PSYCHOPHARMACOLOGY Discussion Responses 2025

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs. Case: An elderly widow who just lost her spouse. Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: • Metformin 500mg BID • Januvia 100mg daily • Losartan 100mg daily • HCTZ 25mg daily • Sertraline 100mg daily Current weight: 88 kg Current height: 64 inches Temp: 98.6 degrees F BP: 132/86 By Day 3 of Week 7 Post a response to each of the following: • List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions. • Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why. • Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used. • List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why. • List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. • For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities? • Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen. Respond to the this discussion. All questions need to be addressed. Discussion 1 En Three questions to ask the patient and a rationale for asking these questions. How may I be of assistance today? This question creates a rapport between you and the patients, and it makes her know that the doctor is ready to listen and help her. What are you doing to cope with grief after losing your husband? This question will help the care provider assess the approaches the patient is using to cope with grief and be able to identify the ones working and not working for the patient. Are you living with someone at home, and are you following your regimen correctly? By asking this question, the care provider will understand the type of support system available at home and know which support to prescribe for the patient and if the support at home is helping the patient follow her regimen correctly. People in the patient’s life to speak to or get feedback from to further assess the patient People in the patient’s life to speak to include her children, her aide, and close friend per her authorization. The feedback I will get from these people will help me know the severity of the patient’s problem. Some of the questions I will ask them are; 1. Has the patient been experiencing worse symptoms of depression since her husband’s dead? This question will help me understand people close to her can know when she is depressed. 2. Does the patient complain about her treatment regimen? This question will allow me to know the side effects of the treatment if any. 3. Has the sleeping patterns changes recently? This question will help me understand the severity of insomnia. Physical and diagnostic tests The physical exams appropriate for this patient include heart rhythm, eye assessment, and oxyhemoglobin saturation. The diagnostic tests for this patient include polysomnography and actigraphy tests. These tests will be used to measure the patient’s sleep patterns. The actigraphy measures sleep efficiency, sleep latency, and total sleep time, and polysomnography will diagnose sleep disorders (Niel et al., 2020) Differential diagnoses for the patient The patient’s differential diagnoses include generalized anxiety disorder, major depressive disorder, and restless leg syndrome. Major depressive disorder (MDD) is likely to explain why the patient is experiencing insomnia. MDD’s clinical presentation include insomnia, difficulty concentrating, appetite loss, and hopelessness. The patient’s husband’s loss contributed to depression, which affected her sleeping pattern. According to Bennabi et al. (2019), patients with MDD are at risk of experiencing sleeping disorders. Since the patient is responding to grief, her chances of developing MDD are high. Pharmacologic agents and their dosing Selegiline Transdermal patch. Apply 6mg daily dose, which is applied every day. If symptoms do not improve, the dose can be increased by 3mg daily for two weeks until it reaches a maximum of 12gm daily. The drug inhibits Monoamine Oxidase-B isoenzyme (Bied et al., 2015). Eszopiclone. The required dose is 3mg, which is administered orally before the patient goes to bed. It is the first-line drug for insomnia, and it interacts with gamma-aminobutyric acid (GABA) receptors at the allosterically binding sites at the benzodiazepine receptors. The drug works by slowing brain activities to allow sleep. The drug induces sedation and hypnosis hence causing sleep (Dixon et al., 2015). Since the patient is complaining of insomnia, eszopiclone will be appropriate in improving this symptom. Drug therapy contraindications Contraindications of using selegiline transdermal include increased risks of serotonin syndrome. The drug contraindicates in the patients taking selective serotonin reuptake inhibitors, mirtazapine, and other vasoconstrictors and analgesics. Check points After administering these drugs, the patient will be assessed after a four-week interval to determine if the symptoms have improved. If the symptoms have not improved after four weeks, selegiline transdermal will be increased by 3mg for four weeks until 12gm, which is the maximum dose per day. If the symptoms improve within the first four weeks, the regimen will be maintained until the patient completes the dose. After completing the dose, the patient will sleep well and the symptoms of depression will be well managed. References Bennabi, D., Charpeaud, T., Yrondi, A., Genty, J. B., Destouches, S., Lancrenon, S., … & Haffen, E. (2019). Clinical guidelines for the management of treatment-resistant depression: French recommendations from experts, the French Association for Biological Psychiatry and Neuropsychopharmacology and the fondation FondaMental. BMC psychiatry , 19 (1), 1-12. https://doi.org/10.1186/s12888-019-2237-x Bied, A. M., Kim, J., & Schwartz, T. L. (2015). A critical appraisal of the selegiline transdermal system for major depressive disorder. Expert review of clinical pharmacology , 8 (6), 673-681. https://doi.org/10.1586/17512433.2016.1093416 Dixon, C. L., Harrison, N. L., Lynch, J. W., & Keramidas, A. (2015). Zolpidem and eszopiclone prime α1β2γ2 GABAA receptors for longer duration of activity. British journal of pharmacology , 172 (14), 3522-3536. https://doi.org/10.1111/bph.13142 Niel, K., LaRosa, K. N., Klages, K. L., Merchant, T. E., Wise, M. S., Witcraft, S. M., Hancock, D., Caples, M., Mandrell, B. N., & Crabtree, V. M. (2020). Actigraphy versus polysomnography to measure sleep in youth treated for craniopharyngioma. Behavioral sleep medicine , 18 (5), 589-597. https://doi.org/10.1080/15402002.2019.1635133

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Patient Management and Delegation 2025

Patient Management and Delegation Complete the Patient Management and Delegation virtual simulation activity which can be found by clicking the Enter Simulation link at the top of the course. From the menu that appears select Virtual Clinical Scenarios and then click Patient Management Delegation. Then debrief on the experience by creating a VoiceThread, video or a written essay. Reflect on your feelings while fulling the role of the charge nurse in the simulated activities on delegation and caseload management. Consider how you utilized the experience and efficiency information provided. Summarize the responsibilities, including planning, coordinating and evaluation of nursing resources, managed by the charge nurse in the simulated activity. Reflect on any correct and incorrect decisions and responses that you would change if you were to repeat this activity. Describe what you learned in this experience that will be incorporated into your clinical practice. References are not required for this reflection. APA format is required for page set up for essay or PowerPoint. Examples of work to show mastery: 3-4 page paper – APA format

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Lab Assignment: Assessing the Abdomen 2025

A woman went to the emergency room for severe abdominal cramping. She was diagnosed with diverticulitis; however, as a precaution, the doctor ordered a CT scan. The CT scan revealed a growth on the pancreas, which turned out to be pancreatic cancer—the real cause of the cramping. Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. To Prepare Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study. · With regard to the Episodic note case study provided: o Review this week’s Learning Resources, and consider the insights they provide about the case study. o Consider what history would be necessary to collect from the patient in the case study. o Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? o Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. The Assignment 1. Analyze the subjective portion of the note. List additional information that should be included in the documentation. 2. Analyze the objective portion of the note. List additional information that should be included in the documentation. 3. Is the assessment supported by the subjective and objective information? Why or why not? 4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis? 5. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. Remember you MUST complete a FULL abdominal exam. Please write this up as a narrative so that you are able to correctly explain your analysis. REQUIRED READINGS Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Chapter 6, “Vital Signs and Pain Assessment” This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment. Chapter 18, “Abdomen” In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 3, “Abdominal Pain” This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis. Chapter 10, “Constipation” The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests. Chapter 12, “Diarrhea” In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform. Chapter 29, “Rectal Pain, Itching, and Bleeding” This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies. Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis. Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center. These sections below explain the procedural knowledge needed to perform gastrointestinal procedures. Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520) Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W.

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Environmental Factors and Health Promotion: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants 2025

The growth, development, and learned behaviors that occur during the first year of infancy have a direct effect on the individual throughout a lifetime. For this assignment, research an environmental factor that poses a threat to the health or safety of infants and develop a health promotion that can be presented to caregivers. Create a 10-12 slide PowerPoint health promotion, with speaker notes, that outlines a teaching plan. For the presentation of your PowerPoint, use Loom to create a voice over or a video. Include an additional slide for the Loom link at the beginning, and an additional slide for references at the end. Include the following in your presentation: Describe the selected environmental factor. Explain how the environmental factor you selected can potentially affect the health or safety of infants. Create a health promotion plan that can be presented to caregivers to address the environmental factor and improve the overall health and well-being of infants. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants. Offer examples, interventions, and suggestions from evidence-based research. At least three scholarly resources are required. Two of the three resources must be peer-reviewed and no more than 6 years old. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource. In developing your PowerPoint, take into consideration the health care literacy level of your target audience, as well as the demographic of the caregiver/patient (socioeconomic level, language, culture, and any other relevant characteristic of the caregiver) for which the presentation is tailored Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. Refer to the resource, “Loom,” located in the Student Success Center, for additional guidance on recording your presentation. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Environmental Factors and Health Promotion: Accident Prevention and Safety Promotion for Parents and Caregivers of Infants 1 Unsatisfactory 0.00%2 Less than Satisfactory 76.00%3 Satisfactory 81.00%4 Good 89.00%5 Excellent 100.00% 100.0 %Content 15.0 %Environmental Factor and the Potential Effect on Infants An environmental factor is not presented. The issue chosen is not environmental. An incomplete summary of how the environmental factor potentially affects infant health or safety is presented.A general description of how the environmental factor potentially affects infant health or safety is presented. There are inaccuracies, or more evidence is needed for support or rationale.A description of how the environmental factor potentially affects infant health or safety is presented. Some support or rationale is needed.A detailed description of how the environmental factor potentially affects infant health or safety is presented. Strong support and rationale are provided. The direct effect of the environmental factor on infant health and safety is well established. 15.0 %Health Promotion Plan for Caregivers to Address Environmental Factor and Improve Infant Health and Well-Being A health promotion plan is not presented.An incomplete health promotion plan is presented. The plan fails to address the environmental issue; or, the plan does not include steps to improve health or safety for infants. There are major inaccuracies.A general health promotion plan is presented. The plan addresses the environmental issue and includes general steps to improve health or safety for infants. There are some inaccuracies. More information or evidence is needed for support. It is unclear if the plan is suitable for the chosen caregiver.A health promotion plan is presented. The plan addresses the environmental issue and includes steps to improve health or safety for infants. Some information or evidence is needed for support. The plan is realistic for the chosen caregiver. A well-developed health promotion plan is presented. The plan clearly addresses the environmental issue and includes specific steps to improve health or safety for infants. Sufficient information and evidence is provided for support. The plan is realistic for the chosen caregiver. 10.0 %Recommendations for Accident Prevention and Safety Promotion Recommendations for safety promotion and accident prevention are not offered.Some recommendations for safety promotion and accident prevention offered are summarized. The recommendations offered are unrelated to the environmental factor; steps recommended do not support the health and safety of infants.Recommendations for safety promotion and accident prevention offered are summarized. The recommendations offered are generally related to the environmental factor. Most steps recommended support the health and safety of infants. There are some inaccuracies. More information or rationale is needed for support and clarity.Recommendations for safety promotion and accident prevention offered are proposed. The recommendations offered relate to the environmental factor and the steps outlined support the health and safety of infants. Some rationale is needed for support or clarity. In general, the recommendations are realistic and suitable for the chosen situation and caregiver.Well-developed recommendations for safety promotion and accident prevention offered are proposed. The recommendations offered clearly relate to the environmental factor. The steps outlined are well thought out and support the health and safety of infants. The recommendations are realistic and highly suitable for the chosen situation and caregiver. 10.0 %Evidence-Based Examples, Interventions, and Suggestions Examples, interventions, and suggestions are not offered. None of the scholarly resources meet the assignment criteria. Some examples, interventions, and suggestions are offered. Most of the research resources do not meet the criteria as outlined in the assignment. General examples, interventions and suggestions are offered. Some of the research resources do not meet the criteria as outlined in the assignment. Examples, interventions, and suggestions offered are evidence-based. At least three scholarly research resources are utilized, and at least two peer-reviewed and no older than 6 years old. Overall, the resources support the examples, interventions and suggestions.Examples, interventions and suggestions are evidence-based and strongly supported. Three or more scholarly research resources are utilized; at least two are peer-reviewed and no older than 6 years old. 10.0 %Community, National, and Web-Based Resources for Health Promotion Resources are not included for the health promotion.Some resources are included, but overall do not meet the criteria as outlined in the assignment. The resources are not relevant to the health promotion. A description does not accompany the resources. The contact information for the resources is incomplete or inaccurate.Resources are included as part of the health promotion. Some of the resources do not meet the criteria as outlined in the assignment. A general description accompanies the resources. Some contact information for the resources is incomplete or inaccurate.Two community resources, a national resource, and a Web-based resource are included with the health promotion. Overall, the resources are relevant to the health promotion and accessible for the caregiver. A description accompanies the resources. The contact information provided for the resources is accurate.Two community resources, a national resource, and a Web-based resource are included with the health promotion. The resources are highly relevant to the health promotion and are accessible for the caregiver. A detailed description accompanies the resources. The contact information provided for the resources is complete and accurate. 15.0 %Appropriateness of Health Promotion for Caregiver and Situation No aspect of the health promotion presentation is relevant to the caregiver or associated demographicThe literacy level is not written for the level of the caregiver or target audience. The socioeconomic level, language, culture, and any other relevant characteristic of the caregiver are not always consistent with representing the caregiver or associated demographic. Major changes need to be made for the presentation to be tailored to the caregiver or associated demographic.The literacy level is generally written for the level of the caregiver or target audience. The socioeconomic level, language, culture, and any other relevant characteristics of the caregiver are generally written representing the caregiver or associated demographic. Some changes need to be made for the presentation to be tailored for the caregiver or associated demographic.The literacy level is written for the level of the caregiver or target audience. The socioeconomic level, language, culture, and any other relevant characteristics of the caregiver are tailored for the caregiver or associated demographic. There are some areas that require revision or slight changeThe literacy level is written for the level of the caregiver or target audience. The socioeconomic level, language, culture, and any other relevant characteristics of the caregiver are tailored for the caregiver or associated demographic. The presentation demonstrates insight into tailoring presentations to a specific target population. 5.0 %PowerPoint and Voice Over Requirements Presentation fails to meet the criteria outlined. The presentation contains fewer than 10 slides, omits speaker notes, and does not have a reference slide. Loom is not utilized for the presentation. Presentation meets some of the criteria outlined. A minimum of 10 slides is used for the presentation. The reference slide and speaker notes are omitted or are not complete. An attempt at a Loom presentation is made.Presentation meets most of the criteria outlined. Presentation uses 10 -12 slides, but the slide arrangement does not support the intended presentation. The reference slides and speaker notes are missing information or contain inaccuracies. A Loom presentation is submitted, but the presentation is inconsistent with the PowerPoint and speaker notes.Presentation meets the criteria outlined. Presentation uses 10 -12 slides and the slide arrangement supports the intended presentation. The speaker notes are submitted and support the presentation. The reference slide is submitted. A Loom presentation is submitted and overall is consistent with the PowerPoint and speaker notes.Presentation meets the criteria outlined. Presentation uses 10 -12 slides and the slide arrangement strongly supports the intended presentation. The speaker notes submitted are well-developed and support the presentation. The reference slide is submitted. A Loom presentation is submitted and is consistent with the PowerPoint and speaker notes. 5.0 %Visual Appeal There are few or no graphic elements. No variation in layout or typography is evident.Color is garish or typographic variations are overused and legibility suffers. Background interferes with readability. Understanding of concepts, ideas, and relationships is limited. In general, the visual presentation is not optimal for the audienceMinimal use of graphic elements is evident. Elements do not consistently contribute to the understanding of concepts, ideas, and relationships. There is some variation in type size, color, and layout. Some of the visual aspects are distracting for the intended audience.Thematic graphic elements are used but not always in context. Visual connections mostly contribute to the understanding of concepts, ideas, and relationships. Differences in type size and color are used well and consistently. Overall, the presentation is visually appealing and suitable for the intended audience.Appropriate and thematic graphic elements are used to make visual connections that contribute to the understanding of concepts, ideas, and relationships. Differences in type size and color are used well and consistently. The presentation has strong visual appeal and is developed with the intended audience in mind. 5.0 %Aesthetic Quality Design is cluttered. Materials detract from the content or the purpose of presentation is low quality.Design detracts from purpose. Text and visuals are too simplistic, cluttered, and busy. Little or no creativity or inventiveness is present.Design is fairly clean, with a few exceptions. Materials add to, not detract from the presentation. Materials used were quality products and easy to see or hear.Design is appropriate and integrates a variety of objects, charts, and graphs to amplify the message.Design is clean. Skillful handling of text and visuals creates a distinctive and effective presentation. Overall, effective and functional audio, text, or visuals are evident. 5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, and language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.The writer is clearly in command of standard, written, academic English. 5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

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Clinical Assignment 2025

EBP Assignment Complete a literature search for a journal article relating to a NUR 2005 concept. Find an article about evidence-based practice or best practices in nursing. Complete a one-page (double spaced, APA format) paper about suicide prevention how the results of the research would impact your nursing practice. Include the name and title of the article in APA format There are 4 assignments that needs to be complete. Please complete each assignment to the BEST of your ability !!! PLEASE READ EACH ASSIGNMENT CAREFULLY and answer each question with at least in paragraph form !

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