“The Application of Theoretical Concepts to Research” Paper is due this week. Your paper should contain the following sections:

• Background: contains two subsections, which includes a brief description of the theorist and the phenomenon of concern in the theory.
• Theory Description: a description of each of the concepts in the theory, a diagram of the theory, and a description of how the concepts are related.
• An Evaluation of the Theory: a description of the theory’s weaknesses and how the metaparadigms are described in the theory.
• Application of the Theory:
  • Describe two studies that used the theory as a framework for their study, including a description of how they operationalized the concepts.
  • How could you use the theory to research a phenomenon in your area of clinical practice? How would you operationalize the concepts?

You MUST use the attached template here to complete your paper.

The paper is to be thoroughly researched and well documented, with relevant material from the nursing theorists presented incorporated into the paper. Use the current edition of the APA Manual throughout the paper. Sources should focus on references from nursing theory but may also include conceptual and theoretical material from other professional domains. The paper, excluding references or appendices, is to be limited to 3-5 pages. Writing should be succinct and well organized, as it is impossible for the facilitator to evaluate form and content separately

Julian Fils Julian Fils: (Week Two)Neurotransmitters and Receptor TheoryCOLLAPSE

Discussion: Neurotransmitters and Receptor Theory

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact psychopharmacologic treatments’ efficacy.

In simple terms, an agonist creates a specific action, and the antagonist opposes a particular activity. Neurotransmitters that occur naturally stimulate receptors and are thus agonists. Some medications also stimulate receptors and are therefore agonists as well. The mechanism of partial agonists or stabilizers the drugs stimulate the receptors lesser than natural neurotransmitter. It is a common misconception that antagonists are the opposite of agonists because they block agonists’ actions. However, although antagonists prevent agonists’ efforts, they have no activity of their own in the agonist’s absence (Stern et al., 2016).

For this reason, antagonists are sometimes called “silent.” Inverse agonists, on the other hand, do have opposite actions compared to agonists. That is, they not only block agonists but can also reduce activity below the baseline level when no agonist is present. Thus, the agonist spectrum reaches from full agonists to partial agonists through “silent” antagonists and finally inverse agonists (Stahl, 2013).

Compare and contrast the actions of g couple proteins and ion gated channels

Neurotransmitters trigger G-protein-linked and ion-channel-linked cascades.  There are four elements linked to the G-protein-linked system. The first element is the neurotransmitter, also referred to as the first messenger. The second is the G-protein coupled receptors which have seven transmembrane regions. The third element a G protein, which is a connecting protein. The fourth element is an enzyme that can synthesize a second messenger when activated (Stahl, 2013).  The first steps involve the neurotransmitter binding to the receptor. It also changes the form of the receptor, which allows it to fit with the G protein. Then, the G protein binding is conformed to the receptor of the neurotransmitter. The two receptors (neurotransmitter and the G protein) work with each other, which then bind to enzyme E and synthesizes the second messenger (Stahl, 2013).

Ion channel receptors are a vital component of nervous system signaling, allowing rapid and direct conversion of a chemical neurotransmitter message to an electrical current. Efficient neurotransmission requires the precise interplay of various neurotransmitter receptors at pre-and post-synaptic compartments. Ligand-gated ion channels play a central role in intercellular communication in the nervous system. Ion channels are the cellular machinery for ion flux across the membrane and, therefore, the basis of the electrical excitation of neurons. Ligand-gated ion channels are oligomeric protein assemblies that convert a chemical signal into an ion flux through the post-synaptic membrane and are involved in essential brain functions such as attention, learning, and memory (Li et al., 2015).

Explain how the role of epigenetics may contribute to pharmacologic action

Epigenetics describes genetic information that is ‘beyond’ or ‘above’ that information coded solely by our genetic code (Stefanska & MacEwan, 2015). Prior research has shown that the initial epigenetic pattern was set during life and gave each neuron its life-long personality. However, recent studies have shown that these neurons are changing. Depending on what happened to them, such as stress, child abuse, dietary deficiencies, psychotherapy, drug abuse, or psychotherapeutic medications, the previously silent genes are now activated once active genes can become silenced. Thus, causing favorable and unfavorable developments. Favorable epigenetics may trigger learning or experience therapeutic effects on medications, and inimical epigenetic mechanisms may trigger drug abuse, addiction, anxiety disorder, or chronic pain (Stahl, 2013). 

Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

As prescribers, psychiatric nurse practitioners must understand the biological and physical aspects of prescribing medication to the mental health population. These medications directly affect the receptors and neurons; therefore, it is imperative to understand the mechanism of action. Recently at work, a geriatric psychiatric patient with a urinary tract infection was having difficulty sleeping. The nurse asked about trazodone as a PRN for sleep. The Psychiatrist explained that trazodone inhibition of the reuptake of serotonin makes it an antidepressant. It is essential to know it also blocks alpha- receptors that can give the side effect of orthostatic hypotension, especially in older patients. What is also crucial is to note that the anticholinergic effects of trazodone cause delirium and confusion.

In this example, a study was conducted by Lockwood & Youssef  (2017), where the study of epigenetic effects on the Brain-Derived Neurotrophic Factor (BDNF)  in patients with bipolar disorder types I and II and major depressive disorder. In this study, methylation was investigated when patients were in various mood states, including manic, hypomanic, mixed, euthymic, and depressed. The effects of valproic acid and lithium and the impact on BDNF were studied. The results have shown that in a mixed or manic state, BDNF methylation levels approximated that of the control subjects. In addition to that, the patients that were in euthymic or depressed states had significantly higher BDNF methylation levels (Lockwood & Youssef, 2017).

References

Li, S., Wong, A. H. C., & Liu, F. (2015). Ligand-gated ion channel interacting proteins and their role in neuroprotection. Frontiers in Cellular Neuroscience, 8. https://doi.org/10.3389/fncel.2014.00125

Lockwood, L., & Youssef, N. (2017). Systematic review of epigenetic effects of pharmacological agents for bipolar disorders. Brain Sciences, 7(12), 154. https://doi.org/10.3390/brainsci7110154

Stahl, S. (2013). Stahl’s essential psychopharmacology print and online bundle: Neuroscientific basis and practical applications. Cambridge University Press.

Stefanska, B., & MacEwan, D. J. (2015). Epigenetics and pharmacology. British Journal of Pharmacology, 172(11), 2701–2704. https://doi.org/10.1111/bph.13136

Stern, T. A., M Fava, Wilens, T. E., & Rosenbaum, J. F. (2016). Massachusetts general hospital psychopharmacology and neurotherapeutics. Elsevier.

Deepinder Bhandohal Week 2 DiscussionCOLLAPSE

Foundational Neuroscience

1.  Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.

Agonists are agents that activate receptors upon their binding, similar to the effect of neurotransmitters, hormones, and other endogenous regulators. Antagonists on the other hand do not affect the action of the receptor but act by blocking the receptor’s effectiveness to prevent binding of other drugs or endogenous molecules for activation. Therefore, an antagonist is a drug that has a receptor binding affinity but do not initiate any intrinsic activity (Seyedabadi, Ghahremani, & Albert, 2019).

Partial agonists have moderate activity compared to full agonists, often producing half the effect. A partial agonist can thus be an agonist-antagonist as it blocks the binding of other molecules while producing limited activity. An inverse agonist binds to the agonist binding site on the receptor but elicits an opposite pharmacological effect. Therefore, partial and inverse agonists influence the efficacy and outcomes of the treatments.

2.  Compare and contrast the actions of G-coupled proteins and ion gated channels.

G-protein coupled receptors (GPCRs) constitute a large family of receptors on the cellular plasma membranes that utilize a G protein to transmit signals inside the cell. Disorders in G-protein coupled receptors may result in diseases as they serve multiple functions within the body. Different responses are elicited by the G-protein coupled receptors following the interaction of G-protein subunits with other proteins within the cell. The subunits (α subunit, and another made up of the β and γ subunits) are produced from the division of G-protein following the binding with guanosine triphosphate. The interaction of these subunits with other proteins triggers diverse signaling pathways within the cell (Seyedabadi, Ghahremani, & Albert, 2019).

Ion channels are proteins that enable the flow of specific ions into and out of the cell. There are three types of gated ion channels; mechanically-gated ion channels, voltage-gated ion channels, and ligand-gated ion channels. Ligand-gated ion channels are ionotropic receptors that close or open in response to ligand binding. Voltage-gated ion channels open or close in response to changes in the membrane potentials. Membrane proteins activated by a GPCR can interact with ligand-gated ion channels to prompt their opening or closing (Alexander et al., 2019).

3.  Explain how the role of epigenetics may contribute to pharmacologic action.

Epigenetics is gene regulation where the gene expression patterns are changed following reversible modification of DNA, RNA, or proteins. Epigenetic alterations enable the understanding and identification of diseases like neurodegenerative disorders or cancers. DNA methylation is an example of disease-causing alterations. Responses to drugs vary based on the cellular changes caused by epigenetic alterations or genetic heterogeneity (Rosenthal & Burchum, 2018).

4.  Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Prescribing medications needs to take account of the patient’s characteristics especially the family history and the genetic implications on diagnosis and treatment. McClarty, Fisher, and Dong (2018) point out the effect of age on dementia treatment, especially when using antipsychotics for the psychological, behavioral, and psychosis symptoms. The treatment has various side effects and is often ineffective due to the effects of aging on drug metabolism and clearance. Age-induced epigenetic alterations also result in pharmacodynamic and pharmacokinetic changes that influence the antipsychotic action of the medication (Nguyen et al., 2020). Epigenetic changes also cause an increase in side effects and altered efficacy of antipsychotics due to histone modifications. Awareness of these changes would inform the prescription decision, especially for the antipsychotics to ensure minimal side effects and maximum efficacy of the selected medication (Camprodon & Roffman, 2016).

References

Alexander, S., Mathie, A., Peters, J. A., Veale, E. L., Striessnig, J., Kelly, E., Armstrong, J. F., Faccenda, E., Harding, S. D., Pawson, A. J., Sharman, J. L., Southan, C., Davies, J. A., & CGTP Collaborators (2019). The Concise Guide to Pharmacology 2019/20: Ion channels. British journal of pharmacology, 176 Suppl 1(Suppl 1), S142–S228. https://doi.org/10.1111/bph.14749

Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier. 

Guidelines on prescribing practice in mental health: A systematic review. Psychiatry Research, 284. https://doi-org.ezp.waldenulibrary.org/10.1016/j.psychres.2019.112671

McClarty, B. M., Fisher, D. W., & Dong, H. (2018). Epigenetic Alterations Impact on Antipsychotic Treatment in Elderly Patients. Current treatment options in psychiatry, 5(1), 17–29.

Nguyen, T., Seiler, N., Brown, E., & O’Donoghue, B. (2020). The effect of Clinical Practice

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

Seyedabadi, M., Ghahremani, M. H., & Albert, P. R. (2019). Biased signaling of G protein coupled receptors (GPCRs): Molecular determinants of GPCR/transducer selectivity and therapeutic potential. Pharmacology & therapeutics, 200, 148–178. https://doi.org/10.1016/j.pharmthera.2019.05.006

2 SOURCES ON EACH DISCUSSION

Create a PowerPoint presentation that addresses each of the following points/questions. Be sure to completely answer all the questions for each bullet point. Use clear headings that allow your professor to know which bullet you are addressing on the slides in your presentation. Support your content with at least four (4) outside sources and the textbook using APA citations throughout your presentation. Make sure to cite the sources using the APA writing style for the presentation. Include a slide for your references at the end. Follow best practices for PowerPoint presentations related to text size, color, images, effects, wordiness, and multimedia enhancements. Review the rubric criteria for this assignment.

Please create a PowerPoint to answer the following:

Case study

Ann, a community nurse, made an afternoon home visit with Susan and her father. After the death of her mother, Susan had growing concerns about her father living alone. “I worry about my father all the time. He is becoming more forgetful and he has trouble seeing. Mom used to take care of him. I am not sleeping and I am irritable around him. Yesterday I shouted at him because he wouldn’t let me help him with his laundry. I felt terrible! I am at my wits’ end! My brothers and sisters do not want to put dad in a nursing home but they are not willing to help out. As usual, they have left me with all the responsibility. I work part time and have two small children to care for.” Susan’s father, Sam, sat quietly with tears filling his eyes. He was well nourished and well-groomed but would not make eye contact. Nurse Ann noticed that the house was clean and orderly. A tray in front of the TV had the remains of a ham sandwich and glass of ice tea. Mail was piled up, unopened on a small table near the front door. There was only one car in the driveway and the yard was in need of attention.

• What questions does Orlando’s theory guide the nurse to consider in caring for Susan and Sam?
• Develop a family plan of care from the perspective of Orlando.

Explore the 1950 and 60’s in the United States:

• Explore was happening in the United States during this time (culture, social, economics, struggles)
• What did nursing look like during this time (what were their jobs like, responsibilities, dress, autonomy, respect)
• What is the most influential accomplishment in nursing theory from the 1950’s and 1960’s?

Assignment Expectations:

Length: 14-20 slides

Structure: Include a title slide, objective slide, content slides, reference slide in APA format. Title/Objective/Reference slides do not count towards the minimum slide count for this assignment.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of four (4) outside scholarly sources and the textbook are required for this assignment.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as a Microsoft PPT document (.pptx) or a PDF document (.pdf)

File name:  Name your saved file according to your first initial, last name, and the assignment number (for example, “RHall Assignment 1.docx”)

M3 Assignment UMBO – 1,2, 3

M3 Assignment PLG – 1, 6

M3 Assignment CLO – 1, 2, 3, 4

 

1) Minimum 6 full pages  (Follow the 3 x 3 rule: minimum three paragraphs per part)

             Part 1: Minimum 1 page

             Part 2: minimum 3 pages

             Part 3: Minimum 1 page

             Part 4: Minimum 1 page

Part 2: Education Teaching Practicum

Audience: Newl  

             Part 4: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.do

__________________________________________________________________________________

Part 1: Pharmacology

Anemias

M.W. is a 69-year-old African American man and was referred to clinic for evaluation of increasing shortness of breath.

Past medical history 

Chronic renal insufficiency

Hypertension

Congestive heart failure

Diabetes mellitus type 2, poor control

Deep vein thrombosis

Alcohol abuse

Chronic obstructive pulmonary disease with respiratory failure

Family history

Noncontributory

Physical examination

Height 69 inches, weight 205 lb

Blood pressure: 138/88

Pulse 86 beats/min, regular

Lungs clear, neck supple negative for jugular venous distention

Lower extremities +1 edema

Laboratory findings

Scr = 2.8 K+ = 5.1

BUN = 56

Na+ = 147

WBC = 5.0

Hb = 8.2

Hct = 24.6

Serum ferritin 189 mg/dL

Social history

Tobacco: 52 pack-years

Alcohol: distant past

Diagnosis: Anemia Of Ckd: Answer the following questions in full sentences using APA citations. 

1. List specific goals of treatment for M.W.

2. What drug therapy would you prescribed? Why?

3. What are the parameters for monitoring success of therapy?

4. Discuss specific patient education based on the prescribed therapy.

5. List one or two adverse reactions for the selected agent that would cause you to change therapy.

6. What over-the-counter and/or alternative medications would be appropriate for M.W.?

7. What dietary and lifestyle changes would you recommended for M.W.?

Part 2: Education Teaching Practicum

Audience: Newly recruited nurses in the pediatric ICU

Topic: Coping strategies for the death of patients in the pediatric ICU

Theory: Elisabeth Kuebler Ross

Pupose:Encourage adequate strategies in nurses to face the death of pediatric patients.

Make an outline for a lesson that will be taught in the future. 

Provide headings to delineate the topics

1. The objectives (4) and standards of the lesson (include QSEN). 

2. Describe the nursing theory that will guide this lesson (Elisabeth Kuebler Ross).

3. Describe the student audience (Novice nurses-Newly recruited)

4. Learning level: 

a. What are the demographics of the students (30-40 YO, nurses, men, and women-Nicklaus Children’s Hospital). 

b. what, if any, interventions may be needed to account for varied learning styles? (VARK Model)

5. Make a road map for presenting the concepts and content: 

a. How will you present the information to the student

b. What visuals will you source, and how will you relay the content clearly and concisely?

6. Preliminary ideas for assessing students, both informally during the lesson and a summative component that can be administered upon completion of the lesson or unit

7. A list of materials that you will reference or hand out during your lesson

Part 3: Womens health

 

Topic

Chronic pelvic pain can be caused by any number of conditions. In primary care, nurse practitioners should be able to outline the basic approach to initial evaluation of and management of these disorders. As you have learned in this unit, there are many causes of chronic pelvic pain.

 

1. Select one of the causes of chronic pelvic pain and describe the symptoms. 

2. Why would you refer this patient for consultation, and to whom? 

3. What are the steps to writing a referral, and what is the NP’s responsibility in follow-up?

Part 4:  Advanced Primary Care of Family Practicum 

 

Check: 

http://www.aanp.org/imag es/documents/publication s/ContractNegotiations.pdf

State of Florida Example ARNP protocol

http://floridasnursing.gov/f orms/arnp-protocolformat.pdf

https://www.aanp.org/practice/practice-management/employment-negotiations

1.What are the main questions, you need to ask your employer during negotiation meeting? 

2.What could be some problems you might encounter during contract negotiation? 

3. How would you approach those problems?

Part 3 – Next Steps

Balancing School and Life – My Quality of Life Self-Care Plan. The purpose of developing this Plan is to set a framework and a plan to maintain wellness and to stay motivated and engaged throughout your Program. Doing this will help you achieve success during your coursework and as a professional nurse.

The goal of the Project is to help you become self-aware and reflective as a means of identifying personal self-care strategies that will increase your energy and help you manage your stress. The Project will give you a chance to learn how this is accomplished as you will be doing similar work with clients during the Program and as a professional nurse to assist them in the same way.

Share in a 2 – 3 page paper, the following (also attach the completed form):

Note: When you are finished besides submitting your plan, be sure to put the Plan where you can see it to remind you to continue to reflect on how you are doing and to motivate you to use the self-care strategies.

Use the Quality of Life Self-Care Wheel Plan for Intention and Action to make your intention (commitments) to take action throughout your Program to stay balanced. Re-assess your scores and write them into this Plan. Then make your intention and identify at least one action for each that you know you can maintain throughout your Program and even as a practicing nurse. Identify any new strategies that you think will “fit” better than what you have been doing and describe why.

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the ‘.docx’ extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

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