    Identification of the key interprofessional stakeholders is not included.

    Identification of the key interprofessional stakeholders is incomplete or incorrect.

    Identification of the key interprofessional stakeholders is included, but lacks supporting detail.

    Identification of the key interprofessional stakeholders is completed and includes supporting detail.

    Identification of the key interprofessional stakeholders is extremely thorough and includes substantial details

    10.0 %Change Initiative and Being a Change Advocate

    An outline of how change would be initiated is not included.

    An outline of how change would be initiated is incomplete or incorrect.

    An outline of how change would be initiated is included, but lacks supporting detail.

    An outline of how change would be initiated is completed and includes supporting detail.

    An outline of how change would be initiated is extremely thorough and includes substantial details.

    NURS 514: Organizational Leadership Discussions and Essay Assignment

    5.0 %Impact of the Change on Current Workflows

    A description of how the change will affect current workflows is not included.

    A description of how the change will affect current workflows is incomplete or incorrect.

    A description of how the change will affect current workflows is included, but lacks supporting detail.

    A description of how the change will affect current workflows is completed and includes supporting detail.

    A description of how the change will affect current workflows is extremely thorough and includes substantial details.

    5.0 %Required Resources for Implementation

    Identification of required resources for implementation is not included

    Identification of required resources for implementation is incomplete or incorrect.

    Identification of required resources for implementation is included, but lacks supporting detail.

    Identification of required resources for implementation is completed and includes supporting detail.

    Identification of required resources for implementation is extremely thorough and includes substantial details.

    5.0 %Risks Within Implementation

    A description of potential risks within the implementation plan is not included.

    A description of potential risks within the implementation plan is incomplete or incorrect.

    A description of potential risks within the implementation plan is included but lacks supporting detail.

    A description of potential risks within the implementation plan is completed and includes supporting detail.

    A description of potential risks within the implementation plan is extremely thorough and includes substantial details.

    NURS 514: Organizational Leadership Discussions and Essay Assignment

    5.0 %Potential Barriers

    A description of potential barriers when implementing the change and handling resistance is not included.

    A description of potential barriers when implementing the change and handling resistance is incomplete or incorrect.

    A description of potential barriers when implementing the change and handling resistance is included, but lacks supporting detail.

    A description of potential barriers when implementing the change and handling resistance is completed and includes supporting detail.

    A description of potential barriers when implementing the change and handling resistance is extremely thorough and includes substantial details.

    30.0 %Presentation of Content

    The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear.

    The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information.

    The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other.

    The content is written with a logical progression of ideas and supporting information exhibiting a unity, coherence, and cohesiveness. Includes persuasive information from reliable sources.

    The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea.

    NURS 514: Organizational Leadership Discussions and Essay Assignment

    10.0 %Layout

    The layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability. The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident.

    The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text.

    The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability.

    The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text.

    The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.

    10.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.)

    Inappropriate word choice and lack of variety in language use are evident. Writer appears to be unaware of audience. Use of primer prose indicates writer either does not apply figures of speech or uses them inappropriately.

    Some distracting inconsistencies in language choice (register) or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately.

    Language is appropriate to the targeted audience for the most part.

    The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted audience, and uses figures of speech to communicate clearly.

    The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.

    5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    Slide errors are pervasive enough that they impede communication of meaning.

    Frequent and repetitive mechanical errors distract the reader.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader.

    Slides are largely free of mechanical errors, although a few may be present.

    Writer is clearly in control of standard, written, academic English.

    5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    100 %Total Weightage
     

     

     

     

     

     

     

    NURS 514: Organizational Leadership Discussions and Essay Assignment

    NURS 514: Organizational Leadership

    EssayLeading in a Complex, Evolving

    Environment

    The purpose of this assignment is to examine the impact of contemporary challenges in care delivery facing nursing leadership. Select and research a major issue in the delivery of care facing nurse leaders today and write a 1,250-1,500 word paper addressing the following:

    Explain the issue(s) you have selected. Why is it a problem? What fuels the issue? Who does it impact and what specific impact does it have on patient care?

    Describe an option for addressing the issue from a systems perspective. What entities/interests (stakeholders, organizations, operational systems, political, economic, public, private, patient) must be taken into account and how are they impacted? Be sure to highlight the direct impact the option has on patient care.

    Discuss the qualities and traits needed of nurse leaders to effectively tackle this issue through the proposed option. Incorporate a leadership theory and AONE Nurse Executive or Manager Competencies in your response. NURS 514: Organizational Leadership Discussions and Essay Assignment.

    Finally, discuss the impact not successfully resolving the issue could have on the future of health care delivery.

    Integrate five scholarly sources into your NURS 514: Organizational Leadership Discussions and Essay Assignment paper.

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

    This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

    You are required to submit this assignment to LopesWrite.

    Leading in a Complex, Evolving Environment 

     

    1

    Unsatisfactory

    0.00%

    2

    Less than Satisfactory

    80.00%

    3

    Satisfactory

    88.00%

    4

    Good

    92.00%

    5

    Excellent

    100.00%

    70.0 %Content

     

    10.0 %Major Issue is Care Delivery

    An explanation of the issue selected is not included.

    An explanation of the issue selected is incomplete or incorrect.

    An explanation of the issue selected is included but lacks supporting detail.

    An explanation of the issue selected is completed and includes supporting detail.

    An explanation of the issue selected is extremely thorough and includes substantial details.

    70.0 %Content

     

    20.0 %Option for Addressing the Issue From a Systems Perspective

    A description of potential options for addressing the issue from a systems perspective is not included.

    A description of potential options for addressing the issue from a systems perspective is incomplete or incorrect.

    A description of potential options for addressing the issue from a systems perspective is included but lacks supporting detail.

    A description of potential options for addressing the issue from a systems perspective is completed and includes supporting detail.

    A description of potential options for addressing the issue from a systems perspective is extremely thorough and includes substantial details.

    70.0 %Content

     NURS 514: Organizational Leadership Discussions and Essay Assignment

    20.0 %Qualities and Traits Needed of Nurse Leaders

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is not included.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is incomplete or incorrect.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is included but lacks supporting detail.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is completed and includes supporting detail.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is extremely thorough and includes substantial details.

    70.0 %Content

     

    20.0 %Impact of Unresolved Issue

    A discussion of the impact not successfully resolving the issue could have on health care delivery is not included.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is incomplete or incorrect.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is included but lacks supporting detail.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is completed and includes supporting detail.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is extremely thorough and includes substantial details.

    20.0 %Organization and Effectiveness

     

    7.0 %Thesis Development and Purpose

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear

    Thesis is apparent and appropriate to purpose.

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    20.0 %Organization and Effectiveness

     

    8.0 %Argument Logic and Construction

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    20.0 %Organization and Effectiveness

     

    ORDER A PLAGIARISM-FREE PAPER HERE

    5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    10.0 %Format

     

    5.0 %Paper Format (Use of appropriate style for the major and assignment)

    Template is not used appropriately or documentation format is rarely followed correctly.

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

    5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    100 %Total Weightage

    NURS 514: Organizational Leadership Discussions and Essay Assignment

  • Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage

    Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage

    Diabetes and Drug Treatments

    Diabetes is an endocrine system disorder that affects millions of children and adults (ADA, 2011). If left untreated, diabetic patients are at risk for several alterations including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations. In this Assignment, you compare types of diabetes including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    To prepare:

    Review this week’s media presentation on the endocrine system and diabetes, as well as Chapter 46 of the Arcangelo and Peterson text and the Peterson et al. article in the Learning Resources. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    Reflect on differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

    Select one type of diabetes.

    Consider one type of drug used to treat the type of diabetes you selected including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.

    Think about the short-term and long-term impact of the diabetes you selected on patients including effects of drug treatments.

    By Day 7

    Write a 2- to 3- page Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage paper that addresses the following:

    Explain the differences between types of diabetes including type 1, type 2, gestational, and juvenile diabetes.

    Describe one type of drug used to treat the type of diabetes you selected including proper preparation and administration of this drug. Include dietary considerations related to treatment.

    Explain the short-term and long-term impact of this diabetes on patients including effects of drugs treatments.

    View options

    Course

    Institution

    Announcements

    Reflection: The buzzard, the bat and the bumblebee

    Posted on: Tuesday, January 1, 2019 2:56:31 PM EST

    Dear Class,

    I was in a meeting the other day and this reflection was read to remind us about the many lessons of life. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    Best wishes for a great week!

    Sincerely,

    Dr. Anderson

    The Buzzard, The Bat & The Bumblebee (Author Unknown)

    THE BUZZARD:

    If you put a buzzard in a pen that is 6 feet by 8 feet but that is entirely open at the top, the bird, in spite of its ability to fly, will be an absolute prisoner. The reason is that a buzzard always begins a flight from the ground with a run of 10 to 12 feet. Without space to run, as is its habit, it will not even attempt to fly, but will remain a prisoner for life in a small jail with no top.

    THE BAT:

    The ordinary bat that flies around at night, a remarkably nimble creature in the air, cannot take off from a level place. If it is placed on the floor or flat ground, all it can do is shuffle about helplessly and, no doubt, painfully, until it reaches some slight elevation from which it can throw itself into the air. Then, at once, it takes off like a flash. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    THE BUMBLEBEE:

    A bumblebee, if dropped into an open tumbler, will be there until it dies, unless it is taken out. It never sees the means of escape at the top, but persists in trying to find some way out through the sides near the bottom. It will seek a way where none exists, until it completely destroys itself.

    PEOPLE:

    In many ways, we are like the buzzard, the bat, and the bumblebee. We struggle about with all our problems and frustrations, never realizing that all we have to do is look up!

    That’s the answer, the escape route and the solution to any problem! Just look up.

    Sorrow looks back, Worry looks around, but faith looks up!

    Live simply, love generously, care deeply, speak kindly.

    Posted by: Holly Anderson

    Posted to: NURS-6521N-28,Advanced Pharmacology.2018 Winter Qtr 11/26-02/17-PT27

    Week 6 formal paper-helpful hints

    Posted on: Monday, December 31, 2018 9:49:22 PM EST

    Dear Class,

    Welcome to Week 6! There is a formal paper due this week. Here is some information that you might find helpful for the upcoming Week 6 formal paper. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    Sincerely,

    Dr. Anderson

    **This is important for the Week 6 writing assignment**

    In referencing type 1 and type 2 diabetes, Arabic numerals are used. This nomenclature changed from using Roman numerals (type I and type II) in 1995. Please refer to textbook (Arcangelo & Peterson) chapter 45 (third edition) and chapter 46 (fourth edition) to view the use of the terms type 1 diabetes and type 2 diabetes within the chapter.

    Clinical Pearls:

    Due to the number of insulin preparations on the market, it is essential to identify/clarify the type of insulin used by your patient. (Recommendation of the Institute for Safe Medication Practices [ISMP]).

    Clinical Pearl #2 (this is information I included from an earlier posting):

    The assignment asks to explain “juvenile diabetes”. The term ”juvenile diabetes” is now confusing as children could be diagnosed with type 2 diabetes or type 1 diabetes (Please take note of the nomenclature for type 1 and type 2 diabetes…Roman numerals II or I are no longer utilized.) Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    The way you might want to approach this part of the writing assignment, is to include a one or two line statement in the opening paragraph or paragraph number 2, about JDRF (formerly known as the Juvenile Diabetes Research Foundation…now known as JDRF) and/or the National Diabetes Association (NDA) position on the terminology of ”juvenile diabetes”. The healthcare community (or community standard as it might be called) no longer uses the phrase ”juvenile diabetes”.

    Some of the points to include in the Week 6 writing assignment:

    a. Select one type of diabetes

    b. Mention one drug class with a specific drug from that classification with dosing information (HINT: Think about starting doses, maximum dosages, any US Boxed Warnings, common side effects that a patient might experience and any common drug interactions.)

    c. As a friendly reminder, include the short-term and long-term impact of your selected type of diabetes on the patient including effects of drug treatments. For short-term impact of your selected diabetes drug, think about some possible side effects of the drug. For the long-term impact, think about how high blood glucose affects the body over long periods of time (**HINT: neuropathy, retinopathy and nephropathy**). Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    When generic drug names or drug categories are in the middle of a sentence, it is not necessary to capitalize the first letter (example: simvastatin, cephalosporins, metformin). If the drug name was a brand name product, then the first letter of the word would be capitalized regardless of where the name appears in a sentence (example: Zocor, Micronase, Glucophage).

    In the writing of formal papers, Latin medical abbreviations are not used. The reader of the paper may have little or no knowledge of the subject matter. The information would be written out fully, such as:

    Start the dose at 500mg orally twice a day before breakfast and dinner (not 500mg po bid before breakfast and dinner).

    Abbreviations need to be written out in full the first time they are used in a formal paper. After the first use, then the abbreviation can be used in the formal paper. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

    Example: American Diabetes Association (ADA)

    American with Disabilities Act (ADA)

    Assistant District Attorney (ADA)

    American Dental Association (ADA)

    **This is important for the Week 6 writing assignment**

    In referencing type 1 and type 2 diabetes, Arabic numerals are used. This nomenclature changed from using Roman numerals (type I and type II) in 1995. Please refer to textbook (Arcangelo & Peterson) chapter 45 (third edition) and chapter 46 (fourth edition) to view the use of the terms type 1 diabetes and type 2 diabetes within the chapter. Juvenile Diabetes and Drug Treatments Essay Assignment – Zocor, Micronase, Glucophage.

  • Leading in a Complex, Evolving Environment NURS 514 ESSAY

    Leading in a Complex, Evolving Environment NURS 514 ESSAY

    Leading in a Complex, Evolving Environment NURS 514 Details: 
    The purpose of this assignment is to examine the impact of contemporary challenges in care delivery facing nursing leadership. Select and research a major issue in the delivery of care facing nurse leaders today and write a 1,250-1,500 word paper addressing the following:

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Explain the issue(s) you have selected. Why is it a problem? What fuels the issue? Who does it impact and what specific impact does it have on patient care?

    Describe an option for addressing the issue from a systems perspective. What entities/interests (stakeholders, organizations, operational systems, political, economic, public, private, patient) must be taken into account and how are they impacted? Be sure to highlight the direct impact the option has on patient care. Leading in a Complex, Evolving Environment NURS 514 ESSAY.

    Discuss the qualities and traits needed of nurse leaders to effectively tackle this issue through the proposed option. Incorporate a leadership theory and AONE Nurse Executive or Manager Competencies in your response.

    Finally, discuss the impact not successfully resolving the issue could have on the future of health care delivery.

    ORDER NOW FOR A CUSTOMIZED ACADEMIC PAPER

    Integrate five scholarly sources into your paper.

    Prepare this Leading in a Complex, Evolving Environment NURS 514 assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

    This Leading in a Complex, Evolving Environment NURS 514 assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Leading in a Complex, Evolving Environment NURS 514 ESSAY.

    You are required to submit this Leading in a Complex, Evolving Environment NURS 514 assignment to LopesWrite.

    View Rubric

    Due Date:
     Dec 19, 2018 23:59:59       
    Max Points: 
    160

    Leading in a Complex, Evolving Environment NURS 514

     

    1

    Unsatisfactory

    0.00%

    2

    Less than Satisfactory

    80.00%

    3

    Satisfactory

    88.00%

    4

    Good

    92.00%

    5

    Excellent

    100.00%

    70.0 %Content

     

    10.0 %Major Issue is Care Delivery

    An explanation of the issue selected is not included.

    An explanation of the issue selected is incomplete or incorrect.

    An explanation of the issue selected is included but lacks supporting detail.

    An explanation of the issue selected is completed and includes supporting detail.

    An explanation of the issue selected is extremely thorough and includes substantial details.

    70.0 %Content

     Leading in a Complex, Evolving Environment NURS 514 ESSAY.

    20.0 %Option for Addressing the Issue From a Systems Perspective

    A description of potential options for addressing the issue from a systems perspective is not included.

    A description of potential options for addressing the issue from a systems perspective is incomplete or incorrect.

    A description of potential options for addressing the issue from a systems perspective is included but lacks supporting detail.

    A description of potential options for addressing the issue from a systems perspective is completed and includes supporting detail.

    A description of potential options for addressing the issue from a systems perspective is extremely thorough and includes substantial details.

    70.0 %Content

     

    20.0 %Qualities and Traits Needed of Nurse Leaders

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is not included.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is incomplete or incorrect.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is included but lacks supporting detail.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is completed and includes supporting detail.

    A discussion of the qualities and traits needs of nurse leaders to effectively tackle the issue is extremely thorough and includes substantial details.

    70.0 %Content

     

    20.0 %Impact of Unresolved Issue

    A discussion of the impact not successfully resolving the issue could have on health care delivery is not included.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is incomplete or incorrect.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is included but lacks supporting detail.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is completed and includes supporting detail.

    A discussion of the impact not successfully resolving the issue could have on health care delivery is extremely thorough and includes substantial details.

    20.0 %Organization and Effectiveness

     

    7.0 %Thesis Development and Purpose

    Paper lacks any discernible overall purpose or organizing claim.

    Thesis is insufficiently developed or vague. Purpose is not clear

    Thesis is apparent and appropriate to purpose. Leading in a Complex, Evolving Environment NURS 514 ESSAY

    Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

    Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

    20.0 %Organization and Effectiveness

     

    8.0 %Argument Logic and Construction

    Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

    Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

    Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

    Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

    Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

    20.0 %Organization and Effectiveness

     

    5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use)

    Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

    Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

    Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

    Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

    Writer is clearly in command of standard, written, academic English.

    Leading in a Complex, Evolving Environment NURS 514 ESSAY

    10.0 %Format

     

    5.0 %Paper Format (Use of appropriate style for the major and assignment)

    Template is not used appropriately or documentation format is rarely followed correctly.

    Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

    Template is used, and formatting is correct, although some minor errors may be present.

    Template is fully used; There are virtually no errors in formatting style.

    All format elements are correct.

    5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)Leading in a Complex, Evolving Environment NURS 514 ESSAY

    Sources are not documented.

    Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

    Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

    Sources are documented, as appropriate to assignment and style, and format is mostly correct.

    Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

    100 %Total Weightage

  • The Buzzard, The Bat & The Bumblebee

    The Buzzard, The Bat & The Bumblebee

    THE BUZZARD:

    If you put a buzzard in a pen that is 6 feet by 8 feet but that is entirely open at the top, the bird, in spite of its ability to fly, will be an absolute prisoner. The reason is that a buzzard always begins a flight from the ground with a run of 10 to 12 feet. Without space to run, as is its habit, it will not even attempt to fly, but will remain a prisoner for life in a small jail with no top.

    THE BAT:

    The ordinary bat that flies around at night, a remarkably nimble creature in the air, cannot take off from a level place. If it is placed on the floor or flat ground, all it can do is shuffle about helplessly and, no doubt, painfully, until it reaches some slight elevation from which it can throw itself into the air. Then, at once, it takes off like a flash. The Buzzard, The Bat & The Bumblebee.

    THE BUMBLEBEE:

    A bumblebee, if dropped into an open tumbler, will be there until it dies, unless it is taken out. It never sees the means of escape at the top, but persists in trying to find some way out through the sides near the bottom. It will seek a way where none exists, until it completely destroys itself.

    PEOPLE:

    In many ways, we are like the buzzard, the bat, and the bumblebee. We struggle about with all our problems and frustrations, never realizing that all we have to do is look up!

    That’s the answer, the escape route and the solution to any problem! Just look up.

    Sorrow looks back, Worry looks around, but faith looks up!

    Live simply, love generously, care deeply, speak kindly. The Buzzard, The Bat & The Bumblebee.

  • Cyclothymic Disorder Decision Tree Case Study Essay Assignment Example

    Cyclothymic Disorder Decision Tree Case Study Essay Assignment Example

    Assignment : Cyclothymic Disorder

    For this Cyclothymic Disorder decision tree case study essay assignment example, 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

    THE CASE STUDY

    Cyclothymic Disorder

    BACKGROUND

    SUBJECTIVE

    Stefanie is a 32-year-old female from Puerto Rico who presents to your office today with complaints of difficulty sleeping. You learn that Stefanie can go for a few days with minimal sleep (about 3 hours/night), but does not seem to be fatigued the next day. Stefanie explains that after 3 days with minimal sleep, she “crashes” and has a good night’s sleep. She states that sleep will be “alright” for a few days, even a few weeks, and then she will have a similar issue with sleep.

    You learn throughout the assessment process that Stefanie has had this problem for years. She noticed that it began in college and thought it was just because of the workload and academic demands. However, she found that it persisted after college. She also notices that she has periods where she will engage in increased amounts of goal-directed activity. She states that things will just “pile up” at work and she gets this burst of energy to “make everything right.” She states that these bursts will last most of the day. She states that these periods show up probably every 2 to 3 weeks. Cyclothymic Disorder decision tree case study essay assignment example.

    Stefanie also confesses to problems with being “down in the dumps.” She states that when she has her episodes in which she endeavors to “make everything right,” she feels fantastic and on top of the world. Cyclothymic Disorder decision tree case study essay assignment example. However, when these periods of energy end, she reports that she feels “depressed”—but then states: “well, maybe not depressed, but I definitely feel sad and empty.” She also endorses feelings of fatigue and a decreased ability to concentrate when she is feeling sad. She finally tells you: “I have lived with this for so long, I have to admit that it is finally a relief to tell someone how I feel!”

    OBJECTIVE

    Stefanie is dressed appropriately to the weather. She has no gait abnormalities. Physical assessment is unremarkable. Gross neurological assessment is within normal limits.

    MENTAL STATUS EXAM

    Stefanie is alert and oriented × 4 spheres. Her speech is clear, coherent, goal directed, and spontaneous. Self-reported mood is “sad.” Affect does appear consistent with dysphoria. Eye contact is normal. Speech is clear, coherent, and goal directed. She denies visual or auditory hallucinations. No overt evidence of paranoid or delusional thought processes noted. She denies suicidal or homicidal ideation and is future oriented. Cyclothymic Disorder decision tree case study essay assignment example.

    At this point, please discuss any additional diagnostic tests you would perform on Stefanie.

    1.Decision Point One

    Diagnosis: Cyclothymic disorder

    2.Decision Point Two: Begin Abilify 10mg orally daily

    RESULTS OF DECISION POINT TWO

    – Client returns to clinic in four weeks

    -Stefanie reports that her mood seems a bit more “stable.” She states that she notices that she has not been as “sad” since she started taking the medication. She does report that for the first 2 weeks, she noticed that whenever she went from a lying or sitting to a standing position, she felt “lightheaded.” Cyclothymic Disorder decision tree case study essay assignment example.

    -She does report that the side effect was quite concerning at times. However, she reports that this is no longer happening.

    3.Decision Point Three: Maintain current dose of Abilify

    Guidance to Student

    In order to meet the criteria for a major depressive episode, the client needs to have five or more symptoms (refer to DSM–5 major depressive episode criteria). She only demonstrates criteria # 1: depressed mood most of the day, nearly every day, as indicated by either subjective reports (e.g., feels sad, empty, or hopeless) or observation made by others (e.g., appears tearful); criteria # 6: “fatigue or loss of energy nearly every day”; and criteria # 8: “diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).” Thus, Stefanie does not meet the criteria for a major depressive episode as she only has three out of the needed five criteria for the diagnosis of a major depressive episode.

    In order to meet criteria for a hypomanic episode, the client needs to have a period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day. Stefanie’s symptoms last 3 days. Additionally, during the period of mood disturbance, the person must have three or more of the qualifying symptoms. Cyclothymic Disorder decision tree case study essay assignment example. Stefanie only has an increase in goal-directed activity and distractibility. Thus, Stefanie does not meet criteria for a hypomanic episode as she only has a decreased need for sleep and an increase in goal-directed activity.

    Since Stefanie has symptoms of both hypomania and depression (but does not meet the criteria for a major depressive or hypomanic episode), and since these behaviors do not occur in the context of a drug/substance or medical condition, Stefanie meets the diagnostic criteria for cyclothymic disorder. Cyclothymic Disorder decision tree case study essay assignment example.

    Some providers will treat cyclothymic disorder with pharmacologic agents used to treat bipolar disorder because individuals with cyclothymic disorder have a higher risk of progression to bipolar disorder. However, there is no consensus in the literature as to the optimal treatment, or if prophylactic psychopharmacologic treatment is beneficial in consideration of the side effects associated with antipsychotics and mood stabilizers.

    Stefanie’s symptoms are most consistent with orthostatic hypotension, which is not uncommon when initiating Abilify. At this point, it sounds as if the side effects have subsided. There is nothing to tell us that we should increase the dose. Similarly, there is nothing in the case to tell us that we should discontinue the Abilify. Instead, routine monitoring should occur.

    The Assignment:

    .

    At each Decision Point, stop to complete the following:

    Decision #1: Cyclothymic 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.

    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. Cyclothymic Disorder decision tree case study essay assignment example.

    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.

    o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Cyclothymic Disorder decision tree case study essay assignment example.

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

     

    Psychiatric Mental Health Nurse Practitioner Role I1: Adult – NURS 6670 – Cyclothymic Disorder decision tree case study essay assignment example

     

                                         Decision #1: Differential Diagnosis

                                                     Cyclothymic disorder

                                                     Reason for this Decision

    Cyclothymic disorder is a mild form of bipolar disorder in which a patient has mood swings throughout two years. The patient has a fluctuating mood swing between depression and hypomania with irritability and a short period of regular activity in between. The patient may sometimes deny that a problem exists. The Cyclothymic disorder starts in adolescence with 15 to 50 percent possibility of developing bipolar type 1 (Tracy, 2012). Patient with this disorder is known to abuse alcohol and other substance abuse. The patient also has a history of multiple religious cults and dilettantism (Saddock, Sadock & Pedro, 2014).   Cyclothymic Disorder decision tree case study essay assignment example.

                What was Hoping to Achieve by Making this Decision

    The patient (Stephanie) is a 32-year-old Hispanic female from Puerto Rican. She is well dressed for the weather. Stephanie is alert oriented x 4. Her speech is clear, spontaneous, goal-directed and coherent. Her gross neurological assessment is within reasonable limits with a steady gait. She denies any homicidal or suicidal ideation. No auditory or visual hallucinations reported (Laureate Education, 2017d).

    Patient Stephanie has been having the following issues for the past two years. She complains of sleeping about 3 hours for few days without being tired and other days have a good night sleep. She experiences period depression now and then, hypomanic phases with enhanced energy, fatigue, sad when unable to concentrate or think good. Cyclothymic Disorder decision tree case study essay assignment example. She had distractibility and enhanced goal-directed activity. Patient symptoms are indicative of cyclothymic disorder (Laureate Education, 2017d).

    Difference between Expected outcome and Achieve outcome with Decision #1

    There is no difference between the expected outcome and the achieve an outcome. The Patient symptoms of mood swings between hypomania and depression, fatigue, high energy, distractibility, decrease the need for sleep and enhanced goal-directed activity are indicative of Cyclothymic disorder
    .

                                     Decision #2: Treatment Plan for Psychotherapy

    Begin Abilify 10mg orally daily

                                                    Reason for this Decision

    Abilify is known to be effective with improving psychotic and manic symptoms within a week but take several weeks for full effect on behavior, cognition and affective stabilization. It increases dopamine output when the concentrations are low, consequently enhancing cognitive, behavioral and affective symptoms. It also reduces dopamine output when the concentrations are high, therefore improving mediating antipsychotic actions and positive symptoms (Stahl, 2014). Cyclothymic Disorder decision tree case study essay assignment example.

    The efficacy of the medication shows between 4–6 weeks for some patient but takes up to 16–20 weeks to show the effect on cognitive symptoms. Educating the patient about the side effect of the medication is crucial. Cyclothymic Disorder decision tree case study essay assignment example. The following baseline of blood pressure, weight, fasting plasma glucose, and fasting lipid profile must be taken and check within three months after starting the medication (Stahl, 2014).The patient is educated about the medication and the side effects (dizziness, hypotension, sedation, nausea, vomiting, headache.

    The patient will be informed to go for psychotherapy because it increased patient awareness of their diagnosis and helped cope with their mood swings. Cyclothymic Disorder decision tree case study essay assignment example. It also helps to prevent full-blown manic attacks from happening (Saddock, Sadock & Ruiz, 2014).

                What was Hoping to Achieve by Making this Decision?

    The aim of giving the patient Abilify is to help stabilize her mood and ability to think well and prevent a full-blown manic attack from happening. When the patient returns for follow up, she will express feeling a little better.

    The Difference between what is Expected and the Achieve outcome with Decision #2

    The expected outcome and achieved outcome are the same. The medication was reduced the symptoms of cyclothymic disorder and the side effect was expected. The patient returned to the clinic for follow-up after four weeks and reported that the medication had helped her not feel sad, but she noted some dizziness which had subsided.

    Decision #3: Treatment Plan for Psychopharmacology

                                                Decision Point Three

                                         Maintain current dose of Abilify

    Reason for Decision

    It is crucial to continue with the same dosage of medication because the patient is doing fine, and the side effect of drugs had disappeared. Increasing the medication or have the patient halting the medication will not able at an advantage to the patient. It is vital to continue to monitor patient progress. Cyclothymic Disorder decision tree case study essay assignment example.

                       What was Hoping to Achieve by Making this Decision?

    The expectation is to achieve significant decreased in patient’s symptoms and to halt relapse of cyclothymic symptoms.

    Expected Result with this Decision.

    The expected result is that the patient will continue to do well with the medication with little or no side effect and prevent relapse. The patient is expected to be doing well with psychotherapy to help with behavioral symptoms.

          Difference between Expected Result and the Achieved Result with Decision

    The expected result and achieved result are the same. Ms. Stephanie returned to the clinic showing decreases symptoms of swing mood and no report of sadness or any issues.

    Ethical Considerations

    It is crucial to consider the following ethical issue while providing care for this patient which beneficence, autonomy, and nonmaleficence. It is significant to assess the patient thoroughly and provided the best treatment without any harm. It is imperative to consider and respect a patient autonomy when providing care. Cyclothymic Disorder decision tree case study essay assignment example.

     

        
                                                  References

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

    Laureate Education (Producer). (2017d).
    A young woman with depression
    [Multimedia file] 
    Baltimore, MD: Author.

    Perugi, G., Hantouche, E., & Vannucchi, G. (2017). Diagnosis and Treatment of Cyclothymia: The “Primacy” of Temperament.
    Current Neuropharmacology
    ,
    15
    (3), 372–379.
     https://doi-
    org.ezp.waldenulibrary.org/10.2174/1570159X14666160616120157

    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. Cyclothymic Disorder decision tree case study essay assignment example.

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

    Tracy, N. (2012). Bipolar Spectrum Disorders – What is Cyclothymia?.  Retrieved from 

    Bipolar Spectrum Disorders – What is Cyclothymia?

    Van Meter, A., Youngstrom, E., Freeman, A., Feeny, N., Youngstrom, J. K., & Findling, R. L. (2016). Impact of Irritability and Impulsive Aggressive Behavior on Impairment and Social Functioning in Youth with Cyclothymic Disorder.
    Journal Of Child And 
     Adolescent Psychopharmacology
    ,
    26
    (1), 26–37.
    https://doi-rg.ezp.waldenulibrary.org 
     /10.1089/cap.2015.0111. Cyclothymic Disorder decision tree case study essay assignment example.

  • PICO Analysis of Delirium Sample Essay

    PICO Analysis of Delirium Sample Essay

    With the aging of our population, cognitive aging has emerged as a leading public health concern. In a 2014 AARP survey, 93% of respondents identified maintaining brain health as a top priority (Inouye, 2015). Yet a substantial void exists in the fundamental understanding of the cognitive aging process and its distinction from cognitive impairments such as delirium and dementia-related conditions. Nearly one third of the older population in the United States is hospitalized each year in relation to acute illness or surgery, and delirium is the most common complication of hospitalization in older persons, and it occurs in an estimated 2.6 million of older adults each year. Delirium has been identified as a leading contributor to short and long term cognitive decline after hospitalization, and at least 40% of these cases are preventable when identified. PICO Analysis of Delirium Sample Essay. The purpose of this analysis is to ascertain a PICO question related to delirium, identify resources used to find supportive literature, review the supportive information, and create an evidence-based table summarizing the data to determine the best delirium screening options.

    ORDER A PLAGIARISM-FREE PAPER HERE

    PICO Question

    In older adult patients with delirium (P), what are the best delirium screening tools (I) compared to the Diagnostic and Statistical Manual or International Classification of Diseases used in defining the diagnosis of delirium (C) to improve early detection and management in older adult patients with delirium (O)?

    Search Strategy

    To find research to support the chosen PICO question, electronic databases such as CINAHL, Google Scholar, PubMed, PsychInfo, and Medline were used. The Hartford Institute for Geriatric Nursing, the American Geriatrics Society as well as the book
    Evidence-Based Geriatric Medicine
    were also used as resources. PICO Analysis of Delirium Sample Essay. The following keywords and phrases were used to search: delirium screening tools, aging, older adults, geriatric, and primary care setting. Articles that were older than five years old as well as secondary sources were excluded.  Articles that applied to the geriatric population, and analyzed the various delirium screening tools and met the criteria were included. The following Boolean search strings were used: delirium screening tools systematic review, and delirium and aging.

     

    Analysis of Literature

    Evidence Table

    Citation

    Conceptual Framework

    Finding

    Research Method

    Implications of Literature Review

    Level of Evidence

    O’Sullivan, D., O’Regan, N. A., & Timmons, S. (2016). Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening Cognitive Impairment: A Review. 
    Dementia and Geriatric Cognitive Disorders
    , 
    42
    (1-2), 42-49. doi:10.1159/000448241. PICO Analysis of Delirium Sample Essay.

     

    Descriptive Theory

    The
    Six-Item Cognitive Impairment Test (6-CIT)
    has been suggested as a useful dementia screening instrument in primary care. The studies on the 6-CIT in primary care present conflicting results and all 3 have significant variations in their selection of cases/reference standards used.

    Systematic Review of Literature

     Although researchers have investigated its accuracy in diagnosing cognitive impairment in primary and secondary care settings, its validity in primary care use has been questioned and there are limited validation studies on its use in secondary care. In addition, the cut-offs used in 2 of the studies favored specificity over sensitivity, which is not desirable for a screening test. The authors recommend that larger studies, which test the psychometric properties of the 6-CIT in primary and acute care settings, are conducted to establish recommendations for routine screening use.

    Level I

    De, J. & Wand, A. (2015). Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients,
    The Gerontologist
    , 55(6), 1079–1099. Retrieved from https://doi.org/10.1093/geront/gnv100. PICO Analysis of Delirium Sample Essay

    Descriptive Theory

    Thirty-one studies describing 21 delirium screening tools were included in the systematic review. Most studies were conducted across a broad range of inpatient settings internationally in elderly inpatients, including patients with dementia but most excluded nonnative language speakers.

    Systematic Review of Literature

    The Confusion Assessment Method was the most widely used instrument to identify delirium, however, specific training is required to ensure optimum performance. The Delirium Rating Scale and its revised version performed best in the psychogeriatric population but requires an operator with psychiatric training. The Nurses’ Delirium Screening Checklist appears best suited to the surgical and recovery room setting. The Single Question in Delirium shows promise in oncology patients. The Memorial Delirium Assessment Scale, while demonstrating good measures of validity in the surgical and palliative care setting, may be better used a measure of delirium severity. The 4As Test performed well when delirium was superimposed on dementia, but it requires further study.

    Level I

    PICO Analysis of Delirium Sample Essay

    Iatraki, E. et al. (2017). Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General Practitioner assessment of Cognition’ tools in a rural aging population in Greece.
    European Journal of General Practice
    , 23(1), 171-178. Retrieved from http://dx.doi.org/10.1080/13814788.2017.1324845

    Predictive Theory

    The ‘
    Test Your Memory’ (TYM)
    and
    ‘General Practitioner assessment of Cognition’ (GPCog)
    instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations.

     

    Randomized Control Trials (RCT)

    PICO Analysis of Delirium Sample Essay

    The clinical validity of TYM/GPCog was assessed through comparison with a screening test that was used to establish risk for cognitive impairment instead of clinical diagnosis of dementia. Although, MMSE is widely used and considered by many as the gold-standard instrument for dementia screening, it has far from perfect sensitivity or specificity. The limited gender and education-level susceptibility of GPCog render it preferable over TYM for routine use in primary care settings in accordance with a growing number of studies in other cultures.

    Level II

    Bellelli, G., Morandi, A., Davis, D. H. J., Mazzola, P., Turco, R., Gentile, S., … MacLullich, A. M. J. (2014). Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496–502. http://doi.org/10.1093/ageing/afu021. PICO Analysis of Delirium Sample Essay

    Prospective Study

    The
    4AT
    screening tool is a sensitive and specific method of screening for delirium in older people. Its brevity and simplicity support its use in routine clinical practice.

    Cross-Sectional Observation Study

    A strength of this study is the provision of a clear description of exactly how the delirium diagnosis was obtained, detailing the procedure which informed scoring by DSM-IV-TR criteria. Some limitations of this study must be acknowledged. The 4AT assessments were performed by experienced physicians, though no specific training in the 4AT was given. Further research is needed to assess the ease of use of 4AT among other professional groups of varying levels of seniority. The clinical outcomes in relation to ‘possible delirium’ as assessed by the 4AT was not studied.

     

    Level II. PICO Analysis of Delirium Sample Essay

    Fick, D. & Mion, L. (2013). Assessing and Managing Delirium in Older Adults with Dementia. Retrieved from https://consultgeri.org/try-this/dementia/issue-d8.pdf

     

    Geriatric Models of Care

    The Hartford Institute states that the best tools for delirium screening in the older adult population are the
    Confusion Assessment Method (CAM)
    algorithm, which relies on the presence of acute onset of symptoms and a fluctuating course, inattention, and either disorganized thinking or an altered level of consciousness; and the
    Delirium Superimposed on Dementia Algorithm (DSDA)
    is recommended for delirium for people with a pre-existing dementia (Fick and Mion, 2013).

    Evidence-Based Practice Guidelines (systematic reviews, RCTs, Cohorts)

    PICO Analysis of Delirium Sample Essay

    While the CAM is a useful tool, the Delirium Superimposed on Dementia Algorithm recognizes that the patient’s baseline mental status is a critical parameter for assessing and treating delirium. The algorithm presents practical ways for bedside nurses to assess delirium and CAM features such as poor attention and fluctuation. The algorithm can be used with patients with dementia who present to the hospital without previous medical evaluation, and/or family members who cannot describe the patient’s mental status pre-hospitalization, who are at increased risk for undetected delirium. The algorithm helps address ageism, a significant barrier to detecting the presence of delirium, wherein clinicians attribute further cognitive loss or lethargy in a person with dementia as an inevitable fact of life for older adults.

    Level I

     

    Purpose of Research Paper

    Delirium is a common, often underdiagnosed, geriatric syndrome characterized by an acute change in attention and consciousness. The elderly population, especially those who are age 70 and older are particularly vulnerable to delirium than those younger due to changes in brain function, multiple general medical problems, polypharmacy, reduced hepatic metabolism of medications, multisensory declines, and brain disorders such as dementia. Polypharmacy is very common in the elderly, and the possibility of drug-drug interactions must be considered as a cause of agitation. PICO Analysis of Delirium Sample Essay. According to Rosen et al (2015), Delirium is frequently seen in older patients in the emergency department (ED), is under-recognized, and has potentially serious consequences. About 7–17% of older adults who present to the ED suffer from delirium (Rosen, 2015). Delirium is a medical emergency with significant associated morbidity and mortality requiring rapid diagnosis and management. Delirium has been identified as a leading contributor to short and long term cognitive decline after hospitalization, and at least 40% of these cases are preventable. As a neuropsychiatric disorder with an underlying organic cause, delirium is known to occur as both an acute and subacute condition that carries significant morbidity and mortality. Combined with its association with dementia and aging, this makes delirium an important topic for primary care providers to become more familiar with as they are tasked with caring for an aging population (Setters and Solberg, 2017).

    Gaps in Existing Literature

    Presently, there are very few RCTs and studies assessing the effectiveness of delirium screening tools in older adults with delirium in primary care settings. Most of the research focused mostly in acute care/hospital settings. A role for routine delirium screening can be clarified through a well-designed delirium screening trial investigating the benefits of delirium screening, coupled with a multicomponent intervention versus usual care.  PICO Analysis of Delirium Sample Essay. It could be challenging to measure emotions and cognitive improvement in a consistent manner across patients. Studies are needed to rigorously evaluate the benefits and potential harms of screening in relation to multiple outcomes such as medical intervention requirements, preventive strategies, delirium reversibility, care needs and economic burden.

    Conclusion

    Despite the limitations on the available research, most data show that the Confusion Assessment Method is widely used, and can used in any clinical setting. And for the patients with underlying dementia conditions, then, the Delirium Superimposed on Dementia Algorithm is recommended per evidence-based practice guidelines. Poor attention is a key marker in delirium and delirium superimposed on dementia patients. In addition, evaluations of the elderly should include a comprehensive review of all drugs being taken, including those that are prescribed, and those taken OTC and herbals. Delirium is often multifactorial and requires an immediate medical attention. Health practitioners should make it a habit to evaluate elderly patients for signs of delirium in every clinical setting especially in primary care settings as it often overlooked. PICO Analysis of Delirium Sample Essay.

     

    References

    Alaglakrishnan, K. (2017). Delirium. Retrieved from

    http://emedicine.medscape.com/article/288890-overview

    Arcangelo, V. P., & Peterson, A. M. (2013). 
    Pharmacotherapeutics for advanced

    practice: A practical approach
     (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins
    .

    Bellelli, G., Morandi, A., Davis, D. H. J., Mazzola, P., Turco, R., Gentile, S., … MacLullich, A. M. J. (2014). Validation of the 4AT, a

    new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age and Ageing, 43(4), 496–502. http://doi.org/10.1093/ageing/afu021

    De, J. & Wand, A. (2015). Delirium Screening: A Systematic Review of Delirium Screening Tools in Hospitalized Patients,
    The

    Gerontologist
    , 55(6), 1079–1099. Retrieved from https://doi.org/10.1093/geront/gnv100

    Fick, D. & Mion, L. (2013). Assessing and Managing Delirium in Older Adults with Dementia. PICO Analysis of Delirium Sample Essay. Retrieved from https://consultgeri.org/try-this/dementia/issue-d8.pdf

    Fong, T. G., Tulebaev, S. R., & Inouye, S. K. (2009). Delirium in elderly adults: diagnosis,

    prevention and treatment. Nature Reviews. Neurology, 5(4), 210–220. http://doi.org/10.1038/nrneurol.2009.24

    Iatraki, E. et al. (2017). Cognitive screening tools for primary care settings: examining the ‘Test Your Memory’ and ‘General

    Practitioner assessment of Cognition’ tools in a rural aging population in Greece.
    European Journal of General Practice
    , 23(1), 171-178. Retrieved from http://dx.doi.org/10.1080/13814788.2017.1324845. PICO Analysis of Delirium Sample Essay.

    Inouye, S. K. (2015). Enhancing cognitive aging: clinical highlights of a report from the Institute of Medicine. 
    Annals Of Internal

    Medicine
    , 
    163
    (4), 307-310. doi:10.7326/M15-1228

    National Institute on Aging (2013). The Dementias: Hope through Research. Retrieved from https://www.nia.nih.gov/alzheimers/publication/dementias/treatment

    O’Sullivan, D., O’Regan, N. A., & Timmons, S. (2016). Validity and Reliability of the 6-Item Cognitive Impairment Test for Screening

    Cognitive Impairment: A Review. 
    Dementia and Geriatric Cognitive Disorders
    , 
    42
    (1-2), 42-49. doi:10.1159/000448241

    Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., & Flomenbaum, N. PICO Analysis of Delirium Sample Essay.  (2015). Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol. Advanced Emergency Nursing Journal, 37(3), 183–E3. http://doi.org/10.1097/TME.0000000000000066

    Setters, B., & Solberg, L. M. (2017). Delirium. 
    Primary Care
    , 
    44
    (3), 541-559. doi:10.1016/j.pop.2017.04.010. PICO Analysis of Delirium Sample Essay.

  • Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

    Assignment 1: Practicum: Decision Tree

    For this Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives

    Students will:

    ORDER A PLAGIARISM-FREE PAPER HERE

    Evaluate clients for treatment of mental health disorders

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

    The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree:

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

    At each Decision Point, stop to complete the following:

    Decision #1: Differential Diagnosis

    Which Decision did you select?

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

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

    Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Decision #2: Treatment Plan for Psychotherapy

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

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

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

    Decision #3: Treatment Plan for Psychopharmacology

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

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

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

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

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

     

    BACKGROUND

    Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.

    Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”

    Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

    OBJECTIVE

    During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.

    When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

    MENTAL STATUS EXAM

    Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.

    Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.

    Decision Point One

    BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?

    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.

    Generalized Anxiety Disorder (GAD)

    Obsessive Compulsive Disorder

    Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

    Decision Point One

     
    Generalized Anxiety Disorder (GAD)

    Decision Point Two

    Begin Paxil 10 mg orally daily

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved.

    Decision Point Three

    Increase Paxil to 20 mg orally daily

    Guidance to Student

    While GAD was not the actual diagnosis in this case, the child’s OCD symptoms did decrease with Paxil. Although Paxil is not FDA-approved for treatment of OCD in children, it is an SSRI like Sertraline and Fluvoxamine, which are FDA-approved for the treatment of OCD. So if there are no objectionable side effects and the symptoms appear to be decreasing, there may be no need to change drugs, but optimizing the dose may be a better choice. Augmentation with psychotherapy may also be useful, but the current dose of Paxil is still somewhat low, so augmenting with psychotherapy would be a good idea, but in and of itself would not be sufficient to meet this child’s needs.

    Finally, while the PMHNP could consider changing to Fluvoxamine, the “controlled release” preparation is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s 
    Prescriber’s Guide
     for further details). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation.

    Decision Point Two

     

    Begin Zoloft 50 mg orally daily

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. Tyrel’s mom is concerned about the decrease in Tyrel’s appetite. She reports that he has been having some decreased appetite and has complained of feeling “sick to his stomach.”

    Decision Point Three

    Change to Fluvoxamine controlled release 100 mg orally every morning

    Guidance to Student

    In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

    Although the child had OCD and not GAD, Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. Starting at too high a dose can result in unfavorable side effects (gastrointestinal side effects are notable in this drug), and we can see that Tyrel is experiencing nausea and decreased appetite. In this case, it is recommended to wait to see if the side effects dissipate. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Decreasing the dose to 12.5 mg orally daily for about 3 or 4 days, then going back to 25 mg orally daily may help to overcome the unfavorable side effects. If side effects persist, the PMHNP may need to consider switching to a different medication.

    Fluvoxamine controlled release is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s 
    Prescribers Guide
     for further details). Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation. It is also worth noting that nothing in the scenario tells us that the Zoloft will not be effective.

    Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. However, in this case, the PMHNP assumed he/she was working with GAD, which may have delayed some of the work of CBT—that is, the focus of the sessions would have focused on the obsessive thoughts/compulsive behaviors versus a generalized anxiety. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. However, in this case, the diagnostic challenge made it difficult.

    Decision Point One

     
    Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

    Decision Point Two

    Refer client to a pediatric neurologist

    RESULTS OF DECISION POINT TWO

     Client returns to clinic in four weeks

     You learn that the pediatric neurologist completed a comprehensive assessment on Tyrel, and although symptoms of OCD seem to have occurred after he was sick, and although antistreptolysin O titers were elevated, there is insufficient evidence for the diagnosis of PANDAS.

    Decision Point Three

    Begin Risperdal 0.5 mg orally twice a day

    Guidance to Student

    If the PMHNP believes that PANDAS is the most likely diagnosis, he or she should consider the nature of the disorder and the extent of the management, which may include high doses of steroids, the potential for plasma exchange therapy, and possibly monoclonal antibody therapy. A scope of practice considerations should be undertaken—that is, does the PMHNP have the necessary knowledge, skills, and abilities to undertake the care of this client? The PMHNP should consider working in collaboration with the pediatric neurologist to optimize outcomes for this client and his family. Although antistreptolysin O and other titers indicate recent alpha streptococci infection, it should be noted that these titers can remain elevated for weeks after the infection and do not necessarily represent the development of negative sequelae such as PANDAS.

    In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

    Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. In this scenario, Fluvoxamine (immediate release) 25 mg orally daily would be the most appropriate agent.

    Week 7: Learning and Motor Disorders in Childhood

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

    Samuel, age 9

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

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

    Photo Credit: PT Images

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree 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.

    Standard 9 “Evidence-Based Practice and Research” (pages 71-72)

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

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

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

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

    “Neurodevelopmental Disorders”

    “Specific Learning Disorder”

    “Motor Disorders”

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

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

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

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

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

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

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

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

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

     

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

     

    To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Review the following medications:

    Tourette syndrome

    Pervasive developmental disorders

    clonidine

    haloperidol

    pimozide

    guanfacine

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

    Optional Resources

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

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

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Discussion: Parent Guide

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

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

    Learning Objectives

    Students will:

    Analyze signs and symptoms of learning and motor disorders in childhood

    Analyze pathophysiology of learning and motor disorders in childhood

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

    Evaluate Parent Guides

    To Prepare for this Discussion:

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

    Review the resources concerning your assigned disorder.

    Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the 
    Accessing Group Discussions
     instructions below. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

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

    Signs and symptoms

    Pathophysiology

    How the disorder is diagnosed

    Treatment options

    Provide a minimum of three academic references.

    By Day 5

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

    By Day 7

    Respond
     to at least 
    two
     other groups’ wikis by providing at least two contributions for improving or including in their Parent Guide and at least two things that you like about their guide. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

    Submission and Grading Information

    Accessing Group Discussions and Wikis

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

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

    Creating a Wiki Page

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

    Grading Criteria

    To access your rubric:

    Week 7 Parent Guide Discussion Rubric

    To access your group discussion / wiki:

    Parent Guide Groups

    Post to Discussion by Day 5 and Respond by Day 7

    To participate in this Discussion:

    Parent Guide Groups – Week 7

    Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment

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

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

    Scenario for Week 7 Case:

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

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives

    Students will:

    Evaluate clients for voluntary commitment

    Evaluate clients for involuntary commitment based on state laws

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

    Recommend actions for treating clients not eligible for involuntary commitment

    To Prepare for this Practicum:

    Review the Learning Resources concerning voluntary and involuntary commitment.

    Read the Week 7 Scenario in your Learning Resources.

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

    The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree (2–3 pages):

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

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

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

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

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

    By Day 7

    Submit 
    your Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Assignment.

    Submission and Grading Information

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

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

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

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

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click 
    Open
    . Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

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

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 7 Assignment 1 Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 7 Assignment 1

    Assignment 2: Practicum: Week 5 Decision Tree

    By Day 7

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

    Submission and Grading Information

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

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

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

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

    Next, from the Attach File area, click on the 
    Browse My Computer
     button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click 
    Open
    . Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

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

    Click on the 
    Submit
     button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 7 Assignment 2 Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

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

    Submit Your Assignment by Day 7

    To submit your Assignment:

    Week 7 Assignment 2

    Assignment 3: Board Vitals

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

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

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

    https://www.boardvitals.com/

    By Day 7

    Complete the Board Vitals questions.

    Practicum Reminder

    Time Logs

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

    Making Connections

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

    Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Next week, you will debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents.