NURS 6050 Week 1 Discussion -Presidential Agendas

NURS 6050 Week 1 Discussion -Presidential Agendas

NURS 6050 Week 1 Discussion -Presidential Agendas

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NURS 6050 Week 1 Discussion -Presidential Agendas
Regardless of political affiliation, every citizen has a stake in healthcare policy decisions. Hence, it is little wonder why healthcare items become such high-profile components of presidential agendas. It is also little wonder why they become such hotly debated agenda items.
Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
To Prepare:

  • Review the Resources and reflect on the importance of agenda-setting.
  • Consider how federal agendas promote healthcare issues and how these healthcare issues become agenda priorities.

By Day 3 of Week 1
Post your response to the discussion question: Consider a topic that rises to the presidential level. How did each of the presidents (Trump, Obama, and Bush) handle the problem? What would you do differently?
By Day 6 of Week 1
Respond to at least two of your colleagues* on two different days by expanding on their response and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
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*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 1, “Informing Public Policy: An Important Role for Registered Nurses” (pp. 11–13 only)
  • Chapter 2, “Agenda Setting: What Rises to a Policymaker’s Attention?” (pp. 17–36)
  • Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 171–180)
  • Chapter 12, “An Insider’s Guide to Engaging in Policy Activities”
    • “Creating a Fact Sheet” (pp. 217-221)

Post by Day 3 and Respond by Day 6 of Week 1
To participate in this Discussion:
Week 1 Discussion
RE: Discussion – Week 1
Collapse
Addressing Opioid Crisis
One of the most tackled topics that are addressed on presidential level for years is the opioid crisis or epidemic. It is also consistent with what I encounter as a nurse in acute care hospital, as we handle patients who are misusing prescription pain relievers, heroin and fentanyl. According to Centers for Disease Control and Prevention (2020, March 19) “128 people die every day from an opioid overdose, and from 1999 to 2018, almost 450, 000 people deaths were recorded.” Because of the increasing number of deaths and devastating effects of the opioid crisis all over the United States of America, a range of actions were initiated nationally by the last three presidents.
First on the list is the former President George Bush, who was determined to fight the unacceptably high levels of drug use as he set the National Drug Control Strategy (Justice.gov, 2006), which explains focuses on three primary elements: stopping drug use before it starts, healing drug users, and disrupting the market for illicit drugs. While the strategy showed interesting plans, cases continued to fluctuate in the communities.
Next in line is the former President Barack Obama, who signed into the 21st Century Cures Act, which “funds a $1 billion proposal to combat the opioid epidemic and enacts mental health reforms focused on serious mental illness, suicide prevention, and mental health parity protections” (Obama White House, 2015). This act included funding the fight against opioid epidemic to provide the resources and treatments people need (Obama White House, 2016). The money may be used to improve prescription drug monitoring programs, to make treatment programs more accessible, to train health care professionals in best practices of addiction treatment, and to research the most effective approaches to prevent dependency (Wikipedia, n.d.).
This was then followed by President Donald Trump administration, who issued a nationwide call to action by declaring opioid crisis as a public health emergency in October 2017. According to the White House (n.d.), the proposed measures include:
Part 1 reducing demand and over-prescription, including educating Americans about the dangers of opioid misuse. Part 2 is cutting down on the supply of illicit drugs by cracking down on the international and domestic drug supply chains that devastate American communities. Part 3 is helping those struggling with addiction through evidence-based treatment and recovery support services. In 2018, President Trump worked with Congress to pass the SUPPORT Act, the single largest legislative package addressing a single drug crisis in history.
Undeniably, these strategies are still in progress, and as a nation we continue to fight for this battle. Unfortunately, drug overdose continues to impact our communities, and it is even leaving us with devastating deaths. If I have to address it differently, I will give more attention to the most vulnerable population who are the younger adults and reinforce education and community action. As a nurse, I can also contribute by helping officials collect new ideas by sharing and interpreting data in the health care system that affect patients and professionals. I will also be an advocate for those who are hesitant to disclose their main concerns and make sure that they will have support systems available. Each individual can do something by adhering to the nation’s policy and implementing it.
References
21st century cures act. (n.d.). Wikipedia. Retrieved September 1, 2020, from /orders/en.wikipedia.org/wiki/21st_Century_Cures_Act
3 letters that explain why president obama is signing the cures act. (2016, December 13). whitehouse.gov. Retrieved September 1, 2020, from /orders/obamawhitehouse.archives.gov/blog/2016/12/12/3-letters-explain-why-president-obama-signing-cures-act
Ending america’s opioid crisis. (n.d.). The White House. Retrieved September 1, 2020, from /orders/www.whitehouse.gov/opioids/
Improving health for all americans. (2015, December 1). whitehouse.gov. Retrieved September 1, 2020, from /orders/obamawhitehouse.archives.gov/the-record/health-care
National drug control strategy: February 2006 [PDF]. (2006). Justice.gov. /orders/www.justice.gov/archive/olp/pdf/ndcs06.pdf
Understanding the epidemic. (2020, March 19). Centers for Disease Control and Prevention. Retrieved September 1, 2020, from /orders/www.cdc.gov/drugoverdose/epidemic/index.html
 Addressing Opioid Crisis.docx (38.241 KB)
Hello Crisanta,
I enjoyed reading your discussion regarding the opioid crisis.  I found this discussion to be informative and well written.  Unfortunately, as a psychiatric nurse, I often encounter individuals who are struggling with substance abuse, as well as mental health illness.  Nurses not only provide these clients with physical and psychological care but provide education regarding the risks of substance addiction, including the physical and psychological consequences, the potential harm to relationships and family life, and the impact on fulfilling basic needs such as holding down a job.  Nurses educate patients regarding treatment options, including those they can use on either an inpatient or outpatient basis and those they can use to cope with substance cravings.
Research has shown that several underlying factors are responsible for drug addiction.  A combination of physical dependence, sexual addiction, violence in the family, and parental history of alcohol/drug use is associated with youth substance addiction (Ahad, 2017).  Substance addiction is also followed by some other issues, such as mental illness, domestic violence, economic deprivation, housing needs, and residence in dangerous neighborhood environments (Ahad, 2017).
President Trump announced on August 10, 2017, his intention to declare a national emergency following the recommendation of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.  Opioid misuse is one of the nation’s most severe preventable public health challenges.  To date, more than 600,000 deaths have occurred, with 180,000 more expected by 2020 (Gostin et al., 2017).  Of the 20.5 million US citizens 12 years of age or older with opioid use disorders in 2015, 2 million have been addicted to prescription pain relievers (Gostin et al., 2017).  A national emergency declaration authorizes public health forces, mobilizes resources, and encourages creative measures to combat a rapidly growing population.
Hydrocodone, oxycodone and overall opioid prescribing have been in a multiyear decline beginning in 2012 through early 2017 (Rose, 2018).  Total opioid analgesic prescriptions decreased 4.5% from 2011 to 2014, prompting rises in tramadol (+25.5%) and buprenorphine (+49.4%) prescriptions (Rose, 2018).  One study I found interesting reported that chronic pain as a medical cause of suicide is second only to bipolar disorder (Rose, 2018).  The distress, exhaustion, and hopeless chronic unrelieved pain can invite thoughts of suicidal ideations.  Death is no longer feared but becomes now a welcoming prospect of permanent relief from pain and anguish (Rose, 2018).  A concern would be that the decrease in prescription opioids would lead to more frequent street usage, causing an increase in substance abuse, overdoses, and suicide attempts and completions related to unrelieved pain.  This concern is why I feel it is so important that the United States continues to address the Opioid Crisis, as well as other substance abuse addictions.
I agree with your intervention to incorporate educational encouragement and community action programs.  An issue must be brought to social consciousness.  Addiction outreach programs should offer mentor programs, workshops, fun activities, awareness-raising rallies, drug take-back events and mediators to reintroduce users and loved ones.  A peer education program (PEPs) study was conducted in Turkey.  PEPs put into effect the use of providing peers with positive role models for each other.  The study was carried out to determine the effect of a PEP on the basic knowledge of adolescents about addiction and on the level of self-efficacy that is needed to avoid substance abuse.  The program lasted 3 months, the adolescents were from 14-16 years old.  After completing the program it was determined to have shown effectiveness and applicability of the PEP in preventing substance abuse among high-school adolescents (Demirezen, 2020).  I feel your discussion post was well thought out and presented.  The Opioid Crisis is a much-needed topic to bring awareness to.  I enjoyed reading your work!
References
Ahad, A., Chowdhury, M., Kundu, I., Tanny, N., & Rahman, M. W. (2017). Causes of Drug
Addiction\among Youth in Sylhet City of Bangladesh. IOSR Journal Of Humanities And Social Science (IOSR-JHSS)22(5), 27-31.
Demirezen, D., Karaca, A., Konuk Sener, D., & Ankarali, H. (2020). Agents of Change: The Role of the
Peer Education Program in Preventing Adolescent Substance Abuse. Journal of Child & Adolescent Substance Abuse, 1-12.
Gostin, L. O., Hodge, J. G., & Noe, S. A. (2017). Reframing the opioid epidemic as a national
emergency. Jama318(16), 1539-1540. /orders/10.1001/jama.2017.13358
Rose, M. E. (2018). Are prescription opioids driving the opioid crisis? Assumptions vs
facts. Pain Medicine19(4), 793-807.

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6050 NURS Week 5 Discussion: Professional Nursing and State-Level Regulations

6050 NURS Week 5 Discussion: Professional Nursing and State-Level Regulations

6050 NURS Week 5 Discussion

6050 NURS Week 5 Discussion: Professional Nursing and State-Level Regulations

                                                                               Discussion Post

Milstead and Short (2019) share that boards of nursing write rules with criteria that applicants must meet to be eligible to sit for licensure examinations and for issuing licenses.“Applicants for licensure must pass an initial licensing examination, then comply with continuing education requirements or undergo competency assessment by the regulatory body that provides oversight for that profession (Milstead & Short, 2019).

The College of Nurses of Ontario (CNO) is the regulatory board of nursing in the province I live, that provides licensure and establishes education requirements for Advanced Practice Registered Nurses (APRN).  APRN’s bring a holistic as well as patient-centered and family-centered approaches to the prevention and management of complex health and behavioral issues addressed in various care settings across the life span (Bosse et al., 2017).

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Within the category of APRN, are Nurse Practitioners (NP). NP’s provide primary, acute, and specialty health care across the lifespan through assessment, diagnosis, and treatment of illnesses and injuries (American Nurses Association).
Within Ontario, CNO defines NP’s as “registered nurses who have met additional education, experience and exam requirements set by the College. They are authorized to diagnose, order and interpret diagnostic tests, and prescribe medication and other treatment” (College of Nurses of Ontario, 2020). CNO has outlined regulations for NP’s.  One regulation the board has outlined for NP’s is in regards to medication administration. Only NP’s who have successfully completed approved additional education are authorized to prescribe controlled substances.
There are also prescription regulations for NP’s in the state of New York. The board of nursing in New York states the “law authorizes nurse practitioners (NPs) to order, prescribe or dispense medications (including controlled substances) for the treatment of their patients. After completing New York State Education Department approved pharmacology coursework and being certified by the New York State Education Department to prescribe, most nurse practitioners must obtain additional government approvals and meet other criteria in order to prescribe medications” (New York State Education Department, 2019).
Both the boards of nursing in Ontario and New York require additional education requirements prior to NP’s being able to prescribe medications. Ontario will allow NP’s after obtaining licensure to prescribe medications, but not controlled substances. To be able to prescribe controlled substances additional education will be needed.The New York State requires all NP’s to have an additional pharmacology coursework prior to having the ability to prescribe any medications.
The New York State board also allows nurses to practice independently and not under the supervision of Physicians (New York State Education Department, 2019). CNO also consider NP’s as independent Practitioners who also do not need to work under the supervision of a Physician (College of Nurses of Ontario, 2020).
The Texas Board of Nursing (2018) differs from New York and Ontario where NP’s must practice under the supervision of a Physician.

