.
Tag: Clinical-Nursing
-
NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
Comprehensive SOAP Template
Patient Initials: AC Age: 68 Gender: Male
SUBJECTIVE DATA: “
About a week ago, I noticed some rash on my right chest, back, and neck. I thought it would get better, but the rash is itchy and painful, it has also gotten worse. I also feel a little feverish.” NURS-6512 Differential Diagnosis for Skin Conditions SOAP noteChief Complaint (CC):
The patient reported noticing skin abnormality about a week ago, “I have an itchy rash on my neck, chest, and back that is peeling and getting worse.” The rash is swollen with clear liquid and painful.History of Present Illness (HPI):
Mr. Alexander Cortez is a 58-year-old Hispanic male. Presents with a patchy rash on the neck, chest, and back region. He states that the rash started about two weeks ago and has progressively gotten worse. He denies changing skin routine or location within the last two weeks, no history of environmental allergies, no known allergy to dye, or latex. Mr. Cortez states he has not tried any treatment for the rash, no worsening, or alleviating factors noted. He complained of pain level 7 on a scale of 1-10. He describes the pain as sharp and states Tylenol 1000mg has helped relieve the pain. He is worried about the rash getting worse and states that the rash and its associated pain interferes with his daily activities and quality of life. NURS-6512 Differential Diagnosis for Skin Conditions SOAP noteMedications:
– Acetaminophen 1000mg
PO Q 6 HRS for pain
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
– Metformin 500mg daily for diabetes
– Atorvastatin 40mg at bedtime for high cholesterol
– Hydralazine 10mg BID for Hypertension
– Amlodipine 5mg daily for hypertension
Allergies:
– Penicillin Reaction (itching)
Past Medical History (PMH):
Hypertension-diagnosed at 43 years old
Hyperlipidemia- diagnosed at 45 years old
Diabetes Mellitus Type 2 diagnosed at 38 years old
Chickenpox: 7 years old
Appendicitis – hospitalization at 28 years old
Past Surgical History (PSH):
Appendectomy 1992
Sexual/Reproductive History:
Currently sexually active with his wife, he denies sexual/reproductive issues. Heterosexual and currently using no barrier methods, no past history of STDs.
Personal/Social History:
The patient is a non-smoker, never smoked. His wife smokes 1pack/day. Mr. Cortez drinks alcohol occasionally, about 1-2 drinks a week. He denies the use of recreational drugs.
Immunization History:
Received flu shot last season
Received pneumococcal vaccine 8/12/2019 during the annual check-up
He does not remember the last tetanus vaccination.
Significant Family History:
-Mother had diabetes mellitus type 2 and died from diabetes complication at 81
-Father had chronic hypertension and died at the age of 78 from a stroke
-Patient does not recall the medical history of grandparents
-Denies any noted illness for his siblings and children.
Lifestyle:
Mr. Cortez runs a small family construction business, which he runs with his son. He is a Christian and attends church with his family every Sunday. The highest level of education is high school with certifications in HVAC and plumbing. He lives at home with his wife, daughter, who is a single mother and grandson. His wife works full time as a secretary, and his health coverage is through his wife’s job. He states he is too busy to exercise, and his diet comprises mainly of heavy meals due to his job. Reports drinking socially, about 2-3 drinks weekly, mostly beer. Never smoked, denies the use of recreational or illicit drugsReview of Systems
General:
Mr. Cortez appears well dressed and well-nourished. Denies weakness and fatigue. No recent weight changes or changes in appetite. No apparent signs of distress.HEENT:
The patient uses glasses, denies vision changes, discharge from eyes, tinnitus, hearing loss, and discharge from ears. Denies loss or decreased sense of smell, nasal drainage, or congestion.Neck:
The patient denies any injury to the neck, swelling, or history of compression. Rash currently present in the neck region.Breasts:
denies lump, discharge, or rashRespiratory:
denies shortness of breath, denies cough or respiratory distress, no history of respiratory disorders except occasional seasonal allergiesCardiovascular/Peripheral Vascular:
Denies chest pain, reports history of hypertension and high cholesterol. He denies history of stroke, edema or heart failure.Gastrointestinal:
Denies nausea or vomiting, and diarrhea. Reports consistent bowel movement every two days.
He also reported that his wife occasionally gives him prune juice to aid his
occasional constipation.Genitourinary:
Pt denies any feeling of urgency or urinary retention. No history of UTI or incontinence denies burning sensation when urinating, denies frequency, and urgency.Musculoskeletal:
The patient reported a history of fall six months ago when he woke up and could not find his cane at the bedside. The patient stated that he takes 30 mins to walk in the evenings three times per week with his wife.Psychiatric:
The patient denies any history of mental illness, no suicidal or homicidal ideations. Reports no history of mental illness in his family.Neurological:
The patient reported feeling lightheaded after his fall 6 months ago but was seen by the ER doctor and has not had any dizziness episodes since then. Denies any headaches or sudden/abnormal movements.Skin:
The patient reports a red rash with blisters filled with clear fluid on his right torso and neck. Patient denies any other skin issues, a history of chickenpox when he was eight years oldHematologic:
Denies any abnormal bleeding. Denies any history of bleeding disorder in his family. Never been diagnosed with anemia, no history of incidents with significant blood loss.Endocrine:
Denies any use of hormonal therapies, denies a history of thyroid disorders.Allergic/Immunologic:
Patient denies any history of allergies, reported that he and his children often have seasonal allergies but usually resolves within a few daysOBJECTIVE DATA:
Physical Exam:
Vital signs:
– Blood Pressure: 148/93 mmHg -Weight.: 285 lbs
– Pulse: 76 BPM -Height: 170 cm
– Respiratory Rate: 18 – Blood glucose: 148 mg/dl
– Temperature: 98.9 F
General:
The patient is alert and oriented, able to communicate clearly, posture, and gesture appropriately, maintains eye contact. Well dressed and groomed, appropriate affect, and reaction. Ambulates independently, gait even and steadyHEENT:
Head, Face is symmetrical, bilateral eyes, ears, and nose symmetrical. No drainage or foul odor noted, no discoloration noted.Neck:
No swelling or deviation was noted. No Jugular Vein Distention noted that the carotid artery is palpable bilaterally, rash noted on the right side, and able to move from side to side.Chest:
Equal rise and fall of chest noted. Clear to auscultation Anterior, Posterior and LateralLungs:
Lung sounds clear, bilaterally anteriorly, posteriorly, and laterally. The respiratory pattern regular, the chest wall is symmetrical, no cough is noted.Heart:
No murmurs or palpitations notedPeripheral Vascular:
symmetrical, No edema or discoloration noted in extremities, Pulse regular 2+ pulse in the bilateral pedal, and 2+ in bilateral radial.Abdomen:
Abdomen soft, flat, and non-tender, no distention noted, no organomegaly noted.Genital/Rectal:
External genitalia intact, no swelling or discoloration notedMusculoskeletal:
Uneven gait noted; the patient uses a cane for balance.Neurological:
Alert and oriented to person, place, time, and situation. CN I – XII intactSkin:
Patients’ skin is generally warm, intact, and dry. Red raised vesicles with clear fluids on the right chest, underarms, neck, and back. Site warm to touch. No other skin abnormality was noted.Clinical Terminology for Skin Condition in Graphic five
The skin condition in graphic five presents as a rash, which is red in color. The rash is present on the right lateral side of the patient’s chest and back. Some of the rashes are fluid-filled and appears blistering.
Differential Diagnosis
Contact Dermatitis
: Contact dermatitis is a common skin disorder that occurs after exposure to allergens or irritants (World, Allergy Organization, 2015). Irritants such as soaps, detergents, stool, and urine trigger irritant contact dermatitis while cosmetics, drugs, food, or dye in people genetically predisposed or sensitized triggers allergic contact dermatitis.The skin condition is characterized by red vesicles that are itchy (World, Allergy Organization, 2015). The location of the rash depends on the exposure to allergens. It is often diagnosed with history and physical (American Academy of Allergy Asthma & Immunology, 2019).
Psoriasis
: Psoriasis is an autoimmune skin condition characterized by dry, red, and scaly rash (Nair & Badri, 2018). There are different types of psoriasis, however, psoriasis in general, is often seen with red scales covered with silver scales (Nair & Badri, 2018). The exact etiology of psoriasis is unknown; however, it has been seen to be genetically transmitted (Nair & Badri, 2020). the rash can appear anywhere in the body, including the eyes and scalp; it is also commonly seen in the knees and elbows; thus, the rash location and progression are often used when diagnosing the condition (Nair & Badri, 2020).Shingles
: Shingles is a skin condition also called Herpes Zoster caused by the varicella-zoster virus; it usually occurs in a patient who has previously had chickenpox virus or people older people with weakened immunity. The shingles rash are blistering red vesicles that usually appear in the face and torso (Carter, 2020). The rash may be itchy and painful with a burning or stinging sensation. It commonly affects one side of the body. It is usually diagnosed by the characteristics of the rash (National Institute of Neurological Disorders and Stroke, 2020).Most Likely Diagnosis
Like many other conditions, diagnosing skin conditions starts with a good assessment, history, and physical (Ball, 2019). Assessment of Certain criteria is critical in helping a provider diagnose a skin disorder. For example, location, color, shape, measurement, surrounding skin, and texture of skin disorders will provide insight and help with accurate diagnosis (Ball, 2019). Other presenting symptoms, including systemic symptoms, are also used to identify and diagnose skin conditions (Ball, 2019) NURS-6512 Differential Diagnosis for Skin Conditions SOAP note. When collecting history and physical for skin conditions, it is important to collect a focused history that helps in diagnosing the skin conditions for example, the onset of skin condition, changes, presence of itch or discharge are some of the histories that help to diagnose skin conditions (Ball, 2019). Diagnostic tests can also help providers rule out certain conditions when diagnosing skin disorders. For example, shingles can be identified by testing for herpes or varicella-zoster virus. (Centers for Disease Control and Prevention, 2019).