Bosse et al. (2017) share that APRNs who are able to work to the full extent of their education and training have greater potential to identify creative approaches for solving problems within these systems, which will benefit nursing as a discipline, the larger health care community, and most importantly the community they serve.

APRNs such as NP’s adhere to the regulations of their regulatory body by maintaining their educational requirements and license requirements. As Bosse et al. (2017) mentioned it is important that NP’s are able to work to the full extent of their education and training. As mentioned above some states still have not allowed NPs to work independently, such as Texas. It would benefit the community served if NP’s in all states and provinces had the ability to practice independently.

                                                                               References

American Nurses Association. (n.d.). ANA enterprse. Retrived December 29, 2020, from /orders/www.nursingworld.org/
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765. /orders/doi-org.ezp.waldenulibrary.org/10.1016/j.outlook.2017.10.002
College of Nurses of Ontario. (2020). Nurse Practitioners. /orders/www.cno.org/en/learn-about-standards-guidelines/educational-tools/nurse-practitioners/
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning
New York State Education Department. (2019). Nursing Prescription Privileges. http://www.op.nysed.gov/prof/nurse/np-ppep.htm
Texas Board of Nursing. (2018). Advance Practice Registered Nurse./orders/www.bon.texas.gov/applications_advanced_practice_registered_nurse.asp

Boards of Nursing (BONs) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:

  • Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of nursing practice.
  • Consider how key regulations may impact nursing practice.
  • Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..

By Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.

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By Day 6 of Week 5
Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 5
To participate in this Discussion:
Week 5 Discussion
Module 3: Regulation (Weeks 5-6)
Laureate Education (Producer). (2018). Regulation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
Compare state/regional board of nursing regulations
Compare boards of nursing and professional nurse associations
Analyze members of boards of nursing
Analyze state regulations for healthcare
Due By
Assignment
Week 5, Days 1–2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 5, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 5, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 5, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 5, Day 7
Wrap-up Discussion.
Week 6, Days 1-6
Continue to compose your Assignment.
Week 6, Day 7
Deadline to submit your Assignment.
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 4, “Government Response: Regulation” (pp. 57–84)
American Nurses Association. (n.d.). ANA enterprise. Retrieved September 20, 2018, from http://www.nursingworld.org
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761–765.
Halm, M. A. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280. doi:10.1111/wvn.12291
National Council of State Boards of Nursing (NCSBN). (n.d.). Retrieved September 20, 2018, from /orders/www.ncsbn.org/index.htm
Neff, D. F., Yoon, S. H., Steiner, R. L., Bumbach, M. D., Everhart, D., & Harman J. S. (2018). The impact of nurse practitioner regulations on population access to care. Nursing Outlook, 66(4), 379–385. doi:10.1016/j.outlook.2018.03.001
Peterson, C., Adams, S. A., & DeMuro, P. R. (2015). mHealth: Don’t forget all the stakeholders in the business case. Medicine 2.0, 4(2), e4. doi:10.2196/med20.4349.
Required Media
Laureate Education (Producer). (2018). The Regulatory Process [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Healthcare economics and financing [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Quality improvement and safety [Video file]. Baltimore, MD: Author.
Discussion: Professional Nursing and State-Level Regulations
Boards of Nursing (BON) exist in all 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands. Similar entities may also exist for different regions. The mission of BONs is the protection of the public through the regulation of the nursing practice. BONs put into practice state/region regulations for nurses that, among other things, lay out the requirements for licensure and define the scope of nursing practice in that state/region.
It can be a valuable exercise to compare regulations among various state/regional boards of nursing. Doing so can help share insights that could be useful should there be future changes in a state/region. In addition, nurses may find the need to be licensed in multiple states or regions.
To Prepare:
Review the Resources and reflect on the mission of state/regional boards of nursing as the protection of the public through the regulation of the nursing practice.
Consider how key regulations may impact nursing practice.
Review key regulations for nursing practice of your state’s/region’s board of nursing and those of at least one other state/region and select at least two APRN regulations to focus on for this Discussion..
By Day 3 of Week 5
Post a comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected.
By Day 6 of Week 5
Respond to at least two of your colleagues* on two different days and explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 5 Discussion Rubric
Post by Day 3 and Respond by Day 6 of Week 5
To participate in this Discussion:
Week 5 Discussion

RE: Discussion – Week 5

Week 5 Discussion

            My husband and I have recently moved from Colorado to North Carolina, and I was disheartened to find out that we had moved from a state that allows APRNs to practice unrestricted to a more rigidly restricted state. In Colorado, newly graduated nurse practitioners must complete an 1800-hour preceptorship with a physician, and they have to be able to meet and collaborate weekly. Following this preceptorship, the nurse practitioner and physician will then enter into a 1800 hours mentorship which has to be outlined with a plan for continued collaboration. (Nurse Practitioner Scope of Practice: Colorado | Thriveap, 2013)

            In North Carolina, APRNs must enter into a collaborative practice agreement with a physician. This agreement will outline the exact drugs and devices the APRN will be allowed to prescribe. Within the first six months, the APRN and physician will meet each month to discuss the agreement’s revisions or quality improvement measures. Once the first six months are complete, the APRN and physician will review the collaborative practice agreement annually. The burden seems to fall on the APRN to pay for a collaborative practice agreement with the physician, and a financial contract for the physician’s services must be drawn up. (North Carolina Scope of Practice Policy – State Profile, 2020)

In February 2019, legislators in North Carolina introduced the SAVE act with the hopes of removing outdated restrictions on APRNs and give them full practice authority. The act had a lot of support, and the North Carolina Nurses Association was hopeful that it would be passed by the end of 2020, but when COVID, the act was placed on the backburner.(Legislative Update 6/26/2020, 2020) It is still eligible to be brought up and voted on anytime this year, but with elections coming up in November, it seems like it will have to be refiled for next year. I hope that amid this pandemic, legislators will realize that allowing APRNs to practice fully could save money and, more importantly, save lives.

            I have found that the VA has nurse practitioner residency programs in most states for FNPs and PMHNPs, and there is one here in Durham, North Carolina. These programs are for one year, and they are paid internships. In 2016, the VA announced that it would recognize full practice authority for NPs, clinical nurse specialists, and nurse-midwives despite certain state restrictions.  (Livanos, 2016)

References

Legislative update 6/26/2020. (2020, June 26). North Carolina Nurses Association. /orders/ncnurses.org/advocacy/legislative/legislative-update-6-26-2020/

Livanos, N. (2016). Increasing avenues to care: Department of veterans affairs makes move to grant aprns full practice authority. Journal of Nursing Regulation, 7(3), 58–62. /orders/doi.org/10.1016/s2155-8256(16)32322-5

North carolina scope of practice policy – state profile. (2020). Scope of Practice Policy. http://dev.scopeofpracticepolicy.org/states/nc/

Nurse practitioner scope of practice: Colorado | thriveap. (2013, November 19). ThriveAP. /orders/thriveap.com/blog/nurse-practitioner-scope-practice-colorado

RE: Discussion – Week 5
Response#1
Hi Shelley,
I enjoyed reading your post. It’s so interesting how different states have such drastically different rules for advanced practice nurses. One would think that during a pandemic, it would be obvious that the need for advanced practice nurses is great, however, it does seem to have put a hold on a lot of things. According to the North Carolina Nurses Association, they remained very confident, naming this act as one of the highest priorities for the 2020 legislative session (NCNA, 2020).  I do agree with you, however, that there may be a hold up due to the presidential election season. Hopefully, though, those in healthcare can continue to advocate for the dire need of advanced practice nurses being able to operate to their full capacity. You mentioned the VA NP residency programs, are you interested in working for the VA? Just curious as to how those programs are. It might be a good option to try; it seems as though it is a great way to incorporate NP’S in utilizing their full practice authority.
One of my good friends that I met along my travel nursing experiences recently moved to Colorado specifically because NP’s are able to work independently. Her goal is to open her own practice and with Colorado’s laws for NP’s, it would allow her, essentially, to be her own medical director. It seems as though, as of 2010, NP’s in Colorado are not required to practice under the supervision of an MD, although, when it comes to prescribing medications there are some limitations early on in their career as an advanced practice nurse (ThriveAP, 2013).
After reading and researching through different state mandates, it’ll be interesting to see what will happen with regards to the independence of NP’s in the coming years. I do hope that North Carolina is finally able to pass the SAVE act!
References:
Nurse Practitioner Scope of Practice: Colorado. (2020, July 22). Retrieved October 02, 2020, from /orders/thriveap.com/blog/nurse-practitioner-scope-practice-colorado
SAVE Act. (n.d.). Retrieved October 02, 2020, from /orders/ncnurses.org/advocacy/legislative/save-act/

RE: Discussion – Week 5
 
Professional Nursing and State-Level Regulations
The state boards of nursing protect the public through controlling the nursing practice. The regulations indicate the level of education and scope of practice required to provide safe and cost-effective care. They vary from one state to another but aim to make sure nurses’ access growing evidence to provide effective care. There are important differences relating to education and renewal of licenses in Maryland and Idaho’s Boards of Nursing.
As mentioned, Maryland and Idaho’s Boards of Nursing have different regulations relating to education and renewal of licenses. In Maryland, the Board of Nursing approves licenses for APRNs upon obtaining a master’s degree or higher in an approved nurse practitioner program (NCSBN, 2020). On the other hand, in Idaho, an APRN only provide evidence of a graduate or post-graduate nursing program degree. Moreover, the nursing license is renewed after a specific period. In the state of Maryland, the renewal of licenses is done annually, and APRNs must provide active national certification and transcripts of refresher courses undertaken during the period of practice (NCSBN, 2020). In Idaho, APRN licenses are renewed after two years, and APRNs must undergo a 10-hour course on pharmacology (NCSBN, 2020). The education and training impart knowledge and skills to support nurses to practice at the advanced level.
Graduate or post-graduate degree, refresher courses, and continuous education required for renewal of APRN license apply to APRN’s scope of practice. Education and license renewal requirements support the provision of safe and cost-effective care by the APRNs (Nursing Licensure, 2020). According to Bosse et al. (2017), continuous education and refresher courses allow nurses to access a growing body of evidence essential in the execution of APRN roles. Per Halm (2018), attaining a graduate or post-graduate degree program and engaging in continuous nursing education helps APRNs to utilize their knowledge and skills to the full extent of their training. Importantly, APRNs must adhere to the education and licensure stipulations. For example, a nurse needs to hold RN and APRN credentials concurrently because RN licensure is a precondition to APRN. The two licensure credentials facilitate a nurse’s licensing process.
The license requirements vary from one state to another. Apart from the required educational qualification, different states require additional training to help APRNs address changes in the ever-changing healthcare sector. The education and renewal of license provisions help nurses with a growing body of evidence to competently provide care to patients
References
Bosse, J., Simmonds, K., Hanson, C., Pulcini, J., Dunphy, L., Vanhook, P., & Poghosyan, L. (2017). Position statement: Full practice authority for advanced practice registered nurses is necessary to transform primary care. Nursing Outlook, 65(6), 761-765.
Halm, M. (2018). Evaluating the impact of EBP education: Development of a modified Fresno test for acute care nursing. Worldviews on Evidence-Based Nursing, 15(4), 272–280.
NCSBN. (2020). Board of Nursing professional licensure requirements. National Council of State Boards of Nursing. /orders/www.ncsbn.org/14730.htm.
Nursing Licensure. (2020). Nurse Practitioner license requirements: Change is in the air. Nursing Licensure. /orders/www.nursinglicensure.org/articles/nurse-practitioner-license.html
Rubric Detail
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Content
Name: NURS_6050_Module03_Week05_Discussion_Rubric
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List View
Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6050_Module03_Week05_Discussion_Rubric

NURS 6050 Week 3 Discussion: Politics And The Patient Protection

NURS 6050 Week 3 Discussion: Politics And The Patient Protection

NURS 6050 Week 3 Discussion

NURS 6050 Week 3 Discussion: Politics And The Patient Protection

RE: Discussion – Week 3
Main Post
Politics and the Patient Protection and Affordable Care Act
Citizens of the United States were presented with a new healthcare reform act known as the Patient Protection and Affordable Care Act in 2010. The Patient Protection and Affordable Care Act, also known as Obamacare, was intended to develop healthcare and health insurance businesses in America. The main aim of Obamacare is to increase new benefits for healthcare, more patient rights, more patient protection, and make healthcare more affordable and accessible to the citizens in the United States. Attempts to repeal and replace Obamacare have been a subject matter constitutionally contested and have the subtle meaning of egotism by politicians to capitalize on voter support.  From a cost-benefit approach, for a system to be cost-effective, the benefits must be higher in comparison to the amount acquired during the enactment of the program (Milstead & Short, 2019). When the Patient Protection and Affordable Care Act was developed, it made access to healthcare available to most American citizens, and thus, repealing and replacing the act will make political lawmakers lose voter support.
Despite the reported accomplishments of the Affordable Care Act, there is still political deliberation to repeal and replace it. Many political leaders are concerned that if the Act is repealed, many Americans will lose coverage from insurance companies (Taylor, et al., 2017). Consequently, many low-income or middle-class families insured under the Act by the Medicaid program will lose their coverage. A study by DaVanzo (2016) projected that if the Affordable Care Act is repealed, by 2026, the number of uninsured persons would have increased by 22 million persons, which can lead to an unparalleled health crisis as persons would no longer be covered and able to receive the care they need.
Since the Act was enacted, it has encountered many disputes among politicians. Since in office, the Trump administration has attempted to repeal and replace Obamacare but has since not succeeded. During his elections, many legislators supported this idea but at the present time, considers this decision a liability as they are up for re-election (Hawryluk, 2020). Legislators are more likely to support agendas that are favorable to them based on a cost-benefit analysis. As such, repealing The Affordable Care Act will not be of benefit to them and the American people. Therefore, they are unlikely to reverse the action.
The Affordable Care Act allows many Americans to have access to services in healthcare, and repealing the Act will only make legislators lose the voter support they want. Most political decisions and policies are driven by an appeal to the expectations of their voters.

References

DaVanzo, D. (2016, December 6). Estimating the Impact of Repealing the Affordable Care Act on Hospitals. Retrieved from AHA.org: /orders/www.aha.org/system/files/2018-02/impact-repeal-aca-report_0.pdf
Hawryluk, M. (2020, August 28). Opposition to Obamacare Becomes Political Liability for GOP Incumbents. Retrieved from KHN: /orders/khn.org/news/opposition-to-obamacare-becomes-political-liability-for-gop-incumbents/
Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurse’s Guide (6 ed.). Burlington, MA: Jones & Bartlett Learning.
Taylor, D., Olshansky, E. F., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017, May 1). Corrigendum to position statement: Political interference in sexual and reproductive health research and health. Nursing Outlook, 65(3), 346-350. doi:/orders/doi.org/10.1016/j.outlook.2017.05.003

Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.
Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.
To Prepare:

  • Review the Resources and reflect on efforts to repeal/replace the Affordable Care Act (ACA).
  • Consider who benefits the most when policy is developed and in the context of policy implementation.

By Day 3 of Week 3
Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.

ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: NURS 6050 Week 3 Discussion: Politics And The Patient Protection

By Day 6 of Week 3
Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
*Note: Throughout this program, your fellow students are referred to as colleagues.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 3 Discussion Rubric

Post by Day 3 and Respond by Day 6 of Week 3
To participate in this Discussion:
Week 3 Discussion
Module 2: Legislation (Weeks 3-4)
Laureate Education (Producer). (2018). Legislation [Video file]. Baltimore, MD: Author.
Learning Objectives
Students will:
Analyze how cost-benefit analysis affects legislative efforts
Analyze legislative intent of bills
Identify proponents and opponents of bills
Analyze legislative process of bills
Advocate policy position for bills
Due By
Assignment
Week 3, Days 1-2
Read/Watch/Listen to the Learning Resources.
Compose your initial Discussion post.
Week 3, Day 3
Post your initial Discussion post.
Begin to compose your Assignment.
Week 3, Days 4-5
Review peer Discussion posts.
Compose your peer Discussion responses.
Continue to compose your Assignment.
Week 3, Day 6
Post at least two peer Discussion responses on two different days (and not the same day as the initial post).
Week 3, Day 7
Wrap up Discussion.
Week 4, Days 1-6
Continue to compose your Assignment.
Week 4, Day 7
Deadline to submit your Assignment.
Learning Resources
Required Readings
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.
Chapter 3, “Government Response: Legislation” (pp. 37–56)
Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 180–183 only)
Congress.gov. (n.d.). Retrieved September 20, 2018, from /orders/www.congress.gov/
Taylor, D., Olshansky, E., Fugate-Woods, N., Johnson-Mallard, V., Safriet, B. J., & Hagan, T. (2017). Corrigendum to position statement: Political interference in sexual and reproductive health research and health professional education. Nursing Outlook, 65(2), 346–350. doi:10.1016/j.outlook.2017.05.003.
United States House of Representatives. (n.d.). Retrieved September 20, 2018, from /orders/www.house.gov/
United States Senate. (n.d.). Retrieved September 20, 2018, from /orders/www.senate.gov/
United States Senate. (n.d.). Senate organization chart for the 115th Congress. Retrieved September 20, 2018, from /orders/www.senate.gov/reference/org_chart.htm
Document: Legislation Comparison Grid Template (Word document)
Required Media
Laureate Education (Producer). (2018). Working with Legislators [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Introduction to Health Policy and Law with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Credit: Provided courtesy of the Laureate International Network of Universities.
Laureate Education (Producer). (2018). Contemporary Issues in Public Health Policy with Joel Teitelbaum [Video file]. Baltimore, MD: Author.
Laureate Education (Producer). (2018). Peter Beilenson: Population Health [Video file]. Baltimore, MD: Author.

Affordable Care Act Cost-Benefit Analysis

The Affordable Care Act (ACA) of 2010, popularly known as Obamacare, is a law that intended to make sure that all Americans had access to health insurance. One of its key factors is that it is determined to ensure that low-income earners can access health services. Most of such people are unemployed, with disabilities, tasked with household responsibilities, or unable to meet the necessity because of the history of their health, such as a chronic disease or medical condition. However, the act is an issue to various political debates with some advocates arguing that it will ensure improved longevity to Americans and advocates stating that it is not in line with the development agenda. The ACA has various winners and losers in terms of legislators seeking reelection and voters having differing interests in the enactment of the policy.
The impact of the enactment of the ACA policy has positive and negative impacts on policymakers seeking reelection. Concerning elected members, those who voted for the bill would benefit by serving people. On the other hand, most politicians are funded by pharmaceutical and medical corporate organizations that make one of the most significant industries in the United States (Hathi & Kocher, 2017). Therefore, although lawmakers will benefit from the electorate’s goodwill, they will lose from the campaign funds. On the other hand, the ACA policy has immeasurable benefits to voters (McKay, 2018). Therefore, ACA influences people positively and negatively.
ACA has positive and negative impacts on the electorate. The higher income citizens realize that the act is a corrective measure towards people earning higher incomes that the unprivileged ones because of the increased taxes. In contrast, lower-income citizens perceive the act as beneficial because most of them have suffered because of lack of sufficient funds to access healthcare services (Milstead & Short, 2019). Therefore, the perception depends on the income of the person.
The cost-benefit analysis affects those legislators who are seeking reelection because they must balance between their need to appease the people and ensure that they can access funds from the corporate entities. The legislators must guarantee that all people are satisfied with the policy. The most significant embarrassment is that politicians are not in a position to please the entire electorate because some Americans, mostly the low-income earners, are concerned about their wellbeing, while others are concerned about having to take care of other humans in the market. Moreover, legislators must consider the impact of their decisions to support the policy and their need to garner campaign money from affected companies.

References
Hathi, S., & Kocher, B. (2017, July/August). The right way to reform health care: To cut costs, empower patients. Foreign Affairs, 96, 17-25.
McKay, A. M. (2018). Fundraising for favors? linking lobbyist-hosted fundraisers to legislative benefits. Political Research Quarterly, 71(4), 869-880. doi:http://dx.doi.org/10.1177/1065912918771745
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.

Week 3 Response Post

Grace G..,

               Thank you for your interesting post. The Affordable Care Act is indeed a beneficial law. According to HHS.gov (n.d.), “the law addresses health insurance coverage, health care costs, and preventive care.” Many Americans and immigrants benefited from this law as it reflects equality when accessing health care services.  For instance, I know a family friend of mine who is a low-income worker. He has a chronic condition and was unintentionally non-compliant with his medications and doctor follow-ups because of high co-payments or total out of pocket spending. However, when the ACA was signed in 2010, he decided to take the opportunity of accessing all the health care benefits that he could get. He started availing free medications and following up with his doctors. It also has been easier for him to attend preventive programs to avoid condition exacerbation.

               Unfortunately, just like the other laws, the Affordable Care Act is not perfect and needs improvement as it affects high-income workers. But instead of improving it, many people who are against the law want it repealed instead. This is where the legislator’s discretion on cost-benefit analysis is applied; it is a “way to compare the costs and benefits of an intervention, where both are expressed in monetary units” (CDC.gov, n.d.). Even if the legislator intends to make an acceptable policy for the goodwill, they would also have to consider the campaign funds that they will need to be re-elected. According to Glassman (2018), “most of the time, members of Congress do want to pass good public policy, but they also have two other important goals, re-election and increased power in the legislature.”

                In the end, I still believe that it is always ideal for the legislators to depend on their decision making for the public good without thinking about the electoral consequences. But just like an ordinary individual, legislators have needs to fulfill, and number one of them is to be re-elected.

References

Glassman, M. (2018, February 7). Why congress doesn’t always do the right thing. The New York Times. Retrieved September 16, 2020, from

                   /orders/www.nytimes.com/2018/02/07/opinion/congress-incentives-public-good.html

What is the affordable care act? (2015, June 7). HHS.gov. Retrieved September 16, 2020, from

                   /orders/www.hhs.gov/answers/affordable-care-act/what-is-the-affordable-care-act/index.html

Cost-benefit analysis. (n.d.). Centers for Disease Control and Prevention (CDC). Retrieved September 16, 2020, from

                   /orders/www.cdc.gov/policy/polaris/economics/cost-benefit-analysis.html

RE: Discussion – Week 3
 
The Affordable Care Act (ACA) legislation was enacted into law to ensure all Americans had access to a health care plan that provided both adequate and affordable health care coverage. This legislation has been the subject of discussion and political debate since. In our cost-benefit analysis we consider what the ACA and changes to the ACA mean politically and for the individual American.
The ACA provides access to affordable health care coverage, and it has helped many Americans. A February 2019 article indicated about twenty million Americans were no longer uninsured since the implementation of the ACA in 2010 (McIntyre & Song, 2019, p.1). Prior to the law being passed, many Americans were either not covered or had inadequate health care coverage. The reason for the lack of adequate coverage in some cases was strictly because the coverage was not affordable, and in other cases it was a matter of coverage not being available through their employer(s) or the available coverage was inadequate. Another big concern for would-be insurance shoppers prior to the implementation of the ACA was pre-existing conditions. The Affordable Care Act addressed all of these situations and concerns. Republican posturing about repealing the ACA in its entirety left the many Americans that have benefitted from the law concerned and wondering if they will again be unable to afford adequate health care coverage for themselves and their families.
Mr. Himes, US Representative from the fourth district of Connecticut, stated while addressing the House that one of the proudest moments of his career in the Chamber “was the passage of the Affordable Care Act, not because it was perfect–it wasn’t–but because it changed the lives for the better of tens of millions of Americans.” (H. Rep No. 165-108, 2019, H5176). In an attempt to illustrate what repeal would look like, he goes on to say “overturning the ACA would raise the number of uninsured people in the United States by 20 to 21 million people. Due to preexisting conditions, more than 100 million Americans could face higher health insurance premiums or the possibility that they might not get insured at all” (H. Rep No. 165-108, 2019, H5176). There are parts of the ACA that many Americans agree should stay, and therefore a total repeal of the ACA seems like a gamble. Mr. Himes asks that as you consider the claim from his “Republican friends that they will preserve preexisting condition coverage, remember that they promised for 10 years to repeal the Affordable Care Act, and they didn’t do it. Then they promised to repeal and replace the Affordable Care Act, and they didn’t do it. So when they promise to preserve preexisting conditions, take that with a grain of salt” (H. Rep No. 165-108, 2019, H5176). It is fair to point out that politicians do not always do what they say they will do, but that is of little comfort to the millions of Americans worried about losing their health insurance coverage.
“Nearly nine years after its passage, the Affordable Care Act (ACA) remains at the forefront of public policy debate” (McIntyre & Song, 2019, p.1), which is worth mentioning since the textbook for this course points out that “policymakers are not necessarily focused on how real people will be affected by changes to Obamacare or Medicare and Medicaid but rather on how the changes will affect their own re-election chances” (Milstead & Short, 2019, p.44). Cost-benefit analysis of the changes to the ACA and the politics surrounding it, along with the potential loss of favor and even future votes for elected officials, highlights the potential for politicians to make decisions they feel will cost them the least votes. The fact that too much deviation from an agreed party agenda could cost a politician favor and votes is something they must consider if they would like to remain in office.
Bottom line, one should consider that elected officials’ decisions could be, at least in part, based on how the decision will impact their future in politics. Unfortunately, this could mean that not all political decisions are being made in the best interest of the American people but rather in the best interest of elected officials worried about losing their jobs. Given this thinking, counting on a politician keeping a promise that might make it harder for him or her to get reelected seems foolish. Therefore, Americans are right to be concerned that a complete repeal of the ACA could remove protections without replacing them in any new healthcare legislation.
 
References
Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th
ed.). Burlington, MA: Jones & Bartlett Learning.
McIntyre, A., & Song, Z. (2019). The US Affordable Care Act: Reflections and directions at the close of a
decade. PLoS medicine16(2), e1002752. /orders/doi.org/10.1371/journal.pmed.1002752
165 Cong. Rec. No. 108. (June 26, 2019) p.H5176. (statement of Rep. Himes)
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6050_Module02_Week03_Discussion_Rubric
Grid View
List View
Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)
Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.
Supported by at least three current, credible sources.
Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 40 (40%) – 44 (44%)
Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.
At least 75% of post has exceptional depth and breadth.
Supported by at least three credible sources.
Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 35 (35%) – 39 (39%)
Responds to some of the discussion question(s).
One or two criteria are not addressed or are superficially addressed.
Is somewhat lacking reflection and critical analysis and synthesis.
Somewhat represents knowledge gained from the course readings for the module.
Post is cited with two credible sources.
Written somewhat concisely; may contain more than two spelling or grammatical errors.
Contains some APA formatting errors.
Points Range: 0 (0%) – 34 (34%)
Does not respond to the discussion question(s) adequately.
Lacks depth or superficially addresses criteria.
Lacks reflection and critical analysis and synthesis.
Does not represent knowledge gained from the course readings for the module.
Contains only one or no credible sources.
Not written clearly or concisely.
Contains more than two spelling or grammatical errors.
Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3.
First Response
Points Range: 17 (17%) – 18 (18%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 15 (15%) – 16 (16%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 13 (13%) – 14 (14%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 12 (12%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Second Response
Points Range: 16 (16%) – 17 (17%)
Response exhibits synthesis, critical thinking, and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.
Demonstrates synthesis and understanding of learning objectives.
Response is effectively written in standard, edited English.
Points Range: 14 (14%) – 15 (15%)
Response exhibits critical thinking and application to practice settings.
Communication is professional and respectful to colleagues.
Responses to faculty questions are answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
Points Range: 12 (12%) – 13 (13%)
Response is on topic and may have some depth.
Responses posted in the discussion may lack effective professional communication.
Responses to faculty questions are somewhat answered, if posed.
Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 11 (11%)
Response may not be on topic and lacks depth.
Responses posted in the discussion lack effective professional communication.
Responses to faculty questions are missing.
No credible sources are cited.
Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
Name: NURS_6050_Module02_Week03_Discussion_Rubric
RE: Discussion – Week 3
 
The Affordable Care Act (ACA), or Obamacare, was signed into legislation in 2010. The ACA changed the healthcare system by reducing the amount citizens paid for themselves and their families for uncompensated care. The act also required every US citizen to have health insurance and provided assistance to those who could not afford it (eHealth, 2020). Although the ACA has been beneficial for most Americans, the Republicans and Democrats have not seen eye to eye on the act. Republicans believe that the ACA violates “American independence with its individual mandate and increased taxation” (HealthNetwork, 2017), hence one of the reasons why Trump has been trying to repeal and replace the act.
Politics is not a strong suit of mine so before starting this week’s discussion post I had to first look into what cost-benefit analysis (CBA) is. CBA is a way to compare the costs and benefits of an intervention. After learning the definition of CBA, I was able to apply it to legislation. One of the main goals of any legislator is to be re-elected. Legislators have to always be on their toes because a simple act such as wanting to repeal and replace the ACA could cause them a vote or monetary losses. By analyzing voters’ views, legislators can then make recommendations for new or changes to policies. When a legislator knows what the people want, they then have a greater chance of achieving their goal of being re-elected.
 
References
eHealth. (2020, October). History and Timeline of the Affordable Care Act (ACA). Retrieved from /orders/www.ehealthinsurance.com/resources/affordable-care-act/history-timeline-affordable-care-act-aca
HealthNetwork. (2017, July). What’s Dividing Republicans and Democrats on Healthcare Reform? Retrieved from HealthNetwork: /orders/healthnetwork.com/blog/differences-between-republicans-and-democrats-on-healthcare/

Advanced Levels of Clinical Inquiry

Advanced Levels of Clinical Inquiry

Your quest to purchase a new car begins with an identification of the factors important to you. As you conduct a search of cars that rate high on those factors, you collect evidence and try to understand the extent of that evidence. A report that suggests a certain make and model of automobile has high mileage is encouraging. But who produced that report? How valid is it? How was the data collected, and what was the sample size?
In this Assignment, you will delve deeper into clinical inquiry by closely examining your PICO(T) question. You also begin to analyze the evidence you have collected.
To Prepare:

  • Review      the Resources and identify a clinical issue of interest that can form the      basis of a clinical inquiry.
  • Develop      a PICO(T) question to address the clinical issue of interest you      identified in Module 2 for the Assignment. This PICOT question will remain      the same for the entire course.
  • Use      the key words from the PICO(T) question you developed and search at least      four different databases in the Walden Library. Identify at least four      relevant systematic reviews or other filtered high-level evidence, which includes      meta-analyses, critically-appraised topics (evidence syntheses),      critically-appraised individual articles (article synopses). The evidence      will not necessarily address all the elements of your PICO(T) question, so      select the most important concepts to search and find the best evidence      available.
  • Reflect      on the process of creating a PICO(T) question and searching for      peer-reviewed research.
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The Assignment (Evidence-Based Project)
Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews
Discussion: Evidence-Based Project Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify      and briefly describe your chosen clinical issue of interest.
  • Describe      how you developed a PICO(T) question focused on your chosen clinical issue      of interest.
  • Identify      the four research databases that you used to conduct your search for the      peer-reviewed articles you selected.
  • Provide      APA citations of the four relevant peer-reviewed articles at the      systematic-reviews level related to your research question. If there are      no systematic review level articles or meta-analysis on your topic, then      use the highest level of evidence peer reviewed article.
  • Describe      the levels of evidence in each of the four peer-reviewed articles you      selected, including an explanation of the strengths of using systematic      reviews for clinical research. Be specific and provide examples.

Discussion: Evidence-Based Project- Resources Provided
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter      2, “Asking Compelling Clinical Questions” (pp. 33–54)
  • Chapter      3, “Finding Relevant Evidence to Answer Clinical Questions” (pp. 55–92)

Davies, K. S. (2011). Formulating the evidence based practice question: A review of the frameworks for LIS professionals. Evidence-Based Library and Information Practice, 6(2), 75–80. /orders/doi.org/10.18438/B8WS5N
Note: You will access this article from the Walden Library databases.
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from /orders/catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010a). Evidence-based practice, step by step: Asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110(3), 58–61. doi:10.1097/01.NAJ.0000368959.11129.79
Note: You will access this article from the Walden Library databases.
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11), 49–52. doi:10.1097/01.NAJ.0000363354.53883.58
Note: You will access this article from the Walden Library databases.
Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010b). Evidence-based practice, step by step: Searching for the evidence. American Journal of Nursing, 110(5), 41–47. doi:10.1097/01.NAJ.0000372071.24134.7e
Note: You will access this article from the Walden Library databases.
Walden University Library. (n.d.-a). Databases A-Z: Nursing. Retrieved September 6, 2019, from /orders/academicguides.waldenu.edu/az.php?s=19981
Walden University Library. (n.d.-c). Evidence-based practice research: CINAHL search help. Retrieved September 6, 2019, from /orders/academicguides.waldenu.edu/library/healthevidence/cinahlsearchhelp
Walden University Library. (n.d.-d). Evidence-based practice research: Joanna Briggs Institute search help. Retrieved September 6, 2019, from /orders/academicguides.waldenu.edu/library/healthevidence/jbisearchhelp
Walden University Library. (n.d.-e). Evidence-based practice research: MEDLINE search help. Retrieved September 6, 2019, from /orders/academicguides.waldenu.edu/library/healthevidence/medlinesearchhelp
Walden University Library. (n.d.-f). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/boolean
Walden University Library. (n.d.-g). Keyword searching: Finding articles on your topic: Introduction to keyword searching. Retrieved September 19, 2018, from http://academicguides.waldenu.edu/library/keyword/searching-basics 
Walden University Library. (n.d.-h). Quick Answers: How do I find a systematic review article related to health, medicine, or nursing? Retrieved September 6, 2019, from /orders/academicanswers.waldenu.edu/faq/72670
Walden University Library. (n.d.-i). Systematic review. Retrieved January 22, 2020, from /orders/academicguides.waldenu.edu/library/healthevidence/types#s-lg-box-1520654

Discussion: Evidence-Based Project
Answer Rubric

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: · Identify and briefly describe your chosen clinical issue of interest. · Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. · Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. · Provide APA citations of the four peer-reviewed articles you selected. · Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.
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 is provided, which delineates all required criteria.
Written Expression and Formatting—English Writing Standards:
Correct grammar, mechanics, and proper punctuation.

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NURS6630 Week 6 Midterm Exam A non-compliant patient states, “Why do you want me to put this poison in my body?”

NURS6630 Week 6 Midterm Exam A non-compliant patient states, “Why do you want me to put this poison in my body?”

NURS6630 Week 6 Midterm Exam

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NURS6630 Week 6 Midterm Exam latest 2018 June Week 6 midterm A non-compliant patient states, “Why do you want me to put this poison in my body?”
Question 1
A non-compliant patient states, “Why do you want me to put
this poison in my body?” Identify the best response made by the
psychiatric-mental health nurse practitioner (PMHNP).
Question 2
Which statement about neurotransmitters and medications is
true?
Question 3
When an unstable patient asks why it is necessary to add
medications to his current regimen, the PMHNP’s best response would be:
Question 4
During gene expression, what must occur prior to a gene
being expressed?
Question 5
While genes have potential to modify behavior, behavior can
also modify genes. How do genes impact this process?
Question 6
Though medications have the ability to target
neurotransmitters in the synapse, it is not always necessary. The PMHNP
understands that this is because:
Question 7
Why is the cytochrome P450 enzyme system of significance to
the PMHNP?
Question 8
It is important for the PMHNP to recognize differences in
pharmacokinetics to safely prescribe and monitor medications. Which of the
following statements does the competent PMHNP identify as true?
Question 9
As it relates to G-protein linked receptors, what does the
PMHNP understand about medications that are used in practice?
Question 10
The PMHNP is considering prescribing a 49-year-old male
clozapine (Clozaril) to treat his schizophrenia and suicidal ideations. The
PMHNP is aware that which factor may impact the dose needed to effectively
treat his condition:
Question 11
A patient is diagnosed with bipolar disorder and is
currently taking carbamazepine (Tegretol), aripiprazole (Abilify), and
melatonin. The PMHNP has just written an order to discontinue the carbamazepine
(Tegretol) for drug-induced thrombocytopenia. The PMHNP is aware that his next
best action is to:
Question 12
A patient recently transferred following a suicide attempt
has a history of schizophrenia, depression, and fibromyalgia. He is currently
taking Amitriptyline (Elavil), Lisinopril, aspirin, and fluoxetine (Prozac).
Which is the best action for the PMHNP to take for this patient?
Question 13
A patient with schizophrenia is given an inverse agonist
that acts on the receptor 5HT and neurotransmitter serotonin. What is the
rationale for prescribing a medication such as this?
Question 14
The PMHNP is caring for four patients. Which patient
statement indicates that benzodiazepines would be beneficial?
Question 15
Ms. Harlow is a 42-year-old patient who is prescribed a drug
that acts on ionotropic receptors. She is curious about the effects of the drug
and how it will act on her symptoms. Which statement made by the PMHNP
demonstrates proper understanding of Ms. Harlow’s prescription?
Question 16
A patient is seeking pharmacological treatment for smoking
cessation. Which drug class does the PMHNP prescribe to the patient?
Question 17
The PMHNP is caring for a new patient who has been
transferred from another office. When meeting with the new patient, the patient
reports, “I feel like I am improving with the stabilizers.” The PMHNP
immediately recognizes that the patient is describing which kind of drug?
Question 18
A patient presents with frequent episodes of mania. Which
statement describes an appropriate treatment approach for this patient?
Question 19
The PHMNP is caring for a patient who would benefit from
nicotine cholinergic, serotonin 3, or glycine receptors. What kind of agent
does the PHMNP want to prescribe for this patient?
Question 20
Which statement made by the patient suggests the patient
will need to be treated with antipsychotics that target paranoid psychosis?
Question 21
A patient has been treated with a number of novel
psychotropic drugs. How is it theoretically possible to identify cognitive
improvement in the patient using neuropsychological assessment batteries after
the pharmacologic therapy?
Question 22
Mr. McCullin is 64 years old with Parkinson’s disease. The
PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help
manage and treat his condition. The PHMNP selects this agent because of which
action it has on patients like Mr. McCullin?
Question 23
Mrs. Trevor is a 44-year-old patient who does not have a
diagnosis of schizophrenia but occasionally reports symptoms of psychosis,
followed by severe fatigue. Mrs. Trevor inquires about the use of amphetamines
to help with her energy levels. Which response made by the PMHNP is most
appropriate?
Question 24
The PMHNP is caring for a patient with schizophrenia and is
considering a variety of treatment approaches. The PHMNP selects a viable treatment
that is consistent with the “dopamine hypothesis of schizophrenia.” What action
does the PMHNP anticipate this treatment having on the patient?
Question 25
A patient is diagnosed with schizophrenia. What increases
the patient’s potential to mediate the cognitive symptoms of the disease?
Question 26
The PMNHP is assessing a 29-year-old patient who takes
antipsychotics that block D2 receptors. What patient teaching should the PMHNP
include related to the possible side effects of this type of drug?
Question 27
The PMHNP is caring for a patient who is taking
antipsychotics heard the psychiatrist tell the patient that the patient would
be placed on a different antipsychotic agent. Which of the following requires
the longest transition time for therapeutic benefit?
Question 28
The PMHNP is assessing a patient who has cirrhosis of the
liver and anticipates that the patient will be prescribed an antipsychotic.
Which medication does the PMHNP suspect will be ordered for this patient?
Question 29
Which statement made by the PMHNP exemplifies correct
teaching of physiological effects in the body?
Question 30
Mrs. Schwartzman is a 52-year-old patient with schizophrenia
and no established history of depression. When meeting with the PMHNP, she
presents with apathy and withdrawn social behavior, and she reports a loss of
joy from enjoyable activities. What does the PMHNP infer from this encounter
with the patient?
NURS6630 Week 6 Midterm Exam latest 2018 June Week 6 midterm A noncompliant patient states, “Why do you want me to put this poison in my body?” Question 31
The PMHNP is taking a history on a patient who has been on
antipsychotics for many years. Which risk factors are most likely to contribute
to a person developing tardive dyskinesia (TD)?
Question 32
The student inquires about antipsychotic medications. Which
response by the PMHNP describes the factors that contribute to reduced risk of
extrapyramidal symptoms (EPS) for patients who take antipsychotics?
Question 33
Mr. Gordon is a middle-aged patient who is taking antipsychotics.
When meeting with the PMHNP, he reports positive responses to the medication,
stating, “I really feel as though the effects of my depression are going away.”
Which receptor action in antipsychotic medications is believed to be the most
beneficial in producing the effects described by Mr. Gordon?
Question 34
A patient who was recently admitted to the psychiatric
nursing unit is being treated for bipolar disorder. Which neurotransmitter is
the PMHNP most likely to target with pharmaceuticals?
Question 35
Ms. Ryerson is a 28-year-old patient with a mood disorder.
She recently requested to transfer to a new PMHNP, after not getting along well
with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical
chart prior to their first appointment. Upon review, the PMHNP sees that the
former provider last documented “patient had rapid poop out.” What does the
PMHNP infer about the patient’s prescription based on this documentation?
Question 36
The PMHNP recognizes that which patient would be
contraindicated for antidepressant monotherapy?
Question 37
Why does the PMHNP avoid treating a patient with
cyclothymia, and has major depressive episodes, with antidepressant
monotherapy?
Question 38
The PMHNP is caring for a patient with the s genotype of
SERT. What does the PMHNP understand regarding this patient’s response to
selective serotonin reuptake inhibitor (SSRI)/SNRI treatment?
Question 39
Ms. Boeckh is a 42-year-old patient with major depression.
The PMHNP understands that which action of norepinephrine will affect Ms.
Boeckh’s serotonin levels?
Question 40
Which statement made by the PMHNP correctly describes the
relationship between NE neurons and pharmaceutical treatment?
Question 41
The PMHNP is assessing a patient in the psychiatric
emergency room. The patient tells the PMHNP that he does not understand why his
depression has not lifted after being on four different antidepressants over
the course of a year. Which of the following symptoms can be residual symptoms
for patients who do not achieve remission with major depressive disorder?
Question 42
Fluoxetine (Prozac) has been prescribed for a patient. Which
of the following statements is true regarding the action of this medication?
Question 43
The nurse educator knows that teaching was effective when
one of the students compares fluvoxamine to sertraline and notes which of the
following similarities?
Question 44
A 45-year-old female patient with allergic rhinitis and
normal blood pressure has had no reduction in depressive symptoms after trying
bupropion, paroxetine, and venlafaxine. What precautions are needed in
considering monoamine oxidase inhibitors (MAOI) in treating her depression?
Question 45
After sitting in on an interdisciplinary treatment team
meeting, the student nurse asks the instructor to explain a system-based
approach to the treatment of depression. What is the appropriate response?
Question 46
A 51-year-old female patient presents with symptoms of
depression, including lack of motivation and difficulty sleeping. What risk
factors would increase her vulnerability for a diagnosis of depression?
Question 47
A nurse overhears that a patient has failed single therapy
with an SSRI and SNRI. She also learns that the patient has been on dual
SSRI/SNRI therapy without adequate symptom control. She approaches the PMHNP
and asks what the next treatment option could be in this seemingly
treatment-resistant patient. The PMHNP tells the nurse she will treat the
patient with the following regimen:
Question 48
Mrs. Radcliff is a 42-year-old patient who is considering
stopping paroxetine. Why does her PMHNP advise against this abrupt
discontinuation of the medicine?
Question 49
A patient is prescribed fluoxetine but is concerned about
the side effects. Which statement demonstrates accurate patient teaching when
discussing the side effects associated with fluoxetine?
Question 50
The PMHNP is caring for a patient with anxiety who develops
mild to moderate hepatic impairment. Which action does the PMHNP take regarding
the use of venlafaxine?
Question 51
A 25-year-old female patient is being prescribed milnacipran
to treat fibromyalgia, and expresses concern regarding “how she will feel and
look” from taking the medicine. Which statement correctly describes the side
effects as a result of taking this medication?
Question 52
Mr. Ruby is a 33-year-old single father who is requesting
pharmacological intervention to treat his fibromyalgia. The PMHNP sees in the
medical chart that he has a recent diagnosis of arrhythmia and a BMI of 29.
During his assessment, the PMHNP learns that Mr. Ruby works 40–50 hours a week
as a contractor and “manages his stress” by smoking 3–4 cigarettes a day and
having 8–10 drinks of alcohol each week. Why would duloxetine be
contraindicated for Mr. Ruby?
Question 53
A patient is prescribed sertraline to treat panic disorder.
Knowing that sertraline can initially cause anxiety or insomnia, what should
the PMHNP do?
Question 54
A patient is prescribed 50 mg of desvenlafaxine to take
every other day for major depressive disorder. What does the PMHNP understand
about this patient?
Question 55
The PMHNP understands that which mechanism contributes to a
worse tolerability profile for patients taking tricyclic antidepressants
(TCAs)?
Question 56
A patient who was prescribed an MAO inhibitor is learning
about dietary modifications. Which statement made by the PMHNP demonstrates
proper teaching of the food-drug interactions for MAO inhibitors?
Question 57
A patient who is prescribed MAO inhibitors asks about
whether he can continue taking pseudoephedrine to relieve his congestion. Which
response by the PMHNP indicates proper understanding of drug-drug
interactions?
Question 58
Ms. Skidmore presents for a follow-up appointment after
being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three
times a day, just like I’m supposed to.” What does the PMHNP understand about
this patient?
Question 59
The PMHNP is caring for several patients who present with
various symptoms and health issues. For which patient does the PMHNP prescribe
pregabalin (Lyrica)?
NURS6630 Week 6 Midterm Exam latest 2018 June Week 6 midterm A noncompliant patient states, “Why do you want me to put this poison in my body?” Question 60
Mr. Gutier is 72 years old with anxiety and depressive
symptoms. His PMHNP is prescribing lorazepam (Ativan). What does the PMHNP
understand regarding this prescription?
Question 61
A patient is being prescribed a sedating antidepressant, but
is concerned about weight gain. Which medication is most likely to be
prescribed to addresses the patient’s concerns?
Question 62
A patient who was diagnosed with bipolar disorder without
mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the
appropriate response?
Question 63
The PMHNP is assessing a patient in the emergency room. The
patient shares that he has been on lithium (Lithobid) for many years. What
blood tests does the PMHMP order?
Question 64
A 39-year old female patient presently on lithium would like
to try a new medication to treat her bipolar disorder. She has had concerns
about side effects from lithium and wants to learn more about Lamotrigine
(Lamictal) as a treatment option. The PMHNP conveys some of the unique aspects
of this agent, including which of the following?
Question 65
A nursing student is seeking clarification on the use of
anticonvulsants to treat depression and is unclear about most effective
outcomes. Which of the following agents does the PMHNP convey as having
uncertain outcomes?
Question 66
A 46-year old male patient mentions several alternative
treatments to Carbamazepine (Tegretol) as a way to manage symptoms of his
bipolar depression. Which of the
following does the PMHNP indicate would not be an agent to treat bipolar depression?
Question 67
The PMHNP is meeting with a new mother who would like to
begin taking medication again to treat her bipolar depression; she is
breastfeeding her 2-month old daughter.
The PMHNP recognizes that which of the following medications is
contraindicated for this patient?
Question 68
The PMHNP assesses a 10-year old male child in the ER and
suspects mania. Which of the following symptoms and recommendations for
follow-up evaluation are appropriate?
Question 69
A patient was diagnosed with GAD 4 weeks ago and was placed
on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once
daily. When he asks the PMHNP why it is necessary to wean him off of the
Clonazepam (klonopin) the best response is:
Question 70
During assessment a patient states “Why are you asking me
about my heart, I am here for my head”, the PMHNP’s best response is:
Question 71
The PMHNP understands that the potential of alcohol abuse in
the anxious patient is higher for the following reason:
Question 72
After ordering flumazenil (Rumazicon) the PMHNP cautions the
staff to monitor for which possible effect?
Question 73
A patient is
prescribed escitalopram (Lexapro) for his anxiety. When he asks why he was
given an antidepressant the PMHNP’s best response is:
Question 74
The PMHNP evaluates the patient for “fear conditioning” when
he asks:
Question 75
A patient diagnosed with PTSD is prescribed propranolol
(Inderal) and the PMHNP understands that he was prescribed this medication for
what purpose:
Question 76
When completing this exam, did you comply with Walden
University’s Code of Conduct including the expectations for academic integrity?

NURS6630 Full Course latest June Week 1 discussion Discussion: Foundational Neuroscience 

NURS6630 Full Course latest June Week 1 discussion Discussion: Foundational Neuroscience

NURS6630 Full Course latest

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NURS6630 Full Course latest 2018 June Week 1 discussion Discussion: Foundational Neuroscience

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

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 1, “Chemical Neurotransmission”
Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”
Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”
Document: Midterm Exam Study Guide (PDF)
Document: Final Exam Study Guide (PDF)
Required Media
Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 3 minutes.
Accessible player
Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 15 minutes.
Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.
Accessible player
Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.
Accessible player
To prepare for this Discussion:
Review this week’s Learning Resources.
Reflect on concepts of foundational neuroscience.
Week 3 discussion
Discussion: The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine
desipramine

To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.
Case 1: Volume 1, Case #1: The man whose antidepressants stopped working
Case 2: Volume 1, Case #7: The case of physician do not heal thyself
Case 3: Volume 1, Case #29: The depressed man who thought he was out of options
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 7 discussion
Discussion: Sleep/Wake Disorders
It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
alprazolam
amitriptyline
amoxapine
clomipramine
Case 1: Volume 2, Case #16: The woman who liked late-night TV
Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady
Case 3: Volume 1, Case #5: The sleepy woman with anxiety
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 9 discussion
Discussion: Presentations of ADHD
Although ADHD is often associated with children, this disorder is diagnosed in clients across the lifespan. While many individuals are properly diagnosed and treated during childhood, some individuals who have ADHD only present with subsyndromal evidence of the disorder. These individuals are often undiagnosed until they reach adulthood and struggle to cope with competing demands of running a household, caring for children, and maintaining employment. For this Discussion, you consider how you might assess and treat individuals presenting with ADHD.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”
Stahl, S. M., & Mignon, L. (2012). Stahl’s illustrated attention deficit hyperactivity disorder. New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab.
Chapter 4, “ADHD Treatments”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For ADHD
armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
Case 1: Volume 1, Case #13: The 8-year-old girl who was naughty
Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter
Case 3: Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 10 discussion
Discussion: Influencing Social Change
Individuals with psychiatric mental health disorders are frequently stigmatized not only by society as a whole, but also by their friends, family, and sometimes healthcare providers. In your role, however, you have the opportunity to become a social change agent for these individuals. For this Discussion, consider how you might make a positive impact for your clients and advocate for social change within your own community.
Learning Objectives
Students will:
Apply strategies to become a social change agent for psychiatric mental health
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151. Retrieved from http://bjp.rcpsych.org/content/203/2/146.full
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Dingfelder, S. F. (2009). Stigma: Alive and well. American Psychological Association, 40(6), 56. Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx
Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary. Culture, Medicine and Psychiatry, 36(1), 78–79. doi:10.1007/s11013-012-9248-0
Note: Retrieved from from the Walden Library databases.
Price, L. H. (2010). Violence in America: Is psychopharmacology the answer? Brown University Psychopharmacology Update, 21(5), 5. Retrieved from http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532
Note: Retrieved from from the Walden Library databases.
Optional Resources
Bennett, T. (2015). Changing the way society understands mental health. National Alliance on Mental Illness. Retrieved from http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health
Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6), 1548–1550. Retrieved from /orders/web.archive.org/web/20170605094514/http://content.healthaffairs.org/content/26/6/1548.full
Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.” New Republic, 210(7), 34–38.
To prepare for this Discussion:
Reflect on how you might influence social change for psychiatric mental health.
Week 2 assignment
Assignment: Assessing and Treating Pediatric Clients With Mood Disorders
When pediatric clients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting with mood disorders.
Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine

Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171
Note: Retrieved from Walden Library databases.
Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf
Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3
Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655
Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 3 assignment
Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amitriptyline
bupropion
citalopram

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from /orders/www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf
Required Media
Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 4 assignment
Assignment: Assessing and Treating Clients with With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 8, “Mood Stabilizers”
Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.
Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”
Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”
Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3
Note: Retrieved from Walden Library databases.
Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.
Retrieved from http://acta.tums.ac.ir/index.php/acta
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring bipolar therapy.
The Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 5 assignment
Assignment: Assessing and Treating Clients With Anxiety Disorders
Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 9, “Anxiety Disorder and Anxiolytics”
Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.
Chapter 4, “First-Line Medications for PTSD”
Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”
Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–-339. doi:10.1002/da.21913
Note: Retrieved from Walden Library databases.
Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
The Assignment
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 6 assignment
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 4, “Psychosis and Schizophrenia”
Chapter 5, “Antipsychotic Agents”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amisulpride
aripiprazole
asenapine
chlorpromazine
clozapine
flupenthixol
fluphenazine
haloperidol
iloperidone
loxapine
lurasidone
olanzapine
paliperidone
perphenazine
quetiapine
risperidone
sulpiride
thioridazine
thiothixene
trifluoperazine
ziprasidone
Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002
Note: Retrieved from Walden Library databases.
Document: Midterm Exam Study Guide (PDF)
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.
Note: Retrieved from Walden Library databases.
Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from /orders/www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf
Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting
Required Media
Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2
Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471
Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
Week 7 assignment
Assignment: Assessing and Treating Clients With Pain
Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 10, “Chronic Pain and Its Treatment”
Stahl, S. M., & Ball, S. (2009a). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the Chronic Pain and Fibromyalgia tab.
Chapter 5, “Pain Drugs”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
amitriptyline
amoxapine
carbamazepine
clomipramine
clonidine (adjunct)
desipramine
dothiepin
doxepin
duloxetine
gabapentin
imipramine
lamotrigine
levetiracetam
lofepramine
maprotiline
memantine
milnacipran
nortriptyline
pregabalin
tiagabine
topiramate
trimipramine
valproate (divalproex)
zonisamide
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
National Institute of Neurological Disorders and Stroke. (2016). Pain: Hope through research. Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#3084_2
Required Media
Laureate Education (2016a). Case study: A Caucasian man with hip pain [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.
The Assignment
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 8 assignment
Assignment: Assessing and Treating Clients With Impulsivity, Compulsivity, and Addiction
Impulsivity, compulsivity, and addiction are challenging disorders for clients across the lifespan. These disorders often manifest as negative behaviors, resulting in adverse outcomes for clients. In your role as the psychiatric mental health nurse practitioner, you have the opportunity to help clients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 14, “Impulsivity, Compulsivity, and Addiction”
Stahl, S. M., & Grady, M. (2012). Stahl’s illustrated substance use and impulsive disorder New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the Substance Use and Impulsive Disorders tab.
Chapter 10, “Disorders of Impulsivity and Compulsivity”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
For obsessive-compulsive disorder
Citalopram
clomipramine
escitalopram
fluoxetine
fluvoxamine
paroxetine
sertraline
venlafaxine
vilazodone
For alcohol withdrawal
chlordiazepoxide
clonidine
clorazepate
diazepam
lorazepam
oxazepam
For bulimia nervosa and binge eating
fluoxetine
topiramate
zonisamide
For alcohol abstinence
acamprosate
disulfiram
For alcohol dependence
nalmefene
naltrexone
For opioid dependence
buprenorphine
naltrexone
For nicotine addiction
bupropion
varenicline
Book Excerpt: Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders. Treatment Improvement Protocol Series, No. 32. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64350/
Chapter 1, “Substance Use Among Adolescents”
Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
Chapter 7, “Youths with Distinctive Treatment Needs”
University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control in adulthood, study finds. Retrieved from /orders/www.sciencedaily.com/releases/2016/01/160120201324.htm
Note: Retrieved from Walden Library databases.
Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. doi:10.1111/j.1365-2125.2012.04457.x
Note: Retrieved from Walden Library databases.
Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. doi:10.3928/00989134-20160314-04
Note: Retrieved from Walden Library databases.
Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. doi:10.1080/15504263.2012.648439
Note: Retrieved from Walden Library databases.
Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., & … Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. doi:10.1016/j.comppsych.2014.04.018
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016c). Case study: A Puerto Rican woman with comorbid addiction [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat adolescent clients requiring therapy for impulsivity, compulsivity, and addiction.
The Assignment
Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Week 9 assignment
Assignment: Assessing and Treating Clients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. They may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric mental health nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for clients across the lifespan. For this Assignment, you consider how you might assess and treat clients presenting with ADHD.

Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: Review all materials from the Discussion.
Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016d). Case study: A young Caucasian girl with ADHD [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
This case study will serve as the foundation for this week’s Assignment.
The Assignment
Examine Case Study: A Young Caucasian Girl With ADHD You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 10 assignment
Assignment: Assessing and Treating Clients With Dementia
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.
Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 13, “Dementia and Its Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
donepezil
galantamine
memantine
rivastigmine
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf
Required Media
Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.
The Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 6 midterm
Question 1
A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP).
Question 2
Which statement about neurotransmitters and medications is true?
Question 3
When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be:
Question 4
During gene expression, what must occur prior to a gene being expressed?
Question 5
While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

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

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix–x
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 1, “Chemical Neurotransmission”
Chapter 2, “Transporters, Receptors, and Enzymes as Targets of Psychopharmacologic Drug Action”
Chapter 3, “Ion Channels as Targets of Psychopharmacologic Drug Action”
Document: Midterm Exam Study Guide (PDF)
Document: Final Exam Study Guide (PDF)
Required Media
Laureate Education (Producer). (2016i). Introduction to psychopharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 3 minutes.
Accessible player
Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology: Disorders of the nervous system: Exploring the human brain [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 15 minutes.
Dr. Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain.
Accessible player
Laureate Education (Producer). (2012). Introduction to advanced pharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 8 minutes.
In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse.
Accessible player
To prepare for this Discussion:
Review this week’s Learning Resources.
Reflect on concepts of foundational neuroscience.
Week 3 discussion
Discussion: The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine
desipramine

To prepare for this Discussion:
Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number.
Case 1: Volume 1, Case #1: The man whose antidepressants stopped working
Case 2: Volume 1, Case #7: The case of physician do not heal thyself
Case 3: Volume 1, Case #29: The depressed man who thought he was out of options
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 7 discussion
Discussion: Sleep/Wake Disorders
It is not uncommon to experience a night or two of disrupted sleep when there is something major going on in your life. However, sleep/wake disorders are much more than an occasional night of disrupted sleep. A recent report from the Centers for Disease Control and Prevention estimated that between 50 and 70 million American have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of Americans will visit their primary care provider for treatment of these disorders, many providers will refer patients for further evaluation. For this Discussion, you consider how you might assess and treat the individuals based on the provided client factors.

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
alprazolam
amitriptyline
amoxapine
clomipramine
Case 1: Volume 2, Case #16: The woman who liked late-night TV
Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady
Case 3: Volume 1, Case #5: The sleepy woman with anxiety
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 9 discussion
Discussion: Presentations of ADHD
Although ADHD is often associated with children, this disorder is diagnosed in clients across the lifespan. While many individuals are properly diagnosed and treated during childhood, some individuals who have ADHD only present with subsyndromal evidence of the disorder. These individuals are often undiagnosed until they reach adulthood and struggle to cope with competing demands of running a household, caring for children, and maintaining employment. For this Discussion, you consider how you might assess and treat individuals presenting with ADHD.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”
Stahl, S. M., & Mignon, L. (2012). Stahl’s illustrated attention deficit hyperactivity disorder. New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab.
Chapter 4, “ADHD Treatments”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For ADHD
armodafinil
amphetamine (d)
amphetamine (d,l)
atomoxetine
Case 1: Volume 1, Case #13: The 8-year-old girl who was naughty
Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter
Case 3: Volume 2, Case #21: Hindsight is always 20/20, or attention deficit hyperactivity disorder
Review this week’s Learning Resources and reflect on the insights they provide.
Go to the Stahl Online website and examine the case study you were assigned.
Take the pretest for the case study.
Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.
Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.
Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.
Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Week 10 discussion
Discussion: Influencing Social Change
Individuals with psychiatric mental health disorders are frequently stigmatized not only by society as a whole, but also by their friends, family, and sometimes healthcare providers. In your role, however, you have the opportunity to become a social change agent for these individuals. For this Discussion, consider how you might make a positive impact for your clients and advocate for social change within your own community.
Learning Objectives
Students will:
Apply strategies to become a social change agent for psychiatric mental health
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151. Retrieved from http://bjp.rcpsych.org/content/203/2/146.full
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Dingfelder, S. F. (2009). Stigma: Alive and well. American Psychological Association, 40(6), 56. Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx
Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary. Culture, Medicine and Psychiatry, 36(1), 78–79. doi:10.1007/s11013-012-9248-0
Note: Retrieved from from the Walden Library databases.
Price, L. H. (2010). Violence in America: Is psychopharmacology the answer? Brown University Psychopharmacology Update, 21(5), 5. Retrieved from http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532
Note: Retrieved from from the Walden Library databases.
Optional Resources
Bennett, T. (2015). Changing the way society understands mental health. National Alliance on Mental Illness. Retrieved from http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health
Mechanic, D. (2007). Mental health services then and now. Health Affairs, 26(6), 1548–1550. Retrieved from /orders/web.archive.org/web/20170605094514/http://content.healthaffairs.org/content/26/6/1548.full
Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.” New Republic, 210(7), 34–38.
To prepare for this Discussion:
Reflect on how you might influence social change for psychiatric mental health.
Week 2 assignment
Assignment: Assessing and Treating Pediatric Clients With Mood Disorders
When pediatric clients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting with mood disorders.
Note: This Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Review the following medications:
amitriptyline
bupropion
citalopram
clomipramine

Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171
Note: Retrieved from Walden Library databases.
Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf
Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3
Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655
Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 3 assignment
Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amitriptyline
bupropion
citalopram

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from /orders/www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf
Required Media
Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 4 assignment
Assignment: Assessing and Treating Clients with With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 8, “Mood Stabilizers”
Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.
Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”
Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”
Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3
Note: Retrieved from Walden Library databases.
Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.
Retrieved from http://acta.tums.ac.ir/index.php/acta
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring bipolar therapy.
The Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 5 assignment
Assignment: Assessing and Treating Clients With Anxiety Disorders
Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 9, “Anxiety Disorder and Anxiolytics”
Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.
Chapter 4, “First-Line Medications for PTSD”
Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”
Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–-339. doi:10.1002/da.21913
Note: Retrieved from Walden Library databases.
Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
The Assignment
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 6 assignment
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 4, “Psychosis and Schizophrenia”
Chapter 5, “Antipsychotic Agents”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amisulpride
aripiprazole
asenapine
chlorpromazine
clozapine
flupenthixol
fluphenazine
haloperidol
iloperidone
loxapine
lurasidone
olanzapine
paliperidone
perphenazine
quetiapine
risperidone
sulpiride
thioridazine
thiothixene
trifluoperazine
ziprasidone
Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002
Note: Retrieved from Walden Library databases.
Document: Midterm Exam Study Guide (PDF)
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.
Note: Retrieved from Walden Library databases.
Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from /orders/www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf
Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting
Required Media
Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Optional Resources
Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2
Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471
Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
Week 7 assignment
Assignment: Assessing and Treating Clients With Pain
Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 10, “Chronic Pain and Its Treatment”
Stahl, S. M., & Ball, S. (2009a). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the Chronic Pain and Fibromyalgia tab.
Chapter 5, “Pain Drugs”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
amitriptyline
amoxapine
carbamazepine
clomipramine
clonidine (adjunct)
desipramine
dothiepin
doxepin
duloxetine
gabapentin
imipramine
lamotrigine
levetiracetam
lofepramine
maprotiline
memantine
milnacipran
nortriptyline
pregabalin
tiagabine
topiramate
trimipramine
valproate (divalproex)
zonisamide
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
National Institute of Neurological Disorders and Stroke. (2016). Pain: Hope through research. Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#3084_2
Required Media
Laureate Education (2016a). Case study: A Caucasian man with hip pain [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.
The Assignment
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 8 assignment
Assignment: Assessing and Treating Clients With Impulsivity, Compulsivity, and Addiction
Impulsivity, compulsivity, and addiction are challenging disorders for clients across the lifespan. These disorders often manifest as negative behaviors, resulting in adverse outcomes for clients. In your role as the psychiatric mental health nurse practitioner, you have the opportunity to help clients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.
Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 14, “Impulsivity, Compulsivity, and Addiction”
Stahl, S. M., & Grady, M. (2012). Stahl’s illustrated substance use and impulsive disorder New York, NY: Cambridge University Press.
To access the following chapter, click on the Illustrated Guides tab and then the Substance Use and Impulsive Disorders tab.
Chapter 10, “Disorders of Impulsivity and Compulsivity”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
For obsessive-compulsive disorder
Citalopram
clomipramine
escitalopram
fluoxetine
fluvoxamine
paroxetine
sertraline
venlafaxine
vilazodone
For alcohol withdrawal
chlordiazepoxide
clonidine
clorazepate
diazepam
lorazepam
oxazepam
For bulimia nervosa and binge eating
fluoxetine
topiramate
zonisamide
For alcohol abstinence
acamprosate
disulfiram
For alcohol dependence
nalmefene
naltrexone
For opioid dependence
buprenorphine
naltrexone
For nicotine addiction
bupropion
varenicline
Book Excerpt: Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders. Treatment Improvement Protocol Series, No. 32. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK64350/
Chapter 1, “Substance Use Among Adolescents”
Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
Chapter 7, “Youths with Distinctive Treatment Needs”
University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control in adulthood, study finds. Retrieved from /orders/www.sciencedaily.com/releases/2016/01/160120201324.htm
Note: Retrieved from Walden Library databases.
Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. doi:10.1111/j.1365-2125.2012.04457.x
Note: Retrieved from Walden Library databases.
Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. doi:10.3928/00989134-20160314-04
Note: Retrieved from Walden Library databases.
Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. doi:10.1080/15504263.2012.648439
Note: Retrieved from Walden Library databases.
Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., & … Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. doi:10.1016/j.comppsych.2014.04.018
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016c). Case study: A Puerto Rican woman with comorbid addiction [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat adolescent clients requiring therapy for impulsivity, compulsivity, and addiction.
The Assignment
Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Week 9 assignment
Assignment: Assessing and Treating Clients With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. They may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric mental health nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for clients across the lifespan. For this Assignment, you consider how you might assess and treat clients presenting with ADHD.

Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Note: Review all materials from the Discussion.
Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.
Note: Retrieved from Walden Library databases.
Required Media
Laureate Education (2016d). Case study: A young Caucasian girl with ADHD [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
This case study will serve as the foundation for this week’s Assignment.
The Assignment
Examine Case Study: A Young Caucasian Girl With ADHD You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 10 assignment
Assignment: Assessing and Treating Clients With Dementia
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.
Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp

Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 13, “Dementia and Its Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
donepezil
galantamine
memantine
rivastigmine
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf
Required Media
Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.
The Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 6 midterm
Question 1
A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP).
Question 2
Which statement about neurotransmitters and medications is true?
Question 3
When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be:
Question 4
During gene expression, what must occur prior to a gene being expressed?
Question 5
While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

NURS6531 All Week Assignments

NURS6531 All Week Assignments latest

NURS6531 All Week Assignments

Week 1 Assignment Practicum Experience – Journal Entry

As a future advanced practice nurse, it is important that you are able to connect your classroom experience to your Practicum Experience. By applying the concepts that you study in the classroom to clinical settings, you enhance your professional competency. Each week, you will reflect on your Practicum Experiences and relate them to the material presented in the classroom. This week, you begin your Practicum Experiences and will write your first Practicum Journal.

To prepare for this course’s Practicum Experience, address the following in your first Practicum Journal:

Select and describe a nursing theory to guide your practice.

Develop goals and objectives for your Practicum Experience in this course. When developing your goals and objectives, be sure to keep the seven domains of practice in mind.

Create a timeline of practicum activities based on your practicum requirements.

In a one-page journal entry (250-300 words), you should do the following:

Describe your practicum goals and objectives using the seven domains of practice

Discuss a nursing theory that would be used to guide your practice.

Include APA-style citations and references

Week 3 Assignment Practicum Experience – Episodic SOAP Note #1

In addition to Journal Entries, SOAP Note submissions are a way to reflect on your Practicum Experiences and connect these experiences to your classroom experience. SOAP Notes, such as the ones required in this course, are often used in clinical settings to document patient care. Please refer to the Seidel, et. al. book excerpt and the Gagan article located in this week’s Learning Resources for guidance on writing SOAP Notes.

All SOAP notes must be signed and each page must be initialed by your preceptor. When you submit your SOAP Notes, you should include the complete SOAP Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your SOAP Notes using SAFE ASSIGN.

Please Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

To Prepare:

Review the Episodic SOAP Note Exemplar provided in this week’s Resources in preparation for this Assignment.

Use the Episodic SOAP Note Template to complete this Assignment.

After completing this week’s Practicum Experience, select a patient that you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

Subjective: What details did the patient provide regarding his or her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management including alternative therapies?

Reflection notes: What would you do differently in a similar patient evaluation?

Please Note: Your Episodic SOAP Note Assignment must be signed by Day 7 of Week 3.

By Day 7 of Week 3

This Assignment is due. You will submit two files for the Week 3 Episodic SOAP Note, including a Word document and pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 3.

Week 6 Assignment Practicum Experience – Episodic SOAP Note #2

After completing this week’s Practicum Experience, reflect on a patient who presented with abdominal pain. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.

All SOAP notes must be signed and each page must be initialed by your preceptor. When you submit your SOAP Notes, you should include the complete SOAP Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your SOAP Notes using SAFE ASSIGN.

Please Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

By Day 7 of Week 6

This Assignment is due. You will submit two files for the Week 6 Episodic SOAP Note #2, including a Word document and pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 6.

Week 8 Assignment Practicum Experience – Comprehensive SOAP Note #3

After completing this week’s Practicum Experience, review the Comprehensive SOAP Note Exemplar and Template in this week’s Resources, and reflect on a patient who presented with musculoskeletal disorders or pain. Describe the patient’s personal and medical history, drug therapy and treatments, and follow-up care.

All SOAP notes must be signed and each page must be initialed by your preceptor. When you submit your SOAP Notes, you should include the complete SOAP Note as a Word document and pdf/images of each page that is initialed and signed by your preceptor. You must submit your SOAP Notes using SAFE ASSIGN.

Please Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

By Day 7 of Week 8

This Comprehensive SOAP Note #3 is due. You will submit two files for the Week 8 Comprehensive SOAP Note #3, including a Word document and pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 6.

Week 10 Assignment Practicum Experience – Journal Entry

To follow up on this course’s Practicum Experience, address the following in your Practicum Reflective Journal:

Select and describe a nursing theory that was used to guide your practice.

What goals and objectives were used for your Practicum Experience in this course? When developing your goals and objectives, were the seven domains of practice in mind?

Were you able to meet the timeline of practicum activities that you set at the beginning of the course in your initial journal based on your practicum requirements? If not, why and how do you plan to meet them in your next practicum experience?

By Day 7

Submit your Reflective Journal.by day 7 of week 10.

Submission and Grading Information

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

Please save your Assignment using the following naming convention: “WK11Assgn1+lastname+first initial”.

Click the Week 11 Assignment 1 link.

Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK11Assgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.

Click on the Submit button to complete your submission.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

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  • Discussion Questions (DQ)

Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

  • APA Format and Writing Quality

Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

  • LopesWrite Policy

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

  • Late Policy

The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

  • Communication

Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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NURS6531 Week 8 Assignment Practicum Experience – Comprehensive SOAP Note #3

NURS6531 Week 8 Assignment Practicum Experience – Comprehensive SOAP Note #3

NURS6531 Week 8 Assignment

NURS6531 Week 8 Assignment Practicum Experience – Comprehensive SOAP Note #3
Practicum Experience – Comprehensive SOAP Note #3
After completing this week’s Practicum Experience, review
the Comprehensive SOAP Note Exemplar and Template in this week’s Resources, and
reflect on a patient who presented with musculoskeletal disorders or pain.
Describe the patient’s personal and medical history, drug therapy and
treatments, and follow-up care.
All SOAP notes must be signed and each page must be
initialed by your preceptor. When you submit your SOAP Notes, you should
include the complete SOAP Note as a Word document and pdf/images of each page
that is initialed and signed by your preceptor. You must submit your SOAP Notes
using SAFE ASSIGN.
Please Note: Electronic signatures are not accepted. If both
files are not received by the due date, faculty will deduct points per the
Walden Late Policies.
By Day 7 of Week 8
This Comprehensive SOAP Note #3 is due. You will submit two
files for the Week 8 Comprehensive SOAP Note #3, including a Word document and
pdf/images of each page that is initialed and signed by your preceptor by Day 7
of Week 6.

Week 8 Assignment
Practicum Experience – Comprehensive SOAP Note #3
After completing this week’s Practicum Experience, review
the Comprehensive SOAP Note Exemplar and Template in this week’s Resources, and
reflect on a patient who presented with musculoskeletal disorders or pain.
Describe the patient’s personal and medical history, drug therapy and
treatments, and follow-up care.
All SOAP notes must be signed and each page must be
initialed by your preceptor. When you submit your SOAP Notes, you should
include the complete SOAP Note as a Word document and pdf/images of each page
that is initialed and signed by your preceptor. You must submit your SOAP Notes
using SAFE ASSIGN.
Please Note: Electronic signatures are not accepted. If both
files are not received by the due date, faculty will deduct points per the
Walden Late Policies.
By Day 7 of Week 8
This Comprehensive SOAP Note #3 is due. You will submit two
files for the Week 8 Comprehensive SOAP Note #3, including a Word document and
pdf/images of each page that is initialed and signed by your preceptor by Day 7
of Week 6.

NURS6531 Week 3 Assignment Practicum Experience – Episodic SOAP Note

NURS6531 Week 3 Assignment Practicum Experience – Episodic SOAP Note #1

NURS6531 Week 3 Assignment Practicum Experience

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NURS6531 Week 3 Assignment latest 2018 September Week 3 Assignment Practicum Experience – Episodic SOAP Note #1
Practicum Experience – Episodic SOAP Note #1
In addition to Journal Entries, SOAP Note submissions are a
way to reflect on your Practicum Experiences and connect these experiences to
your classroom experience. SOAP Notes, such as the ones required in this
course, are often used in clinical settings to document patient care. Please
refer to the Seidel, et. al. book excerpt and the Gagan article located in this
week’s Learning Resources for guidance on writing SOAP Notes.
All SOAP notes must be signed and each page must be
initialed by your preceptor. When you submit your SOAP Notes, you should
include the complete SOAP Note as a Word document and pdf/images of each page
that is initialed and signed by your preceptor. You must submit your SOAP Notes
using SAFE ASSIGN.
Please Note: Electronic signatures are not accepted. If both
files are not received by the due date, faculty will deduct points per the
Walden Late Policies.
To Prepare:
Review the Episodic SOAP Note Exemplar provided in this
week’s Resources in preparation for this Assignment.
Use the Episodic SOAP Note Template to complete this
Assignment.
After completing this week’s Practicum Experience, select a
patient that you examined during the last 3 weeks. With this patient in mind,
address the following in a SOAP Note:
Subjective: What details did the patient provide regarding
his or her personal and medical history?
Objective: What observations did you make during the
physical assessment?
Assessment: What were your differential diagnoses? Provide a
minimum of three possible diagnoses. List them from highest priority to lowest
priority. What was your primary diagnosis and why?
Plan: What was your plan for diagnostics and primary
diagnosis? What was your plan for treatment and management including
alternative therapies?
Reflection notes: What would you do differently in a similar
patient evaluation?
Please Note: Your Episodic SOAP Note Assignment must be
signed by Day 7 of Week 3.
By Day 7 of Week 3
This Assignment is due. You will submit two files for the
Week 3 Episodic SOAP Note, including a Word document and pdf/images of each
page that is initialed and signed by your preceptor by Day 7 of Week 3.

Week 3 Assignment
Practicum Experience – Episodic SOAP Note #1
In addition to Journal Entries, SOAP Note submissions are a
way to reflect on your Practicum Experiences and connect these experiences to
your classroom experience. SOAP Notes, such as the ones required in this
course, are often used in clinical settings to document patient care. Please
refer to the Seidel, et. al. book excerpt and the Gagan article located in this
week’s Learning Resources for guidance on writing SOAP Notes.
All SOAP notes must be signed and each page must be
initialed by your preceptor. When you submit your SOAP Notes, you should
include the complete SOAP Note as a Word document and pdf/images of each page
that is initialed and signed by your preceptor. You must submit your SOAP Notes
using SAFE ASSIGN.
Please Note: Electronic signatures are not accepted. If both
files are not received by the due date, faculty will deduct points per the
Walden Late Policies.
To Prepare:
Review the Episodic SOAP Note Exemplar provided in this
week’s Resources in preparation for this Assignment.
Use the Episodic SOAP Note Template to complete this
Assignment.
After completing this week’s Practicum Experience, select a
patient that you examined during the last 3 weeks. With this patient in mind,
address the following in a SOAP Note:
Subjective: What details did the patient provide regarding
his or her personal and medical history?
Objective: What observations did you make during the
physical assessment?
Assessment: What were your differential diagnoses? Provide a
minimum of three possible diagnoses. List them from highest priority to lowest
priority. What was your primary diagnosis and why?
Plan: What was your plan for diagnostics and primary
diagnosis? What was your plan for treatment and management including
alternative therapies?
Reflection notes: What would you do differently in a similar
patient evaluation?
Please Note: Your Episodic SOAP Note Assignment must be
signed by Day 7 of Week 3.
By Day 7 of Week 3
This Assignment is due. You will submit two files for the
Week 3 Episodic SOAP Note, including a Word document and pdf/images of each
page that is initialed and signed by your preceptor by Day 7 of Week 3.