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
The skin condition presented in this graphic is seen on the torso’s right lateral side; the rash appears to be red, fluid-filled, and blistering. Mr. Cortez states that the rash began about a week ago and is present only on his right side; he denies change in routine or exposure to irritants that could suggest allergic or irritant contact dermatitis. Also, the rash seen in contact dermatitis is scaly (Dains et al., 2019). Psoriasis rash, in this case, is unlikely because while psoriasis rash is red, it is also scaly and often appears on the knees, elbows, lower back, and scalp (Roland, 2018). Also, psoriasis is characterized by unique systemic symptoms such as swollen and painful joints, which Mr. Cortez denies (Davis, 2020). Shingles are the most likely diagnosis in this case because the rash, in this case, is red vesicles clustered together, appears in a linear arrangement, and is located on the right side of the torso without crossing the midline. According to Carter (2020), shingles rash are red lesions that are usually unilateral. During history, Mr. Cortez denies systemic symptoms that may suggest psoriasis; he also denies history, suggesting contact dermatitis. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
References
American Academy of Allergy Asthma & Immunology (2019). Contact dermatitis overview. Retrieved from
https://www.aaaai.org/conditions-and-treatments/library/allergy-library/contact-dermatitisBall, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019).
Seidel’s guide to physical examination: An interprofessional approach
(9th ed.). St. Louis, MO: Elsevier Mosby.Carter, T. M. (2020). Shingles: Not Just a Rash. Journal for Nurse Practitioners, 16(2), 111–115.
https://doi-org.ezp.waldenulibrary.org/10.1016/j.nurpra.2019.10.013
Centers for Disease Control and Prevention (2019). Laboratory Testing for VZV. Retrieved from
https://www.cdc.gov/shingles/lab-testing/index.htmlConceicao, V. (2018). Prevention and management of shingles and associated
complications.
Journal of Community Nursing, 32
(6), 40–43. NURS-6512 Differential Diagnosis for Skin Conditions SOAP noteDains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and
clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Nair, P. A. & Badri, T. (2020). Psoriasis. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK448194/National Institute of Neurological Disorders and Stroke (2020). Shingles Information Page. Retrieved from
https://www.ninds.nih.gov/Disorders/All-Disorders/Shingles-Information-PageRoland, J. (2018). Shingles vs. psoriasis: What’s the difference? Retrieved from
https://www.healthline.com/health/psoriasis/shingles-vs-psoriasis#symptomsWorld, Allergy Organization (2015). Contact dermatitis: Synopsis. Retrieved from
https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/contact-dermatitis-synopsisAssignment 1: Lab Assignment: Differential Diagnosis for Skin Conditions
Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.
To Prepare
Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.
Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
Consider which of the conditions is most likely to be the correct diagnosis, and why.
Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment. NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.
The Lab Assignment
Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of
three to five
possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. NURS-6512 Differential Diagnosis for Skin Conditions SOAP noteBy Day 7 of Week 4
Submit
your Lab 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 “WK4Assgn1+last name+first initial.(extension)” as the name.
Click the
Week 4 Assignment 1 Rubric
to review the Grading Criteria for the Assignment.Click the
Week 4 Assignment 1
link. You will also be able to “View Rubric” for grading criteria from this area.Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click
Open
.If applicable: From the Plagiarism Tools area, click the checkbox for
I agree to submit my paper(s) to the Global Reference Database
.Click on the
Submit
button to complete your submission.NURS_6512_Week_4_Assignment_1_Rubric
Grid View
List View
Excellent
Good
Fair
Poor
Using the SOAP (Subjective, Objective, Assessment, and Plan) note format:
· Create documentation, following SOAP format, of your assignment to choose one skin condition graphic (identify by number in your Chief Complaint). · Use clinical terminologies to explain the physical characteristics featured in the graphic.
30
(30%)
– 35
(35%)The response clearly, accurately, and thoroughly follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response clearly and thoroughly explains all physical characteristics featured in the graphic using accurate terminologies.
24
(24%)
– 29
(29%)The response accurately follows the SOAP format to document one skin condition graphic and accurately identifies the graphic by number in the Chief Complaint. The response explains most physical characteristics featured in the graphic using accurate terminologies.
NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
18
(18%)
– 23
(23%)The response follows the SOAP format, with vagueness and some inaccuracy in documenting one skin condition graphic, and accurately identifies the graphic by number in the Chief Complaint. The response explains some physical characteristics featured in the graphic using mostly accurate terminologies.
0
(0%)
– 17
(17%)The response inaccurately follows the SOAP format or is missing documentation for one skin condition graphic and is missing or inaccurately identifies the graphic by number in the Chief Complaint. The response explains some or few physical characteristics featured in the graphic using terminologies with multiple inaccuracies.
· Formulate a different diagnosis of three to five possible considerations for the skin graphic. · Determine which is most likely to be the correct diagnosis, and explain your reasoning using at least three different references from current evidence-based literature.
45
(45%)
– 50
(50%)The response clearly, thoroughly, and accurately formulates a different diagnosis of five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained clearly, accurately, and thoroughly using three or more different references from current evidence-based literature.
39
(39%)
– 44
(44%)The response accurately formulates a different diagnosis of three to five possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained accurately using at least three different references from current evidence-based literature.
NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
33
(33%)
– 38
(38%)The response vaguely or with some inaccuracy formulates a different diagnosis of three possible considerations for the skin graphic. The response determines the most likely correct diagnosis with reasoning that is explained vaguely and with some inaccuracy using three different references from current evidence-based literature.
0
(0%)
– 32
(32%)The response formulates inaccurately, incompletely, or is missing a different diagnosis of possible considerations for the skin graphic, with two or fewer possible considerations provided. The response vaguely, inaccurately, or incompletely determines the most likely correct diagnosis with reasoning that is missing or explained using two or fewer different references from current evidence-based literature.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5
(5%)
– 5
(5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4
(4%)
– 4
(4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
3
(3%)
– 3
(3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
0
(0%)
– 2
(2%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6512_Week_4_Assignment_1_Rubric NURS-6512 Differential Diagnosis for Skin Conditions SOAP note
-
Discussion: Diversity and Health Assessments
Discussion: Diversity and Health Assessments
May 2012, Alice Randall wrote an article for
The New York Times
on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012) Discussion: Diversity and Health Assessments.ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity. Discussion: Diversity and Health Assessments.
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion.
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
By Day 1 of this week, you will be assigned a case study by your Instructor.
Note
: Please see the “Course Announcements” section of the classroom for your case study assignment.Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you. Discussion: Diversity and Health Assessments
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3 of Week 2
Post
an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on
Submit! Discussion: Diversity and Health AssessmentsRead
a selection of your colleagues’ responses.By Day 6 of Week 2
Respond on or before Day 6
on 2 different days
to at least
two
of your colleagues who were assigned a different patient than you. Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why. Discussion: Diversity and Health Assessments -
Use of Prostate-Specific Antigen Test in Healthcare Essay
Use of Prostate-Specific Antigen Test in Healthcare Essay
The Use of Prostate-Specific Antigen Test in Healthcare
Introduction
Various diagnostic tests are performed by healthcare personnel to confirm or determine a disease’s presence in patients suspected to have it. Diagnostic tests protect patients by finding potential health problems in their early stages of development that are easily treatable and prevent health complications that result from the later stages of disease development. Also, diagnostic tests help patients minimize their healthcare spending by finding potential ailments sooner, which can be treated under minimal costs. Some of the diseases whose negative impact can be considerably reduced if identified in their early development stages include various forms of cancer. Prostate cancer is the second most common type of cancer among men in the world. Use of Prostate-Specific Antigen Test in Healthcare Essay Screening performed using the Prostate-Specific Antigen Test is used to detect prostate cancer at an early stage where treatment can efficiently intervene and reduce mortality among male patients. This purpose of this paper is to describe how the Prostate-Specific Antigen test is used in healthcare.
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
The Purpose of the Prostate-Specific Antigen Test
The Prostate-Specific Antigen Test is primarily used to confirm prostate cancer in men in its early stages of development. The Test is used to measure the amount of Prostate-Specific Antigens [PSA] in the blood. PSA refers to proteins made by normal and malignant tissues of the prostate gland. High levels of Protein-Specific Antigens in the blood may suggest the presence of prostate cancer (Tikkinen et al., 2018). Prostate-Specific Antigen tests can also be used to identify other prostate gland problems, including inflammation and enlargement of the prostate. Besides, Prostate-Specific Antigen tests can be used to monitor prostate cancer treatment and find out whether the disease is under control or reoccurring (Lawrenson, et al., 2015). Prostate cancer is usually treated through radiation, surgery, chemotherapy, and hormone therapy. These treatments make the amounts of protein-specific Antigens circulating in the bloodstream significantly. Physicians perform regular testing to determine the level of Protein-Specific Antigens circulating in the bloodstream to determine whether cancer has reoccurred. If the disease reoccurs, additional screening using protein-specific Antigen tests are performed to make recommendations that will aid in the additional treatment and control of the disease. Use of Prostate-Specific Antigen Test in Healthcare Essay
How the Test is conducted
The Prostate-Specific Antigen test is performed by removing some blood from the patient, usually from the arm. The blood samples are then taken to the laboratory to determine the amount of PSA in the blood. The diagnostic test results may take several days, such as one week, before the results come out. Healthcare personnel reports the Test results as the ratio of nanograms of PSA per milliliters of blood [ng/ml]. Even though Prostate-Specific Antigen tests are used to screen for prostate cancer, their results cannot indicate an absolute confirmation of prostate cancer’s presence or absence (Ilic et al., 2018). Consequently, male patients who have high PSA amounts are required to undertake a prostate biopsy to make the absolute confirmation for prostate cancer. Prostate biopsy refers to the procedure of removing small samples of prostate tissues and observing them using a microscope to confirm whether the patient has or lacks prostate cancer. If it is confirmed the patient has prostate cancer, the biopsy also reveals the likelihood of the cancer growing and spreading rapidly.
Reliability and Validity
The use of PSA tests to perform prostate cancer screenings is not highly reliable or valid. Even though most people with prostate cancer have high PSA levels in their bloodstream, other non-malignant conditions might also contribute to the increase in the levels of PSA. Consequently, the PSA test does not provide precise information concerning prostate cancer disease in individuals. At best, using PSA tests to perform prostate cancer screenings results in a small reduction in the mortality risks caused by prostate cancer. Screening using PSA tests might help people detect prostate cancer in the early stages of development. The diagnosis of cancer at an early stage might make it easy to treat and cure, unlike in the later developed stages of the disease. However, prostate cancer screening using PSA tests does not affect the disease’s overall mortality rates (Martin et al., 2018). Prostate cancer develops slowly over many years. Consequently, people may have prostate cancer that does not reveal any symptoms or cause health problems during their lifetimes.
Also, the harms of conducting prostate cancer screenings using PSA tests outweigh the benefits. Male patients who partake PSA tests for prostate cancer screenings risk getting over-diagnosed and over-treated (Ilic et al., 2018). Patients might be over-diagnosed when the PSA tests detect tumors that lack symptoms during their lifetime. Due to over-diagnosis, these harmless tumors might be subjected to various cancer treatments such as chemotherapy and radiation. These treatments have accompanying complications and harmful side effects, including pain, incontinence, bleeding, infections, and erectile dysfunction. Use of Prostate-Specific Antigen Test in Healthcare Essay. Again, PSA tests can make some people experience negative psychological effects. For instance, people with high PSA levels in their blood might suffer from anxiety and distress if they conduct biopsy tests that fail to confirm the presence of prostate cancer (Biddle et al., 2017). Besides, some patients might experience anxiety because of knowing they have slow-growing tumors even though they are harmless.
Conclusion
In conclusion, PSA tests are used to perform prostate cancer screenings and enable early detection of the disease. The early detection of prostate cancer makes it easy for the disease to be treated and eliminate more healthcare spending that might have taken place in the later developed stages. PSA tests can also detect other prostate gland related problems such as inflammation and enlargement. Besides, PSA tests are used to monitor the treatment and recurrence of prostate cancer. The PSA tests are conducted by removing blood, especially from the arm of the patients. The blood samples are tested in the labs for about one week. The results reveal PSA’s level in the blood and are used to indicate whether the patient might have prostate cancer. Since the PSA tests are not precise, further tests such as a prostate biopsy to confirm the presence of the disease. The PSA tests are not reliable in reducing the overall mortality rates of people having prostate cancer. At best, they help people detect cancerous tumors’ growth at an early stage, enabling them to get interventional treatment. However, these tumors grow at a slow rate and might lack to show any symptoms. Besides, these tumors might be harmless and fail to affect the patients in their lifetime. The PSA tests might result in more harm than good by over-diagnosing and over-treating patients, making them experience harmful side effects and complications such as erectile dysfunctions, infections, and pain. Use of Prostate-Specific Antigen Test in Healthcare Essay.
References
Biddle, C., Brasel, A., Underwood III, W., & Orom, H. (2017). Experiences of uncertainty in men with an elevated PSA.
American journal of men’s health
,
11
(1), 24-34.Ilic, D., Djulbegovic, M., Jung, J. H., Hwang, E. C., Zhou, Q., Cleves, A., & Dahm, P. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis.
bmj
,
362
, k3519.Lawrenson, R., Lao, C., Obertová, Z., Brown, C., Holmes, M., Tyrie, L., … & Laking, G. (2015). Management and characteristics of patients with metastatic prostate cancer in a cohort of New Zealand men.
Oncology
,
88
(3), 157-163.Martin, R. M., Donovan, J. L., Turner, E. L., Metcalfe, C., Young, G. J., Walsh, E. I., … & Sterne, J. A. (2018). Effect of a low-intensity PSA-based screening intervention on prostate cancer mortality: the CAP randomized clinical trial.
Jama
,
319
(9), 883-895.Tikkinen, K. A., Dahm, P., Lytvyn, L., Heen, A. F., Vernooij, R. W., Siemieniuk, R. A., … & Junod, N. (2018). Prostate cancer screening with prostate-specific antigen (PSA) test: a clinical practice guideline.
Bmj
,
362
, k3581. Use of Prostate-Specific Antigen Test in Healthcare Essay
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
Assignment 1: Case Study Assignment: Assessment Tools and Diagnostic Tests in Adults and Children
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results. Use of Prostate-Specific Antigen Test in Healthcare Essay
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.
Photo Credit: Getty Images/Hero Images
For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2).
Note:
Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Consider how you could encourage parents or caregivers to be proactive toward the child’s health.
The Assignment
Assignment
(3–4 pages, not including title and reference pages)
:Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.
Assignment Option 2: Child Health Case:
Include the following:
An explanation of the health issues and risks that are relevant to the child you were assigned.
Describe additional information you would need in order to further assess his or her weight-related health.
Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight.
By Day 6 of Week 3
Submit
your Assignment.Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK3Assgn1+last name+first initial.(extension)” as the name.
Click the
Week 3 Assignment 1 Rubric
to review the Grading Criteria for the Assignment.Click the
Week 3 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 “WK3Assgn1+last name+first initial.(extension)” and click
Open
.If applicable: From the Plagiarism Tools area, click the checkbox for
I agree to submit my paper(s) to the Global Reference Database
.Click on the
Submit
button to complete your submission.NURS_6512_Week_3_Assignment_1_Rubric_Option_1
Excellent
Good
Fair
Poor
In 3–4 pages, address the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
o What is its purpose?
o How is it conducted?
o What information does it gather?
30
(30%)
– 35
(35%)The response clearly, accurately, and with specific detail describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
24
(24%)
– 29
(29%)The response accurately describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
18
(18%)
– 23
(23%)The response vaguely and/or with some inaccuracy describes how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
0
(0%)
– 17
(17%)The response is inaccurate or missing descriptions of how the assessment tool or diagnostic test assigned is used in healthcare, including its purpose, how it is conducted, and what information it gathers.
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.
45
(45%)
– 50
(50%)The response accurately and thoroughly evaluates the test or tool’s validity and reliability, and explains any issues with clear sensitivity, reliability, and predictive values. Student’s research is clear, accurate, and appropriate for the evaluation.
39
(39%)
– 44
(44%)The response accurately evaluates the test or tool’s validity and reliability, and explains any issues with sensitivity, reliability, and predictive values. Student’s research is somewhat clear, accurate,and appropriate for the evaluation.
33
(33%)
– 38
(38%)The response vaguely and/or with some inaccuracy evaluates the test or tool’s validity and reliability, and explains any issues with some sensitivity, reliability, and predictive values. Student’s research is vague or inaccurate for the evaluation.
0
(0%)
– 32
(32%)“The response is inaccurate and/or missing evaluations of the test or tool’s validity and reliability, with explanations of any issues missing or lacking sensitivity, reliability, and predictive values. Student’s research is missing, inaccurate, or lacking for the evaluation.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
5
(5%)
– 5
(5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.
4
(4%)
– 4
(4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.
Use of Prostate-Specific Antigen Test in Healthcare Essay
3
(3%)
– 3
(3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.
0
(0%)
– 2
(2%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Use of Prostate-Specific Antigen Test in Healthcare Essay Total Points: 100 Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_1 NURS_6512_Week_3_Assignment_1_Rubric_Option_2 Grid View List View Excellent Good Fair Poor In 3–4 pages, address the following: An explanation of the health issues and risks that are relevant to the child you were assigned. 20 (20%) – 25 (25%) The response clearly, accurately, and in detail explains the relevant health issues and risks for the assigned child. 19 (19%) – 24 (24%) The response accurately explains the relevant health issues and risks for the assigned child. 18 (18%) – 23 (23%) The response vaguely and with some inaccuracy explains the relevant health issues and risks for the assigned child. 0 (0%) – 17 (17%) The response is inaccurate and/or missing explanations of the relevant health issues and risks for the assigned child. Describe additional information you would need in order to further assess his or her weight-related health. 20 (20%) – 25 (25%) The response clearly and accurately describes detailed additional information needed to further assess the child’s weight-related health. 19 (19%) – 24 (24%) The response accurately describes additional information needed to further assess the child’s weight-related health. 18 (18%) – 23 (23%) The response vaguely and with some inaccuracy describes additional information needed to further assess the child’s weight-related health. 0 (0%) – 17 (17%) The response is inaccurate and/or missing a description of additional information needed to further assess the child’s weight-related health. Identify and describe any risks, and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion. 18 (18%) – 20 (20%) The response clearly and accurately identifies and describes in detail any risks to the child’s health. The response clearly and accurately identifies and describes in detail further information needed to gain a full understanding of the child’s health, with a detailed explanation of how to gather that information in a way that is sensitive to the child. 16 (16%) – 17 (17%) The response accurately identifies and describes any risks to the child’s health. The response accurately identifies and describes further information needed to gain a full understanding of the child’s health, with a clear explanation of how to gather that information in a way that is sensitive to the child. Use of Prostate-Specific Antigen Test in Healthcare Essay 14 (14%) – 14 (14%) The response vaguely and with some inaccuracy identifies and describes any risks to the child’s health. The response vaguely identifies and describes further information needed to gain a full understanding of the child’s health, with a vague explanation of how to gather that information in a way that is sensitive to the child. 0 (0%) – 13 (13%) The response identifies inaccurately and/or is missing descriptions of any risks to the child’s health. The response identifies inaccurately and/or is missing descriptions of further information needed to gain a full understanding of the child’s health, with an inadequate or missing explanation of how to gather that information in a way that is sensitive to the child. Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information. 10 (10%) – 10 (10%) The response clearly and accurately lists three or more specific questions that would gather more information about the child. Specific questions are carefully worded to clearly demonstrate sensitivity to the parent(s) or caregiver(s) of the child. 9 (9%) – 9 (9%) The response lists three specific questions that would gather more information about the child. Specific questions are worded to demonstrate sensitivity to the parent(s) or caregiver(s) of the child. 8 (8%) – 8 (8%) The response lists three questions with wording that is vague and lacking specificity for gathering more information about the child. Some wording of the questions lacks sensitivity to the parent(s) or caregiver(s) of the child. 0 (0%) – 7 (7%) The response lists two or fewer confusing or inadequate questions, or is missing questions, for gathering more information about the child. Wording of questions provided lacks sensitivity to the parent(s) or caregiver(s) of the child. Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight. 5 (5%) – 5 (5%) The response clearly describes two or more detailed strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 4 (4%) – 4 (4%) The response describes at least two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 3 (3%) – 3 (3%) The response vaguely describes two strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. 0 (0%) – 2 (2%) The response inadequately describes one strategy or is missing strategies to encourage the parent(s) or caregiver(s) to be proactive about the child’s health and weight. Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3 (3%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic. Use of Prostate-Specific Antigen Test in Healthcare Essay 0 (0%) – 2 (2%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3 (3%) – 3 (3%) Contains several (3 or 4) grammar, spelling, and punctuation errors. 0 (0%) – 2 (2%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%) Uses correct APA format with no errors. 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. 3 (3%) – 3 (3%) Contains several (3 or 4) APA format errors. 0 (0%) – 2 (2%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6512_Week_3_Assignment_1_Rubric_Option_2 Use of Prostate-Specific Antigen Test in Healthcare Essay
-
NURS 6512 Diversity and Health Assessments Discussion Essay
NURS 6512 Diversity and Health Assessments Discussion Essay
Module 2: Functional Assessments and Assessment Tools
Health disparities affect just a segment of the population differently. Attitudes toward health care and treatment can also vary among different populations. Therefore, nurse practitioners, as well as medical professionals, need to provide custom care that acknowledges and recognizes these differences in order to serve its diverse patient population. Nurse practitioners becoming more self-aware of themselves can help them realize new things about their own culture which in turn, can open their eyes to appreciating cultural differences. NURS 6512 Diversity and Health Assessments Discussion Essay. Medical teams’ understanding of patients’ beliefs and values, will aid in providing a better care because when a patient cannot find providers that resemble them, their beliefs, their culture, or other facets of their life, it may delay or prevent them from seeking care. As a health care team, it is important that we are diverse in large part just like our patients are diverse. A lack of cultural understanding increases negative attitudes towards cross-cultural care and affects healthcare professionals’ perceived preparedness to take care of culturally diverse patients. Anxiety when combined with uncertainty, can further decrease effective communication leading to increased use of stereotypes. Nurse practitioners need to have an increased awareness about the sociocultural. NURS 6512 Diversity and Health Assessments Discussion Essay.
ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER HERE
I choose the case study number one; EB is a 68-year-old black female who comes in for follow-up of hypertension. She has glaucoma and her vision has been worsening during the past few years. She lives alone and is prescribed four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL 200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily) NURS 6512 Diversity and Health Assessments Discussion Essay. Poor adherence to antihypertensives has been shown to be a significant factor in poor blood pressure (BP) control. A good communication with patients about her medication-taking behavior may be central to improving adherence “A patient-centered approach in which the provider engages the patient in a process of shared decision making has been identified as an important factor in improving patient adherence” (Kaihlanen, Hietapakka & Heponiemi, 2019). Example, the use of “Open-Ended Strategies” and your patients feel comfortable and address them by their preferred names. Hypertension (HTN) affects more than 29% of the adult population and increases the risk for adverse outcomes. Poorly controlled or managed HTN can lead to stroke, kidney damage, vision loss, fluid in the lungs, memory loss, and erectile dysfunction (AHA, 2010) . Research studies have consistently shown that” most patients with established HTN have poorly controlled blood pressure (BP) and that 30% to 70% of patients do not take their BP medications as prescribed” as seen in the case of this patient (Bokhour, Berlowitz, Long & Kressin, 2006). NURS 6512 Diversity and Health Assessments Discussion Essay.
The nurse practitioner understanding that development of hypertension is related to both genetic and lifestyle factors such as genetic, age, gender, body shape, and family history, and lifestyle factors of excessive drinking, smoking, poor eating habits, and reduced physical activity will help in the management of this patient problems. As health care team, it is important that we are diverse in large part just like our patients are diverse “A lack of cultural understanding increases negative attitudes towards cross-cultural care and also affects healthcare professionals’ perceived preparedness to take care of culturally diverse patients” (Kaihlanen, Hietapakka & Heponiemi, 2019). Also, research shows that African Americans are genetically more at risk for glaucoma, making early detection and treatment more important. Early diagnosis and treatment and medication adherence are key in preventing vision loss from glaucoma “High BP could increase intraocular pressure (IOP) by increased production of aqueous humor by means of elevated ciliary blood flow and capillary pressure and decrease of aqueous outflow as a result of increased episcleral venous pressure” (Leeman & Kestelyn, 2019) NURS 6512 Diversity and Health Assessments Discussion Essay.
A low BP, whether spontaneous or secondary to antihypertensive therapy, can play a part in reducing OP intraocular pressure (IOP). Therefore, antihypertensive treatment has shown have a preventive effect on the development of glaucoma and both high BP and low BP having been associated with an increased risk of glaucoma (Leeman & Kestelyn, 2019). Patients with high BP should be screened for glaucoma, and patients with glaucoma should be screened for arterial hypertension. Patients with coexisting glaucoma and high BP should undergo closer ophthalmologic examinations. This patient requires close ambulatory BP monitoring be performed with the deterioration her vision and a referral to an eye doctor initial and then every six months subsequently will be recommended for treatment and management of her glaucoma.
In the case of this 68-year-old AA female who presented to the clinic with elevated BP in clinic with a BP of 182/99 with HR of 84. When developing strategic measures for medication adherence and planning for this patient findings suggestive should include barriers due to self-efficacy, time with hypertension diagnosis, medication inefficiency and age are critical factors to consider “Racial-ethnic minorities are less often engaged in decision on their treatment than white adults, which may be a contributing factor to lower adherence in the former” (Bokhour, Berlowitz, Long, & Kressin, 2006). Some patients do not accept the diagnosis, which is obviously a major impediment to adherence as well. Lack of knowledge about hypertension and its consequences are logically linked to suboptimal adherence. Diversity in health care goes far beyond a language barrier “It’s about understanding the mindset of a patient within a larger context of culture, gender, sexual orientation, religious beliefs, and socioeconomic realities” (Bokhour, Berlowitz, Long, & Kressin, 2006).
As a future nurse practitioner, I can empower this patient to take her medications as Prescribed by doing effective two-way communication to doubles the odds of taking her medications properly. Try to understand the barriers and address them honestly to build that trust. I will develop simple method and directions to help improve medication adherence by simplify the regimen. Talk to her, show empathy and address her concerns or fears. Encourage the use of adherence tools, like day-of-the-week pill boxes or mobile apps such that will work to match the action of taking medications on daily routine example, mealtime or bedtime. To help impart knowledge, I will write down prescription instructions clearly, and reinforce them verbally. Modify patients’ beliefs and behavior by providing positive reinforcement such as offering incentives when medications are taken successfully. Always ask for patients’ input when discussing recommendations and making decisions and remind patient to call the office with any questions or concerns “Interventions to promote adherence require several components to target these barriers, and health professionals must follow a systematic process to assess all the potential barriers” (Burnier & Egan, 2019). Also, a healthy lifestyle modification example, healthy eating habits, engaging in enough physical activity, abstaining from tobacco use, and limiting alcohol intake can help with blood pressure control.
Using multiple strategies, the nurse practitioner can assess the patients’ medication-taking behavior, and to identify potential reasons for the lack of BP control, and plan intervention accordingly. NURS 6512 Diversity and Health Assessments Discussion Essay
What Are Your Medical and Surgical Histories?
What Prescription and Non-Prescription Medications Do You Take? …
What Allergies Do You Have? …
What Is Your Smoking, Alcohol, and Illicit Drug Use History?
Did you take all your pills?
When was the last time you see eye doctor?
Socioeconomic, lifestyle, religion and other cultural factors especially religious doctrine among African American community has a lengthy traditional belief. This is because, spiritual or religious experiences of African Americans may shape beliefs about the causes of illness, as well as treatment decisions. There is also a tendency for religious faith and prayer to be having substantial potential for healing and may serve as an alternative to medical care for serious illnesses. Among African Americans, it is generally expected that family members, including extended family members, will play an important role in treatment decisions. With this patient, it is critical to increase family education about disease states and the benefits of compliance in achieving successful outcomes (Purnell, & Fenkl, 2019).
Conclusion.
Patient poor adherence may be partially due to problems of access and cost of medication, however, patients’ beliefs about HTN and medication may also play a significant role. Not all patients treated for hypertension follow their health care professional’s advice especially when it comes to long-term medication therapy. Medication adherence is very important and non-adherence increases patients risks for death. Most patient stooped taking their prescription drugs they believed that they were cured or thought that they had been advised to stop by their provider. Some nonadherence to medications has been attributed to both intentional meaning a conscious decision not to take medications and unintentional, a failure to take medications due to poor understanding or forgetfulness. Socioeconomic, lifestyle, religion and other cultural factors especially religious doctrine among African American community has a lengthy traditional belief. This is because, spiritual or religious experiences of African Americans may shape beliefs about the causes of illness, as well as treatment decisions. Medical teams understanding of patients belief and values, will aid in providing a better care because when a patient cannot find providers that resemble them, their beliefs, their culture, or other facets of their life, it may delay or prevent them from seeking care.
References
Bokhour, B. G., Berlowitz, D. R., Long, J. A., & Kressin, N. R. (2006). How do providers assess antihypertensive medication adherence in medical encounters? Journal of General Internal Medicine, 21(6), 577-583. doi:10.1111/j.1525-1497.2006. 00397.x
Burnier, M., & Egan, B. M. (2019). Adherence in Hypertension. Circulation Research, 124(7), 1124-1140. doi:10.1161/circresaha.118.313220
Kaihlanen, A., Hietapakka, L., & Heponiemi, T. (2019). Increasing cultural awareness: Qualitative study of nurses’ perceptions about cultural competence training. BMC Nursing, 18(1). doi:10.1186/s12912-019-0363-x
Leeman, M., & Kestelyn, P. (11 mar 2019). AHA, 73, NO. 5. doi: https://doi.org/10.1161/HYPERTENSIONAHA.118.11507
Purnell, L. D., & Fenkl, E. A. (2019). Barriers to Culturally Competent Health Care. Handbook for Culturally Competent Care, 19-26. doi:10.1007/978-3-030-21946-8_3 NURS 6512 Diversity and Health Assessments Discussion Essay
-
NURS – 6003 Discussion Posting Exemplars
NURS – 6003 Discussion Posting Exemplars
Discussion Posting Exemplars
SAMPLE POST: Use this as a guide for writing and formatting posts
My Goals and University Vision and Mission
As a nurse for over 10 years and with the advances in technology applied to the
health care arena, I have become more interested in the role of a nurse within
informatics. My professional goal is to work full-time in the area of nursing informatics.
Unfortunately, I knew that obtain this position, I needed to advance my degree. I began
looking into various colleges and universities that can provide me with the education
needed to obtain an advanced degree with a focus in nursing informatics.
After several months of investigating, I located Walden University. At first, I was
drawn to Walden because it offered the flexibility that I needed. However, as I
investigated the university further, Walden’s mission and vision statement resonated
with me. I knew I had made the right choice. The College of Nursing vision and mission
statements described what I felt and thought yet could not put into words. According to
the Walden University College of Nursing (2011a), their vision is for graduates to
transform nursing to meet the needs of communities. Technology is transforming health
Discussion Posting
ORDER A PLAGIARISM-FREE PAPER HERE
Exemplars
NURS – 6003 Discussion Posting Exemplars
care and the degree I will obtain at Walden will help me to assist my organization with
this transformation.
Another reason I was drawn to Walden University was the high standards they
have for all students. The College of Nursing stated in their mission that their program is
“academically rigorous…contextually relevant…” (Walden University, 2011a, para. 4).
This statement matches my academic goal. I am not looking for just a piece of paper at
the end, I am looking to gain the necessary knowledge that I need to make an impact
within my organization.
Incorporation of Social Change
Walden University (2011b) defined positive social change as a “deliberate process
of creating and applying ideas, strategies, and actions to promote the worth, dignity, and
development of individuals, communities, organizations, institutions, cultures, and
societies” (para. 4). I have always had a feeling that I want my life to mean something
and to have an effect on those around me whether it is directly or indirectly. As a nurse,
the will to help others is a core foundation of why I got into nursing in the first place. I
plan to incorporate social change with the knowledge gained at Walden University by
“putting that knowledge into practice” (Walden University, 2010b, para. 3). I plan to
contribute to my field when I graduate by helping lead my coworkers and my
organization through the computerized changes and advancement of technology at
work. While helping others, I will be part of the clinical informatics team as the team
transitions the organization into new computerized programs. NURS – 6003 Discussion Posting Exemplars
© 2018 Laureate Education Inc. 3
References
Walden University. (2011a). About the school. Retrieved from
http://www.waldenu.edu/Colleges-and-Schools/College-of-HealthSciences/15863.htm
Walden University. (2011b). Vision, mission, and goals. Retrieved from
NURS – 6003 Discussion Posting Exemplars
-
Discussion: Factors That Influence the Development of Psychopathology
Discussion: Factors That Influence the Development of Psychopathology
This week’s discussion aims to analyze historically and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology. Historically, psychopathology’s perception is that of behaving outside the norm of what the present culture and society perceive as “normal.” Exactly who is responsible for deeming what is normal or not has perplexed this writer. Just as Marturano, A., (2020) wrote in his article “Italy and leadership: psychopathology or culture of a nation,” The history of an area, culture, war, persecution influences the prevalence of psychopathology. The cultural beliefs of ancient times are still found in the leadership of the leaders in Italy. Discussion: Factors That Influence the Development of Psychopathology Aristotle was responsible for categorizing concepts and objects etc. It has always needed to have things organized into ideas with descriptions and lists of the intrinsic aspect of what is being classified. The identification of psychopathology can be found during Biblical times when what would be called today psychopathology was considered being “possessed” by evil spirits. Discussion: Factors That Influence the Development of Psychopathology
BUY A PLAGIARISM-FREE PAPER HERE
Experiences and education, research, studies have brought different theoretical constructs. As more information is gathered, more theories are discovered. In the late 1970s, this writer can remember discussing the Nature vs. Nurture construct. Today we would have to say both are responsible for the development or the expression of psychopathology as the interactions and experiences stimulate the individual’s biological and genetic expressions, which result in behaviors manifested. However, it wasn’t until the Era of Enlightenment when the study and focus on psychiatric care came to be. Until the 19
th
century, Schizophrenia, the worse of mental illness, was considered “another form of lunacy: (Kaplan,2008) Discussion: Factors That Influence the Development of Psychopathology. During the era of Enlightenment, the attitude towards mental health began to change. Phillipe Pines, a psychiatrist during this era, believed in an illness model of symptoms and treatment. Thus, the mentally ill’s moral treatment was brought to light because it was the belief the cause of the mental illness was to be found in the patient’s environment Kaplan,2008). Pines believed in studying the brains of psychiatric patients hoping to find the root cause of mental illness. The rationalization of doing this resulted in the destruction of the once scientific German psychiatrist under the Nazi influence. They would gas their patients under a cloud of eugenics. Discussion: Factors That Influence the Development of PsychopathologyMasten and Kalstabakken (2018) Discuss the implications for developmental psychopathology (DP) as a multidisciplinary approach for research and therapy. The idea is that one needs to understand the psychopathology in a developing person and know what the “normal” behaviors and expectations exist for a specific developing person at a given point in time. This developmental theory appears to have built upon Erickson’s theory of developmental psychology. Individuals grow and learn from the interactions they have in society. “Individuals grow and change due to their interaction between natural ecosystem factors (e.g., air and water quality, and exposure to macrobiotic organisms) also play a critical role to development” (Masten, and Kulstabakken,2018).
Those who live in extreme poverty areas, lead-based tenements, gangs at each corner, and now the stress of virtual schooling and not being with their peers are greater at risk of having some form of mental health problem. Continuous pressure from the unknown increase an individual’s risk of psychopathology as well Discussion: Factors That Influence the Development of Psychopathology. Those living in poverty with a lack of health care coverage, housing, and food security are at higher risk for mental health issues.
The root cause of psychopathology is related to social, cultural, genetic, and biological factors. Not one element can be identified.
Reference
Kaplan, R. M. (2008). Being Bleuler: the second century of Schizophrenia, The Royal Australian and New Zealand College of Psychiatrists. Doi: 10.1080/10398650802302176
Marturano, A., (2020), Italy and leadership: psychopathology or culture of a nation?,
International Journal of Psychoanalysis and Education,
12(1)Masten, A.S., & Kalsstabakken, A. W., (2018), Developmental Perspectives on Psychopathology in Children and Adolescents, APA Handbook of Psychopathology: Child and Adolescent Psychopathology, edited by Butcher, J. Nl, & Kendall, P. C. Discussion: Factors That Influence the Development of Psychopathology
response
There are so many great points in this post. I am worried about the mental health as well of the students having to be isolated and do virtual learning. “Social isolation leads to chronic loneliness and boredom, which if long enough can have detrimental effects on physical and mental well-being. The timelines of the growing pandemic being uncertain, the isolation is compounded by mass panic and anxiety (Duan, 2020).” Not only has the pandemic caused illness and death across the country, it has wreaked havoc on the mental health of those who are isolated. The upcoming holidays are even more worrisome. With the social isolation that is now in place, our future as mental health providers is even more important that before. :Last year, about 374,000 people ended up in the nation’s emergency rooms with self-inflicted injuries, and 48,000 people died by suicide.” Discussion: Factors That Influence the Development of Psychopathology
Carley S, Hamilton M. Suicide at Christmas. Emergency Medicine Journal 2004;21:716-717
Duan, L., Zhu, G. (
2020
).
Psychological interventions for people affected by the COVID-19 epidemic
. The Lancet Psychiatry, 7(4),
300
–
302
.Thank you for your post. I agree with your points in your post. Mental health has evolved over time and different ways of analyzing social and cultural views Discussion: Factors That Influence the Development of Psychopathology. Mental disorders impose a significant economic burden, not just on the individuals with the disorders but also on households, communities, employers, healthcare systems and government budgets (Jenkins, Baingana, Ahmad, McDaid & Atun, 2011). As you mentioned poverty can have an increased impact on mental health for those who are already at risk, although the effects of poor health on poverty are by no means unique to mental illness, their negative impacts are greater than for most acute and chronic illnesses (Jenkins et al., 2011).
Jenkins, R., Baingana, F., Ahmad, R., McDaid, D., & Atun, R. (2011). Social, economic, human rights and political challenges to global mental health.
Mental health in family medicine
,
8
(2), 87–96.Discussion: Factors That Influence the Development of Psychopathology
In many realms of medicine, objective diagnoses can be made: A clavicula is broken. An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015) Discussion: Factors That Influence the Development of Psychopathology.
Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach? Discussion: Factors That Influence the Development of Psychopathology
To Prepare:
Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.
Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.
By Day 3 of Week 1
Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.
Read
a selection of your colleagues’ responsesBy Day 6 of Week 1
Respond
to at least
two
of your colleagues on
2 different days
by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.Note:
For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on
Submit!post
Mental, emotional, and behavioral (MEB) development is a product of complex neurobiological processes that interact with characteristics of the physical and social environment, beginning before conception and continuing beyond adolescence. Healthy development is shaped by experiences and circumstances that cross generations within families and affect entire neighborhoods and communities. Therefore, understanding of MEB development must be based on an integrated appreciation of connections that have been identified among.
Biological processes, including brain development and the expression of genes as individual characteristics; physical, social, behavioral, and intergenerational experiences that affect conception, gestation, and childbirth; Although neurobiological mechanisms are a central focus of research on MEB outcomes, it is important to note that these mechanisms are the downstream consequence of complex cellular and molecular variation that emerges in response to the interplay between genes and environments. Genes and environments both operate to create variation, and the interplay between these variables is the foundation for the emergence of individual variation
Development accelerates in response to environmental threat. For example, girls who encounter several types of challenges experience the onset of puberty earlier than girls who do not. The challenges for which these connections have been established include an absent father, maternal depression, family conflict, and low ratio of income to needs, but these effects can be buffered by secure childhood attachment (Deardorff et al., 2011; Ellis and Garber, 2000; Sung et al., 2016) Discussion: Factors That Influence the Development of Psychopathology.
Neuroimaging studies suggest that the acceleration of development is also evident in brain systems, such as those that regulate fear and learning (Gee et al., 2013), and in the connectivity between cortical and subcortical brain structures that have implications for emotional regulation (Callaghan and Tottenham, 2016).
Genetic, environmental, neurobiological, and behavioral characteristics account for differences in the way’s individuals respond to influences such as stress or adversity. This phenomenon, known as differential susceptibility, provides a framework for thinking about ways to account for both healthy MEB development and the development of MEB disorders, a framework that focuses not on the relative vulnerability or resilience in distinct subtypes of individuals but on the degree of plasticity an individual exhibits. Cortical sensory processing capacity and the ability of the prefrontal cortex to filter emotional stimuli have been suggested as potential neural mechanisms accounting for differential susceptibility (Boyce, 2018).
A growing body of evidence is revealing the ways in which characteristics of the more distal social environment affect development. These factors include poverty and inequality, discrimination and racism, marketing of unhealthy products, and effects of involvement with the criminal justice system. These more distal influences on MEB development place distinct limits on society’s ability to foster healthy MEB development and prevent MEB health disorders at a population level.Discussion: Factors That Influence the Development of Psychopathology
Healthy early development (physical, social, emotional, and cognitive) strongly influences a wide range of later outcomes, including mental health, heart disease, literacy and numeracy, criminality, and economic participation across the life span. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic status; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion (Healthy People, 2015).
Furthermore, individual influences including sleep, nutrition, and physical activity; characteristics of the family and surrounding community, including safety, nurturing interactions, peer behavior, and social-emotional support in school; and characteristics of the broader society in which the individual, family, and community are situated, such as poverty and economic inequality, systemic racism and discrimination, law- and policy-driven factors, and the marketing of unhealthful products can also be a factors influencing the development of psychopathology.
References
Boyce WT. The orchid and the dandelion: Why some children struggle and how all can thrive. New York: Alfred A. Knopf; 2018 Discussion: Factors That Influence the Development of Psychopathology
Callaghan BL, Tottenham N. The stress acceleration hypothesis: Effects of early-life adversity on emotion circuits and behavior. Current Opinion in Behavioral Sciences. 2016; 7:76–81. 10.1016/j.cobeha.201511.018
Deardorff J, Ekwaru JP, Kushi LH, Ellis BJ, Greenspan LC, Mirabedi A, Landaverde EG, Hiatt RA. Father absence, body mass index, and pubertal timing in girls: Differential effects by family income and ethnicity. Journal of Adolescent Health. 2011;48(5):441–447.
Healthy People 2020. Disparities. 2015. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
responses
I enjoyed this post! Thank you for pointing out that mental health is not a choice! It a combination of so many things, and making the public aware of this is so important and vital to the future of mental health. “Depression is a disease, where neurotransmitters in the brain, such as norepinephrine, dopamine, and serotonin, are reduced, and there is something wrong in the mood control circuit of the brain (Yim, 2016).” Discussion: Factors That Influence the Development of Psychopathology
Your points if healthy early development is poignant in this post. In my initial post, I stated how the rural area that I live in has finally started mental health services in schools and I am hoping that this is the push needed to help my community has a brighter future in mental health as well as erasing the stigma associated with mental health. “The paradox is that young people aged between 12 and 25 years have had by far the worst levels of access to mental health care across the whole lifespan. Health services are poorly designed, grossly under-resourced and typically unfriendly to, and untrusted by, young people (McGorry, 2018).”
Yim J. Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review. Tohoku J Exp Med. 2016 Jul;239(3):243-9. doi: 10.1620/tjem.239.243. PMID: 27439375.
McGorry PD, Mei C. Early intervention in youth mental health: progress and future directions
Evidence-Based Mental Health 2018;21:182-184 Discussion: Factors That Influence the Development of Psychopathology
Thank you for your very informative post! Brain development and the expression of genes begin from the time of gestation and continue to adulthood. Many factors influence the biological processes that determine the growth of these structures. These changes can result in psychiatric disorders such as depression disorders, anxiety disorders, and more severe disorders such as schizophrenia. One such variable is stress. The stress response involves the release of the stress hormones epinephrine, norepinephrine, and adrenocorticotropic. These stress hormones are directly released into the maternal bloodstream and the fetal bloodstream. The fetus will have an increased heart rate and blood pressure. (Sadock, Sadock, and Ruiz,2015, p 1083). The developing brain circuits and medial prefrontal cortex (mPFC) have significant roles in the top-down regulation of the HPA (stress axis). The stress axis is particularly susceptible to environmental influences. Moreover, there does not need to be a direct experience with stress for the developing brain and genes to be affected. Being near someone who is stress can result in bystander stress (Lehmann, Weigel, Elkahloun, and Herkenham, 2017; Nelson, 2017).
In today’s world, all are bombarded with stress. All of us are dealing with Covid-19. Many people have lost their dreams, having to close their business, lay off, or have their business burned to the ground. Many have lost their jobs. Even though people go through the everyday routine and are not guaranteed or who are “essential workers” and are employed, they put themselves in harm’s way; and stress is felt. Our gene expressions are being changed. Worry about finances, our future, or our loved ones’ future are all forms of stress. Stress has been associated with depression, anxiety, and psychosis (Holttum, 2014). Today, children feel the stress of being confined and not being able to socialize with their friends. Those who are pregnant and undergoing the stress of this world are producing more children with depression, anxiety, ADHD, personality disorders, or psychotic disorders. Psychotherapy has been found to change the structure of the gene expression and other brain structures. Psychotherapy may be our saving grace in today’s world. This writer believes that stress management skills and exercises should be taught in school, and perhaps telehealth sessions for children and adults. How do you see this society being impacted by the stressors of today’s world? Discussion: Factors That Influence the Development of Psychopathology
References
Holttum, S.,(2014), when bad things happen our brains change, but psychotherapy and support can help the recovery of our brains and our lives,
Mental Health and Social Inclusion
, 18(2), PP 52-58Nelson, E. E., (2017), Learning through the ages: How the brain adapts to the social world across development,
Cognitive Development, 42(2017
), 84-94Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015),
Sadock’s & Sadock’s synopsis of psychiatry,
(11
th
ed.), Wolters Kluwer Discussion: Factors That Influence the Development of Psychopathology -
NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
Laureate Education (Producer). (2018).
The Foundation of Success
[Video file]. Baltimore, MD: Author.Laureate Education (Producer). (2018).
The Walden Journey to a Masters in Nursing: The Journey Begins
[Video file]. Baltimore, MD: Author.Laureate Education (Producer). (2018).
The Walden Journey to a Masters in Nursing: Networking and Collaboration
[Video file]. Baltimore, MD: Author. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional SuccessBUY A PLAGIARISM-FREE PAPER HERE
Learning Objectives
Students will:
Analyze relationships among Walden’s vision, mission, goals, and social change initiatives to professional and academic goals
Analyze the relationship between MSN program outcomes and perspectives to professional and academic goals
Identify academic and professional collaborators for academic and professional success
Identify concepts for Walden student readiness
Identify individuals or teams to collaborate with for success in the MSN program and as a practicing nurse
Due By
Assignment
Week 1, Days 1–2
Read the Learning Resources.
Compose your initial Discussion post.
Begin to compose Part 1 of your Assignment.
Week 1, Day 3
Post your initial Discussion post.
Begin to check your knowledge with the Quiz.
Continue to work on of Part 1 of your Assignment.
Week 1, Day 4
Continue to check your knowledge with the Quiz.
Continue to work on Part 1 of your Assignment
Week 1, Day 5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to check your knowledge with the Quiz.
Continue to compose your final draft of Part 1 of your Assignment.
Week 1, Day 6
Post two peer Discussion responses.
Continue to check your knowledge with the Quiz.
Continue to compose your final draft of Part 1 of your Assignment.
Week 1, Day 7
Wrap up Discussion.
Final day to complete Quiz.
Deadline to submit your final draft of Part 1 of your Assignment.
Photo Credit: David Baumber/Vetta/Getty Images
Learning Resources
Required Readings
Nurse.org. (n.d.). List of nursing organizations. Retrieved November 14, 2018, from https://nurse.org/orgs.shtml
Schmidt, K. (n.d.). 5 reasons nurses should engage in professional networking [Blog post]. Retrieved November 14, 2018, from https://blog.bluepipes.com/5-reasons-nurses-should-take-professional-networking-seriously/
Walden University. (n.d.). Connect to Walden. Retrieved November 14, 2018, from https://www.waldenu.edu/connect
Walden University. (n.d.). College of Nursing. Retrieved June 5, 2020, from https://www.waldenu.edu/about/colleges-schools/college-of-nursing
Review the College of Nursing’s vision and mission.
Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu
Select College of Nursing, then Master of Science in Nursing (MSN). Review the MSN Learning Outcomes on this page.
Walden University. (n.d.). Walden University catalog. Retrieved October 4, 2019, from https://catalog.waldenu.edu
Select Introduction, then the link “Vision, Mission, and Goals” under the Introduction header. Review Walden’s vision, mission, and goals.
Walden University. (n.d.). Writing center. Retrieved November 14, 2018, from https://academicguides.waldenu.edu/writingcenter
Wofford, P. (2018). 10 networking tips for nurses who hate networking. Retrieved from https://nurse.org/articles/tips-for-nurse-networking/
Academic Success and Professional Development Plan Template (Word document)
Discussion Posting Exemplars (PDF)
Discussion: Networking Opportunities
In this module, you begin laying the foundation for your academic and professional success. Your efforts begin with a vision that includes your own definition of success. Your vision may vary from those of your colleagues, but this does not mean you have to take these first steps alone.
Walden University and the College of Nursing also have a vision and mission, which include helping you to make your own vision a reality. Members of your new academic community, such as faculty, support teams, and fellow students, can also be helpful. Current practitioners and other member of the professional community can also help you to clarify your vision.
This Module’s Discussion asks you to consider how the Walden mission and vision as well as the College of Nursing’s mission and vision apply to your professional and academic goals. You will also begin to identify individuals and teams who can help you along the way as you begin designing the “blueprint”—your Academic Success and Professional Development Plan—that will guide you toward your own vision for academic and professional success.
To Prepare:
Review the Walden and College of Nursing mission and vision statements, Walden’s goals and University Outcomes, and the MSN Program Learning Outcomes presented in this Module’s Learning Resources.
Reflect on your professional and academic goals as they relate to your program/specialization.
Consider how the information in these resources fit with your own goals and to your becoming a scholar-practitioner.
Also consider academic and professional individuals and teams with whom you may collaborate in support of your efforts as a student at the university and as a professional within your organization and career.
By Day 3 of Week 1
Post
a brief introduction of yourself to your colleagues. Include an explanation as to how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN Program Outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner.By Day 6 of Week 1
Respond
to at least
two
of your colleagues’ posts by suggesting additional individuals and/or teams with whom you wish to collaborate or by offering additional networking strategies. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional SuccessSubmission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
Quiz: Walden’s Student Readiness Orientation
You probably have a lot of questions (and perhaps some hesitation) about the journey you are undertaking. How do I navigate the online classroom? How can I have access to a library in this environment? The Student Readiness Orientation (SRO) minicourse available on your MyWalden page provides answers to such questions and helps ensure you understand how to navigate the online classroom and utilize the many resources available to you as a student at Walden. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
The Readiness Check will help you determine your prepardness for navigating the online classroom.
The questions presented on the Quiz are derived from the readiness check presented in the SRO.
Click on the Week 1 Quiz link after you have read the directions carefully.
The readiness check includes 15 questions in various formats including true/false and multiple choice. If you score 12 or below, please retake the exam. You may retake the exam as many times as you would like in order to achieve your desired score. Your highest score will be recorded. To retake the Quiz, click on “Take Test Again” (this does not appear as a hyperlink but works as a hyperlink when you click on the area).
To view the questions you answered correctly and incorrectly, click on your score in the “My Grades” area.
To Prepare:
Review the Walden’s SRO found on your MyWalden page. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
By Day 7
Complete the quiz.
Submission and Grading Information
Submit Your Quiz by Day 7 of Week 1
To submit your Quiz:
Week 1 Quiz
Assignment: Academic Success and Professional Development Plan
Part 1: Developing an Academic and Professional Network
When was the last time you read Meditation XVII of John Donne’s
Devotions Upon Emergent Occasions
?Unless you are a student of seventeeth-century poetry, you may not be all that familiar with this piece. However, you may be much more familiar with one of its well-known phrases: “No man is an island…”. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
As you begin your journey toward achieving your academic and professional goals, you have a great opportunity to network with academics and professionals who can help ensure you do not travel alone. This network can help to clarify your own vision for success and can help guide you now and in the future. To paraphrase Donne, no one is an island.
Begin creating an academic and professional network by identifying which academic and professional connections and resources with which you need to collaborate to succeed in your MSN program and as a practicing nurse.
To Prepare:
Consider individuals, departments, teams, and/or resources within Walden University and within your profession that you believe can support your academic and professional success.
Identify at least two academic and at least two professional individuals, colleagues, or teams that might help you succeed in your MSN program and as a practicing nurse.
Download the
Academic Success and Professional Development Plan Template
. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional SuccessThe Assignment:
Academic and Professional Network
Complete Part 1 of your
Academic Success and Professional Development Plan Template
. Be sure to address the following:Identify
at least two
academic and
at least two
professional individuals or teams to collaborate with to be successful in your MSN program and as a practicing nurse.Explain why you selected these individuals and/or teams and how they will support your success in the MSN program and as a practicing nurse.
By Day 7 of Week 1
Submit
Part 1 of your
Academic Success and Professional Development Plan Template
.Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK1Assgn+last name+first initial.(extension)” as the name. NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
Click the
Week 1 Assignment Rubric
to review the Grading Criteria for the Assignment.Click the
Week 1 Assignment
link. You will also be able to “View Rubric” for grading criteria from this area.Next, from the Attach File area, click on the
Browse My Computer
button. Find the document you saved as “WK1Assgn+last name+first initial.(extension)” and click
Open
.If applicable: From the Plagiarism Tools area, click the checkbox for
I agree to submit my paper(s) to the Global Reference Database
.Click on the
Submit
button to complete your submission.Grading Criteria
To access your rubric:
Week 1 Assignment Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 1 Assignment draft and review the originality report.
Submit Your Assignment by Day 7 of Week 1
To submit your Assignment:
Week 1 Assignment NURS – 6003 Module 1 (Week 1): Networking for Academic and Professional Success
-
African American Child Suffering From Depression marked
African American Child Suffering From Depression marked
Treating Depression with Suicidality in Pediatrics Using Appropriate Medications: The Case of an 8 Year-Old African American Boy
The most authoritative and reliable diagnostic tool in psychiatry is the DSM-5 which is currently in its fifth edition. It is the
Diagnostic and Statistical Manual of Mental Disorders
. It classifies depression (major depressive disorder or MDD to be precise) under the broad diagnostic category of ‘Depressive Disorders’. The category also includes conditions such as dysthymia or persistent depressive disorder. Together with MDD, dysthymia presents with characteristic sadness, emptiness, and irritability (Sadock et al., 2015; APA, 2013). The case study is about an African American male child brought by his mother and who presents with sadness, thoughts about death, and a Children’s depression Rating Scale (CDRS) score of 30. Even without the symptoms, this CDRS score alone indicates that the boy is suffering from significant depression African American Child Suffering From Depression marked. From the history, it is clear that the boy avoids his peers in school and keeps to himself. He has complained of feeling sad, a sign that he may be experiencing anhedonia or indifference to happiness. The mental status examination or MSE also shows that the boy has suicidal thoughts (thoughts about death) as well as affect that is blunt. Considered in their totality, these symptoms align very well with the diagnosis of major depressive disorder (MDD) as outlined in the DSM-5 (APA, 2013). There are no other abnormalities found in the boy through laboratory investigations and physical examination. For this reason, the occurrence of the symptoms cannot be directly attributable to any physical illness or the effects of a substance or medication. DSM-5 criteria for diagnosing MDD include a lack of concentration, suicidal thoughts or thoughts about dying and death, prolonged sadness, a loss of interest in normal daily activities, feeling that one has no value, and psychomotor retardation (APA, 2013). This is a paper about the appropriate use of medications in treating this pediatric depression case. African American Child Suffering From Depression markedBUY A PLAGIARISM-FREE PAPER HERE
Decision Point One
At this decision point one; the decision taken is to give the 8 year-old boy with depression the selective serotonin reuptake inhibitor (SSRI) known as sertraline or Zoloft. This is an atypical antidepressant that happens to be effective against pediatric depression but that is only FDA-approved for use in treating the disorder in adults. What the FDA approval means is that there is still no safety and efficacy data from randomized controlled trials in children. However, clinicians still use such medications legally by reducing the dosages to fit the pediatric profile of their young patients. This is called off-label prescription (Allen et al., 2018; Vijay et al., 2018; Mir & Geer, 2017). In the case of Zoloft, there is enough anecdotal evidence that it is indeed effective in treating depression in children too when used off-label. The drug was started at an initial dose of 25 mg per day orally (Rosenthal & Burchum, 2018; Stahl, 2017). The child will then be monitored very closely for any signs of toxicity and adverse reactions that may occur. This is considering that information on these parameters is nonexistent for this medication in children. In other words, the information cannot be found in the package insert of medication literature that accompanies the medication (it is off-label in pediatrics).
The choice of sertraline is informed by several considerations. These are some of the reasons why a clinician may resort to off-label medications to treat pediatric conditions. Two of these stand out. The first one is when the child’s life is at risk and the physician or clinician thinks that they may benefit faster from the use of the off-label medication based on their personal experience and judgement. In this case, the African American boy has admitted to having thoughts about death and dying. This could be interpreted as suicidal ideation which places his life at risk. The second reason for using off-label medications in pediatric conditions is when there are not enough efficacious FDA-approved drugs to treat a pediatric condition. If the clinician feels that the child may then benefit from an off-label drug they have used before, they may then go ahead and use it in the spirit of beneficence as a bioethical principle (Haswell, 2019). Use of the off-label drug sertraline is therefore informed by the need to benefit the child far outweighing the risks.
The decision to choose sertraline (Zoloft) instead of the other two options (paroxetine or Paxil and bupropion or Wellbutrin) was informed by evidence-based practice (EBP). From the clinician’s experience and discussions with colleagues, sertraline has proved efficacious before when used off-label to treat pediatric major depressive disorder (Chon et al., 2017). The efficacy demonstrated by the off-label sertraline is such that remission of symptoms can be achieved within a matter of just four weeks. The hope when choosing sertraline or Zoloft was that remission of the boy’s symptoms would be achieved quickly. A confirmation of this would be made by patient testimony and repeat assessment using the CDRS (Shanahan et al., 1987). The child is expected to score lower than the initial 30 points that indicated major or significant depression.
A for the ethical considerations, the fact that the sertraline is off-label means that there is a real risk of unknown adverse effects affecting the child. However, the benefits to be gained by the child outweigh the risks and therefore it is beneficence that reigns. To mitigate the risk of harm to the patient, he will be monitored very closely and the sertraline stopped immediately there is any indication of an adverse outcome (nonmaleficence) (Haswell, 2019). These are the two bioethical principles that define the ethical perspective of this case.
Decision Point Two
On return for review and re-evaluation, the child and his mother reported that they had not experienced any improvement in the boy’s condition. In other words, the condition of depression and its symptoms remained intact even after starting the off-label sertraline (Zoloft). The boy had been taking the medication at a dose of 25 mg orally per day for the past four weeks as planned. But the absence of a change in the symptoms was not surprising at all. This lack of surprise is informed by knowledge about the pharmacodynamics of sertraline (Zoloft). Its therapeutic effect is known to start in earnest anywhere from two to four weeks (Stahl, 2017). Because of that, the boy was still well within the timeframe for the start of the therapeutic action of sertraline.
The decision taken at this decision point two was therefore to double the dose of the sertraline (Zoloft) to 50 mg orally every day for another four weeks. This decision is evidence-based as Stahl (2017) states that an increase in the dose of sertraline is indicated if the therapeutic effect does not kick in between four and six weeks. Also, increasing the dose would coincide with the beginning of the therapeutic effect and therefore maximise the benefit. The reasons for not choosing the other two options available were also evidence-based. An increase of the sertraline dose to 37.5 mg would have had minimal effect even after the therapeutic effect kicked in. Stopping sertraline and introducing fluoxetine or Prozac would have been premature and ill-informed. Even though Prozac is FDA-approved to treat MDD in children (Stahl, 2017); the off-label sertraline must first be given a chance to produce its full therapeutic effects before considering stoppage.
What was hoped would be achieved by doubling the dose of sertraline as done above was to produce a symptom reduction by about 50%, as indicated by the CDRS scores. In evidence-based practice, this is what is considered as a therapeutic response. Ethical considerations at this stage would be about autonomy. The mother and the child would be counselled and given psychoeducation so that they can remain adherent to the treatment and comply with the dosing. They will make this decision based not on coercion, but on the principle of concordance (Snowden et al., 2014). The decision by mother and child to continue with the same medication at an increased dose regardless of the apparent absence of improvement will therefore be informed (autonomy).
Decision Point Three
The child is returned after a total of eight weeks on sertraline (Zoloft), the last four of which were at an increased dose of 50 mg per day orally. As expected, the patient and his mother report a significant reduction of in his depressive symptoms. The CDRS assessment confirms this by showing that indeed the reduction in depressive symptoms is by half (50%). Indeed, the sertraline had now begun demonstrating its therapeutic effect after four weeks of use. Because the child was obviously responding well to the off-label sertraline, the decision made at this point was to raise its dose to 75 mg orally per day. This was expected to provide sustained symptom remission in a robust way. The other two options were rejected because there was a therapeutic response already demonstrated by the use of the off-label sertraline. The hope in increasing the sertraline dose was to increase the therapeutic response by at least another 25% to 30%. Ethically, beneficence and nonmaleficence were to be upheld as on the previous occasions.
Conclusion
This case of the 8 year-old African American male child with a diagnosis of major depression is a test of the pharmacotherapeutic acumen of the clinician. A thorough knowledge is required of the pharmacodynamics of each of the agents, as is knowledge about off-label use and FDA approval. Above all, the clinician needs to be abreast of the current evidence-based practice concerning pharmacologic treatment of childhood psychiatric conditions. Major depressive disorder is a diagnosis made in both adults and children. However, treatment by FDA-approved drugs in adults is straightforward. This is not the case in pediatrics. For this reason and based on anecdotal evidence and EBP, the choice of off-label sertraline was made. Knowledge of its pharmacodynamics enabled persistence even in the face of nonresponse within the first four weeks. The reduction in depressive symptoms by 50% was the turning point in treatment. It showed that the child was demonstrating a therapeutic response. This provoked a further increase to 75 mg orally every day, which was to sustain the effect and produce an even bigger response. In all, the decisions made were the best and the treatment was a success.
References
Allen, H.C., Garbe, M.C., Lees, J., Aziz, N., Chaaban, H., Miller, J.L., Johnson, P., & DeLeon, S. (2018). Off-label medication use in children, more common than we think: A systematic review of the literature.
The Journalof the Oklahoma State Medical Association, 111
(8), 776–783.
https://europepmc.org/article/pmc/pmc6677268American Psychiatric Association [APA] (2013).
Diagnostic and Statistical Manual of Mental Disorders (DSM-5), 5
th
ed
. Author. African American Child Suffering From Depression markedChon, M-W., Lee, J., Chung, S., Kim, Y., & Kim, H-W. (2017). Prescription pattern of antidepressants for children and adolescents in Korea based on nationwide data.
Journal of Korean Medical Science, 32
(10), 1694-1701.
https://doi.org/10.3346/jkms.2017.32.10.1694Haswell, N. (2019). The four ethical principles and their application in aesthetic practice.
Journal of Aesthetic Nursing
, 8(4), 177-179.
https://doi.org/10.12968/joan.2019.8.4.177Mir, A.N. & Geer, M.I. (2017). Off-label use of medicines in children.
International Journal of Pharmaceutical Sciences and Research
.Rosenthal, L.D., & Burchum, J.R. (2018).
Lehne’s pharmacotherapeutics for nurse practitioners and physician assistants
. Elsevier.Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015).
Synopsis of psychiatry: Behavioral sciences clinical psychiatry, 11
th
ed
. Wolters Kluwer.Shanahan, K.M., Zolkowski-Wynne, J., Coury, D.L., Collins, E.W., & O’Shea, J.S. (1987). The Children’s Depression Rating Scale for normal and depressed outpatients.
Clinical Pediatrics, 26
(5), 245-247.
https://doi.org/10.1177/000992288702600506Snowden, A., Martin, C., Mathers, B., & Donnell, A. (2014). Concordance: A concept analysis.
Journal of Advanced Nursing, 70
(1), 46-59.
https://doi.org/10.1111/jan.12147Stahl, S.M. (2017).
Stahl’s essential psychopharmacology: Prescriber’s guide, 6th ed
. Cambridge University Press.Vijay, A., Becker, J.E., & Ross, J.S. (2018). Patterns and predictors of off-label prescription of psychiatric drugs.
PLoS ONE 13
(7): e0198363.
https://doi.org/10.1371/journal.pone.0198363BACKGROUND INFORMATION
The client is an 8-year-old
African
American
male who arrives at the ER with his mother. He is exhibiting signs of
depression
. African American Child Suffering From Depression markedClient complained of feeling “sad”
Mother reports that teacher said
child
is withdrawn from peers in classMother notes decreased appetite and occasional periods of irritation
Client reached all developmental landmarks at appropriate ages
Physical exam unremarkable
Laboratory studies WNL
Child
referred to psychiatry for evaluationMENTAL STATUS EXAM
Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but
child
smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead. African American Child Suffering From Depression markedYou administer the Children’s
Depression
Rating Scale, obtaining a score of 30 (indicating significant
depression
)RESOURCES
§ Poznanski, E., & Mokros, H. (1996).
Child
Depression
Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.Decision Point One
Select what you should do:
Begin Zoloft 25 mg orally daily
Begin Paxil 10 mg orally daily
Begin Wellbutrin 75 mg orally BID
The Assignment: 5 pages
Examine Case Study: An
African
American
Child
Suffering
From
Depression
. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. African American Child Suffering From Depression markedAt each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
Rubric scores
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1–2 pages)
• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). African American Child Suffering From Depression marked
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples
Decision #2 (1–2 pages)
• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1–2 pages)
• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. African American Child Suffering From Depression marked
Conclusion (1 page)
• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
RESPONSE
Agree with decision point one but I do not see the other two options addressed with primary literature to support not using either. Paxil has significant data that shows the highest rate of SI in this population. Wellbutrin has little evidence of use in peds and also, when studied, was looked at in MDD/ADHD.
Agree with decision point two and see an adequate discussion to support.
I would mention that a lack of ADE also supports escalating the dose here.
I do not agree with decision point three. It has only been 4 weeks since your last dose increase. Not a full 6-8 weeks and he has shown a full response (reduction of symptoms by 50% or greater). The most appropriate answer here would be to continue with the same dose. A dose increase here could lead to ADE.
APA formatting should be with a left justified top line with a one tab singular indentation for each line below per citation. African American Child Suffering From Depression marked
-
Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
//
Bipolar TherapyBipolar Therapy
Client of Korean Descent/Ancestry
BACKGROUND INFORMATION
The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder.
Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?” Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
She weights 110 lbs. and is 5’ 5”
SUBJECTIVE
Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.”
BUY A PLAGIARISM-FREE PAPER HERE
You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work.
Genetic testing reveals that she is positive for CYP2D6*10 allele.
Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago.
MENTAL STATUS EXAM
The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation. Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
The Young Mania Rating Scale (YMRS) score is 22
RESOURCES
§ Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
Decision Point One
Select what you should do:
Begin Lithium 300 mg orally BID
Begin Risperdal 1 mg orally BID
Begin Seroquel XR 100 mg orally at HS
Assignment: Assessing and Treating Patients With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.
To prepare for this Assignment:
Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.
The Assignment: 5 pages
Examine
Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder.
You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.
Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.
Decision #1 (1 page)
Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #2 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
Decision #3 (1 page)
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder
Conclusion (1 page)
Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.
Note:
Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder