psychiatric nursing 2025

This should be done in next 11 hours Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies. This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies. Assignment: Assessing and Treating Pediatric Clients With Mood DisorderWhen 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. Learning Objectives Students will: Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy Evaluate efficacy of treatment plans Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients 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. Learning Objectives Students will: Assess client factors and history to develop personalized plans of antidepressant therapy for pediatric clients Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric clients requiring antidepressant therapy Evaluate efficacy of treatment plans Analyze ethical and legal implications related to prescribing antidepressant therapy to pediatric clients 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? you can do a new assignment or edit this. use the same format .NOTE Plagiarism must be less than 20 % for this to be accepted . reference not counted . thx The assessing and Treating Pediatric Clients with Mood Disorders Introduction Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self-harm, and suicidality. The depression rate among children this day is so disturbing. The effect of depression is devastating since it leads to a variety of physical and emotionally problems. 1 Depression can reduce the child ability to function at academically (American Psychiatric Association, 2018). We can categorize depression in children into two types, the 1st is major depression in this type of depression the child will be in depression for less than a month and the child might experience it again sometime in life. Dysthymia depression is a less form of severe chronic depression that last for two years in total (American Psychological Association, 2016). This is the most serious and considered the leading cause of suicide death, and disability in adolescent in this age group (WHO, 2014) Selective serotonin reuptake inhibitors (SSRIs) is antidepressant and helps children and adolescent to get back into a stable mood from mood disorder. It is important to monitor children at a closely at the first four weeks of administering this medication, this help identify a change in behavior. Some sign to watch for include sleeplessness, withdrawal from social gathering or unnecessary agitation (Anxiety and Depression Association of America, 2016). 2 This paper is my opportunity to examine An African American Child Suffering From Depression. What is, what treatment options are available and the effects of the stigma of MDD on the African American child and family. 3 African Americans are no different when its comes to prevalence of mental health conditions when compared to the rest of the population. Poverty level affects mental health status. 1 African Americans living below the poverty level, as compared to those over twice the poverty level, are 3 times more likely to report psychological distress Decision Selected # 1 I will choose Zoloft 25mg as my first choice of medication Reason for Selection: I have work with a diverse group of patient in including African American in the course of my experience working in children in hospitals unit several years .I have to start with Zoloft 25mg. most provider I worked with will not want to give much medication because of this age group. 1 Zoloft is considered “off-label meaning it is not approve by the Food and Drug Administration (FDA) to treat depression in children and adolescents; randomized controlled trials (RCTs) approved it because the benefits. 1 According to the International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP, 2016), Zoloft is safes and is the best option to treat mood disorders in children in this age group. Expected Results In the 1st two weeks of therapy, we expect some progress as the child is expected to exhibit that there is evident in physical symptoms like increase in appetite, and sleep. We should also expected increase is the child concentration within a month, and an increase peer group interactions, and expected to withdraw less from peers. If all things work as expected and absent of adverse reaction, will continue with the treatment (IACAPAP, 2016), Differences between Expected outcome and Actual outcome After two weeks, he patient is expected to come back for a visit to be evaluated for the medication effectiveness. If the goal of the medication is met, and there is no symptom for side effect, then the medication and the dosage will remain the same until the next appointment. If expected result is not not met and there is no sign or symptom of adverse effect, the medication will be increased to Zoloft 50mg. I have to be aware that, the difference between the expected outcome and actual outcome is the dosage being low or higher than the needed therapeutic level for the patient (National Alliance on Mental Illness, 2017). Decision Selected # 2 Reason for Selection: Decision one within four weeks follow-up, my expected outcome has not been achieved. The child is still presented with depressive symptoms. The patient and parent denies any side effect of Zoloft., but the child is still showing signs of major depressive disorder (MDD). I will increase Zoloft to 50mg to attain medication therapeutic effect. 1 This will be done after addressing the effect with patient and family and documented after discussing the risks, benefits and education about MDD and the planned of treatment by increasing the dosage, goals for this client remain the same. We will continue to monitor any side effects, like suicidality risk (National Alliance on Mental Illness, 2017). Expected Results My client should be able to verbalize some positive changes like reduce in depressive symptoms of Zoloft 50mg. If the higher dose help in reducing depression with no side effect of medication. 1 I will now encourage patient and reassure parents. This improvement should include participating in groups, peers interaction , improve sleep, appetite and academic improvement (American Psychiatric Association, 2018). 4 Differences between Expected outcome and Actual outcome There should be appositive noticeable change with therapeutic of Zoloft 50mg, a decrease in depression symptoms with and no adverse reaction that indicate otherwise that patient is tolerating the therapeutic medication adjustment well. 1 Since at this level, there is no difference between the expected result and the actual result therefore the patient will continue with the Zoloft 50mg. Patient should be monitoring continue, and the next schedule appointment. Decision Point Three Maintain current dose of Zoloft 50mg orally daily Reason for Selection When the patient shows improvement, we have to keep schedule medication especially when there is no side effect of medication. My patient has shown great degree of improvement, and there is no side effect to this patient with the dose of Zoloft 50mg. 1 The monitoring of the side effect will include suicidal thought (National Alliance on Mental Illness, 2017). Expected Results Treatment of depression, and monitoring is a continues process. 1Patient improvement should daily, and the signs of depression will be eliminated gradually with dosage of Zoloft 50mg. Patient peer interaction, sleep, appetite, should gradually improve. Differences between Expected Results and Actual Results Choosing Zoloft 50mg on my African American child patient seems to be working, with no problem. Patient is responding well to therapy. I will continue patient with current dose. With this gradual improvement, I have no reasons to change medication or dosage. I will schedule an appointment and the dose might be increase if depression increases. 1 The expected result would be in treating any side effect to the medication so that maximum therapeutic effects can be achieved. The actual result is that there is an achievement in medication therapeutic effect that is needed by the patient (National Alliance on Mental Illness, 2017). 5 Ethical Considerations Suicidal ideation or behavior is only one reason for which close monitoring is important for children started on antidepressant therapy (Mitchell et al., 2014). Therefore, providers who are considering the use of antidepressants in children, adolescents, and young adults must first balance the risk of suicidality with the clinical need for an antidepressant (Mitchell et al., 2014). 1 The ethic consideration can be classified as an accumulation of reasoning and principle of treatment of depression. The suicidal tendency in the used of antidepressant medication has led the FDA to require that all antidepressant medicine should be labeled by pharmaceutical companies with the caution of suicidal on the label (Sondheimer, 2010). Any child that is below the age of 18years old cannot take decision on depression treatment without the parent approval according to FDA regulation (Sondheimer,2010). Therefore, it is paramount to educate the parent of the treatment given to the child as well the consent of the parent. In case of danger, the consent advice of the parent may be ignored (Sondheimer, 2010). The Zoloft is “off-label” so a greater precaution and parent approval needs to be obtain before dispensing. 6 This lack of knowledge leads many to believe that a mental health condition is a personal weakness or some sort of punishment from God. Many African Americans also have trouble recognizing the signs and symptoms of mental health conditions, leading to underestimating the effects and impact of mental health conditions. 3 Faith and spirituality can help in the recovery process but should not be the only option you pursue. If spirituality is an important part of your life, your spiritual practices can be a strong part of your treatment plan. Your spiritual leaders and faith community can provide support and reduce isolation. 7 Conclusion The FDA advises that doctors prescribe the smallest quantity of pills possible to help reduce the risk of deliberate or accidental overdose. A careful monitoring by parents, caregivers and health care professionals is important for any child or teenager taking an antidepressant for depression or any other condition. 1 Food and Drug Administration (FDA or USFDA) has a rule and regulation set for the treatment of behavioral disorder in children, the guideline which must be follow to the letter (National Alliance on Mental Illness, 2017). Supervising and safe monitoring of the child is very important during therapy (National Alliance on Mental Illness, 2017). 1 The legality guiding the treatment of a child with psychiatric problem has increase because of increase national awareness. As a psychiatric nurse, I strive to increase my knowledge of the legal and ethical implications of prescribing psychotropic medications for children. and adolescents with major depression and anxiety disorders. 3 African Americans are no different when its comes to prevalence of mental health conditions when compared to the rest of the population, depression one of the mental health issues in African American community. 1 References American Psychiatric Association (2018). Practice guideline for the treatment of patients with the major depressive disorder (3rd ed., pp. 152). Arlington (VA): 1 American Psychiatric Association (APA). 2 Retrieved from https://www.guideline.gov/summaries/summary/24158? 1 American Psychological Association. (2016). 1 Psychotropic Medications for Children and Adolescents. Retrieved from: 1 http://www.apa.org/pi/families/resources/child-medications.pdf. Anxiety and Depression Association of America. (2016). 1 Anxiety and Depression in Children. Retrieved from:https://adaa.org/living-with-anxiety/children/anxiety-and-depression International Association for Child and Adolescent Psychiatry and Allied Professions. Bennet, N. (2016). 5 Legal and ethical issues related to the prescription of psychiatric medication to children (and teens). Retrieved from https://www.ohsu.edu/xd/health/for-healthcare-professionals/telemedicine-network/for-healthcare-providers/ohsu-echo/upload/Legal-and-Ethic-issues-treating-C-and-A-mental-health-Bennett-N-2016.pdf De Vries, Y. A., De Jonge, P., Kalverdijk, L., Bos, J. H., Schuiling-Veninga, C. C., & Hak, E. (2016). 5 Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands: choice of antidepressant and dose. European Child & Adolescent Psychiatry, 25(11), 1161-1170. Retrieved from https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=4&sid=2505bbce-c8cf-4f53-9c28-70e0106cb774%40sessionmgr120 Department of Human and Health Services. (2013). Antidepressant Medications: 5 Use in Pediatric Patients. Retrieved from https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Pharmacy-Educatio Mitchell, A. 5 M., Davies, M. A., Cassesse, C., & Curran, R. (2014). 5 Antidepressant Use in Children, Adolescents, and Young Adults: 10 Years After the Food and Drug Administration Black Box Warning. The Journal for Nurse Practitioners, 10(3), 149-156. Retrieved from https://www-sciencedirect-com.ezp.waldenulibrary.org/science/article/pii/S1555415513004856?via%3Dihub Sheridan, D. C., Lin, A., & Zane Horowitz, B. (2017). 5 Suicidal bupropion ingestions in adolescents: increased morbidity compared with other antidepressants. Clinical Toxicology, 1-5. Retrieved from https://www.tandfonline.com/doi/abs/10.1080/15563650.2017.1377839 Stahl, S. M. (2017). 5 Stahl’s essential psychopharmacology: The prescriber’s guide (6th ed.). New York, NY: Cambridge University Press.

Nursing Assignment Help 2025

Asthma and Stepwise Management 2025

To Prepare Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children. Consider how you might apply the stepwise approach to address the health needs of a patient in your practice. Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following: Describe long-term control and quick-relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient. Explain the Stepwise Approach to asthma treatment and management for your patient. Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific. Please review the rubric for this assignment.. Grid View List View Excellent  Good  Fair  Poor  Describe the long-term control and quick relief treatment options for the asthma patient from your practice, as well as the impact these drugs might have on your patient. Points Range:  27 (27%) – 30 (30%)  The presentation clearly and accurately describes in detail the long-term control and quick relief treatment options for the asthma patient from their practice. The presentation clearly and accurately describes in detail the impact these drugs might have on their patient. Points Range:  24 (24%) – 26 (26%)  The presentation accurately describes the long-term control and quick relief options for the asthma patient from their practice. The presentation accurately describes the impact these drugs might have on their patient. Points Range:  21 (21%) – 23 (23%)  The presentation inaccurately or vaguely describes the long-term control and quick relief options for the asthma patient from their practice. The presentation inaccurately or vaguely describes the impact these drugs might have on their patient. Points Range:  0 (0%) – 20 (20%)  The presentation inaccurately and vaguely describes the long-term and quick relief options for the asthma patient from their practice, or is missing. The presentation inaccurately and vaguely describes the impact these drugs might have on their patient, or is missing.  Explain the stepwise approach to asthma treatment and management for your patient. Points Range:  27 (27%) – 30 (30%)  The presentation clearly and accurately explains in detail the stepwise approach to asthma treatment and management for their patient. Points Range:  24 (24%) – 26 (26%)  The presentation accurately explains the stepwise approach to asthma treatment and management for their patient. Points Range:  21 (21%) – 23 (23%)  The presentation inaccurately or vaguely explains the stepwise approach to asthma treatment and management for their patient. Points Range:  0 (0%) – 20 (20%)  The presentation inaccurately and vaguely explains the stepwise approach to asthma treatment and management for their patient.  Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific. Points Range:  27 (27%) – 30 (30%)  The presentation clearly and accurately explains in detail how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. The presentation provides accurate and detailed examples to support the explanation provided. Points Range:  24 (24%) – 26 (26%)  The presentation accurately explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. The presentation provides accurate examples to support the explanation provided. Points Range:  21 (21%) – 23 (23%)  The presentation inaccurately or vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. The presentation provides inaccurate or vague examples to support the explanation provided. Points Range:  0 (0%) – 20 (20%)  The presentation inaccurately and vaguely explains how stepwise management assists health care providers and patients in gaining and maintaining control of the disease, or is missing. The presentation provides inaccurate and vague examples to support the explanation provided, or is missing.  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. Points Range:  5 (5%) – 5 (5%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity. Points Range:  4 (4%) – 4 (4%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Points Range:  3.5 (3.5%) – 3.5 (3.5%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Points Range:  0 (0%) – 3 (3%)  Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time.  Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation Points Range:  5 (5%) – 5 (5%)  Uses correct grammar, spelling, and punctuation with no errors Points Range:  4 (4%) – 4 (4%)  Contains a few (1–2) grammar, spelling, and punctuation errors Points Range:  3.5 (3.5%) – 3.5 (3.5%)  Contains several (3–4) grammar, spelling, and punctuation errors Points Range:  0 (0%) – 3 (3%)  Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding Total Points: 100

Nursing Assignment Help 2025

SOAP assessment 2025

CASE STUDY 2: Focused Throat Exam Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus during the past 2 weeks, Lily figured she shouldn’t take her 3-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested. To Prepare · By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. · Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP Notes have specific data included in every patient case. With regard to the case study you were assigned: · Review this week’s Learning Resources and consider the insights they provide. · Consider what history would be necessary to collect from the patient. · 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? · Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. The Assignment Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each. Episodic/Focused SOAP Note Template – (delete information on this template and input one related to the patient in the case study above). Patient Information: Initials, Age, Sex, Race S. CC (chief complaint) a BRIEF statement identifying why the patient is here – in the patient’s own words – for instance “headache”, NOT “bad headache for 3 days”. HPI : This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example: Location: head Onset: 3 days ago Character: pounding, pressure around the eyes and temples Associated signs and symptoms: nausea, vomiting, photophobia, phonophobia Timing: after being on the computer all day at work Exacerbating/ relieving factors: light bothers eyes, Aleve makes it tolerable but not completely better Severity: 7/10 pain scale Current Medications : include dosage, frequency, length of time used and reason for use; also include OTC or homeopathic products. Allergies: include medication, food, and environmental allergies separately (a description of what the allergy is ie angioedema, anaphylaxis, etc. This will help determine a true reaction vs intolerance). PMHx : include immunization status (note date of last tetanus for all adults), past major illnesses and surgeries. Depending on the CC, more info is sometimes needed Soc Hx : include occupation and major hobbies, family status, tobacco & alcohol use (previous and current use), any other pertinent data. Always add some health promo question here – such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system. Fam Hx : illnesses with possible genetic predisposition, contagious or chronic illnesses. Reason for death of any deceased first degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent. ROS : cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows: General: Head : EENT : etc. You should list these in bullet format and document the systems in order from head to toe. Example of Complete ROS: GENERAL: No weight loss, fever, chills, weakness or fatigue. HEENT: Eyes: No visual loss, blurred vision, double vision or yellow sclerae. Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose or sore throat. SKIN: No rash or itching. CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema. RESPIRATORY: No shortness of breath, cough or sputum. GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood. GENITOURINARY: Burning on urination. Pregnancy. Last menstrual period, MM/DD/YYYY. NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control. MUSCULOSKELETAL: No muscle, back pain, joint pain or stiffness. HEMATOLOGIC: No anemia, bleeding or bruising. LYMPHATICS: No enlarged nodes. No history of splenectomy. PSYCHIATRIC: No history of depression or anxiety. ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia. ALLERGIES: No history of asthma, hives, eczema or rhinitis. O. Physical exam : From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format i.e. General: Head: EENT: etc. Diagnostic results : Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines) A . Differential Diagnoses (list a minimum of 3 differential diagnoses).Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence based guidelines. P. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. References You are required to include at least three evidence based peer-reviewed journal articles or evidenced based guidelines which relates to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 6th edition formatting. Resources for references 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 11, “Head and Neck” This chapter reviews the anatomy and physiology of the head and neck. The authors also describe the procedures for conducting a physical examination of the head and neck. Chapter 12, “Eyes” In this chapter, the authors describe the anatomy and function of the eyes. In addition, the authors explain the steps involved in conducting a physical examination of the eyes. Chapter 13, “Ears, Nose, and Throat” The authors of this chapter detail the proper procedures for conducting a physical exam of the ears, nose, and throat. The chapter also provides pictures and descriptions of common abnormalities in the ears, nose, and throat. 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 15, “Earache” This chapter covers the main questions that need to be asked about the patient’s condition prior to the physical examination as well as how these questions lead to a focused physical examination. Chapter 21, “Hoarseness” This chapter focuses on the most common causes of hoarseness. It provides strategies for evaluating the patient, both through questions and through physical exams. Chapter 25, “Nasal Symptoms and Sinus Congestion” In this chapter, the authors highlight the key questions to ask about the patients symptoms, the key parts of the physical examination, and potential laboratory work that might be needed to provide an accurate diagnosis of nasal and sinus conditions. Chapter 30, “Red Eye” The focus of this chapter is on how to determine the cause of red eyes in a patient, including key symptoms to consider and possible diagnoses. Chapter 32, “Sore Throat” A sore throat is one most common concerns patients describe. This chapter includes questions to ask when taking the patient’s history, things to look for while conducting the physical exam, and possible causes for the sore throat. Chapter 38, “Vision Loss” This chapter highlights the causes of vision loss and how the causes of the condition can be diagnosed. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Head and neck: 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). Head and neck: 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. 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). Eyes: 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). Eyes: 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. 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). Ears, nose, and throat: 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). Ears, nose, and throat: 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. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. 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. Chapter 71, “Visual Function Evaluation: Snellen, Illiterate E, Pictorial This section explains the procedural knowledge needed to perform eyes, ears, nose, and mouth procedures. Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis. Chapter 2, “The Comprehensive History and Physical Exam” (Previously read in Weeks 1, 3, 4, and 5) Bedell, H. E., & Stevenson, S. B. (2013). Eye movement testing in clinical examination. Vision Research 90, 32–37. doi:10.1016/j.visres.2013.02.001. Retrieved from https://www.sciencedirect.com/science/article/pii/S0042698913000217 Rubin, G. S. (2013). Measuring reading performance. Vision Research, 90, 43–51. doi:10.1016/j.visres.2013.02.015. Retrieved from http://www.sciencedirect.com/science/article/pii/S0042698913000436 Harmes, K. M., Blackwood, R. A., Burrows, H. L., Cooke, J. M., Harrison, R. V., & Passamani, P. P. (2013). Otitis media: Diagnosis and treatment. American Family Physicians, 88(7), 435–440. Otolaryngology Houston. (2014). Imaging of maxillary sinusitis (X-ray, CT, and MRI). Retrieved from http://www.ghorayeb.com/ImagingMaxillarySinusitis.html This website provides medical images of sinusitis, including X-rays, CT scans, and MRIs (magnetic resonance imaging).

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Walden NURS6521 Week 6 Quiz 2017 2025

Question 1 A nurse is developing a care plan for a patient who has multiple sclerosis. An expected outcome for the patient who is receiving glatiramer would be a decrease in A) chest pain B) fatigue C) breathing difficulties D) heart palpitations Question 2 A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout. The nurse will instruct the patient to avoid which of the following foods? A) Green beans B) Shrimp C) Eggs D) Milk Question 3 A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery. Which of the following insulin regimens is most likely to achieve adequate glycemic control? A) Small doses of long-acting insulin administered four to five times daily B) Doses of basal insulin twice daily with regular insulin before each meal C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening D) Divided doses of intermediate-acting insulin every 2 hours, around the clock Question 4 A 65-year-old woman has an advanced form of rheumatoid arthritis. Her treatment includes a regular dosage of methotrexate. The nurse will advise her to take which of the following vitamin supplements while taking the drug? A) Vitamin A B) Vitamin B C) Vitamin C D) Vitamin D Question 5 A 49-year-old woman has been diagnosed with myalgia. The physician has recommended aspirin. The patient is concerned that the aspirin will upset her stomach. The nurse will encourage the patient to A) crush the tablet before swallowing B) swallow the tablet whole C) swallow the tablet with milk or food D) avoid drinking milk for 3 hours after swallowing the tablet Question 6 A nurse is working with a 57-year-old man who is a former intravenous drug abuser. He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis. Which of the following will the nurse include in her teaching plan for this patient? A) Avoid high-fat foods B) Drink plenty of water every day C) Take the tablets before bedtime D) Avoid red meat Question 7 A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer. During the patient education session for self-administration, the nurse will emphasize A) the need to rotate the injection site of the drug B) the need to avoid crushing the tablet C) the need to place the tablet under the tongue D) the need to use only the thigh muscle for the drug injection site Question 8 A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout. Which of the following will the nurse monitor the patient most closely for? A) Hypothermia B) Hypotension C) Renal dysfunction D) Bleeding Question 9 A nurse will monitor which of the following when assigned to a patient taking allopurinol for chronic gout who visits the clinic every 2 months? A) Liver function tests B) Blood sugar levels C) Blood pressure D) Body temperature Question 10 Which of the following would be the most important safety-related instruction for a nurse to give to a patient taking baclofen (Lioresal)? A) Do not walk or drive after taking the drug B) Discontinue the use of alcohol C) Learn to self-administer the drug D) Take a laxative when needed Question 11 A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the nurse’s immediate attention? A) Decreased libido B) Increased blood glucose C) Dry eyes D) Jittery feeling Question 12 A nurse is caring for a patient who has been diagnosed with hypothyroidism. Levothyroxine (Synthroid) has been prescribed.Before the drug therapy is started, the nurse will assess for which of the following? A) History of taking anticoagulant drugs B) Allergy to seafood C) Hirsutism D) The patient’s age Question 13 A nurse is instructing a patient in the administration of regular insulin by the subcutaneous route. Which of the following strategies would the nurse suggest if the goal is to promote absorption of the regular insulin? A) Rotate injection sites by using the arm one day, the stomach the next day, and the thigh the day after and then repeating the cycle B) Select one injection site for regular insulin injections and use it exclusively C) Administer the medication 30 to 60 minutes after a meal D) Select one anatomic area for regular insulin injections and then use serial locations within that area. Question 14 A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident. He has been taking dantrolene (Dantrium) for 2 weeks. The nurse will monitor which of the following? A) Prothrombin time and partial thromboplastin time B) Urine specific gravity C) Alanine aminotransferase and total bilirubin levels D) Follicle-stimulating hormone levels Question 15 The nurse is conducting a medication reconciliation of a new resident of a long-term care facility. The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout.What is the primary purpose of this drug? A) To balance urate concentration and prevent gout attacks B) To promote the remodeling of damaged synovium C) To potentiate the metabolism of dietary purines D) To achieve pain relief in joints affected by gout Question 16 A 33-year-old man has developed acute gouty arthritis. He has been prescribed colchicine. When developing a care plan for this patient, which factor will be most important for the nurse to consider? A) Dietary habits B) Work environment C) Typical daily fluid intake D) Ethnicity Question 17 During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following? A) The patient’s environment B) The patient’s diet C) The condition of the patient’s skin D) The condition of the patient’s nasal passages Question 18 A patient is taking gabapentin (Neurontin) for spasticity associated with multiple sclerosis. Which of the following should be the priority for monitoring? A) Hepatic function B) Cardiac function C) Respiratory function D) Renal function Question 19 Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine. Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine? A) The resident has not eaten breakfast because of a recent loss of appetite B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm C) The resident had a fall during the night while transferring from her bed to her bathroom D) The resident received her annual influenza vaccination the previous day Question 20 To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should A) administer calcium supplements B) position the patient in the side-lying position C) administer carbohydrates D) monitor for nausea and vomiting Question 21 A 34-year-old male patient is prescribed methimazole (MMI). The nurse will advise him to report which of the following immediately? A) Vertigo B) Intolerance to cold C) Loss of appetite D) Epigastric distress Question 22 A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s A) blood pressure B) potassium level C) use of alcohol D) use of salt in his diet Question 23 A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity. Consequently, she has been prescribed Dantrolene (Dantrium). In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide? A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.” B) “We’ll need to closely monitor your blood sugar levels for the next week.” C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.” D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.” Question 24 A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? A) Eat a high-protein diet B) Decrease the dosage if any adverse effect is experienced C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight D) Have a complete blood cell count done weekly Question 25 A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen. What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient? A) Risk for Injury related to CNS depressant effects B) Diarrhea related to anticholinergic effects C) Altered Nutrition, Less than Body Requirements, related to appetite suppression D) Impaired Swallowing related to increased muscle tone Question 26 A 70-year-old woman who is on long-term ibuprofen therapy for osteoarthritis has returned to the clinic for her regular 6-month visit. In the last couple of months, she has been having increasing periods of abdominal pain. The nurse suspects that this pain may be related to A) anemia B) peptic ulcer disease or gastritis C) interstitial nephritis D) constipation Question 27 A 13-year-old patient has juvenile arthritis. He has recently had oral surgery and was told by the surgeon to take aspirin for the pain. The nurse will monitor for which of the following? A) Bronchoconstriction B) Hepatotoxicity C) Aplastic anemia D) Agranulocytosis Question 28 A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning. The nurse administers colchicine intravenously in order to A) avoid aggravating the gastrointestinal tract B) ensure quick distribution of the drug C) prevent the risk of infection or bleeding D) minimize the risk of depressed bone marrow function Question 29 A 66-year-old woman has experienced a significant decline in her quality of life as a result of worsening rheumatoid arthritis. Her physician has prescribed etanercept and the nurse is responsible for facilitating this new aspect of the patient’s drug regimen. This will involve the administration of A) daily, outpatient intravenous therapy B) daily, oral administration C) weekly subcutaneous injections D) weekly administration of an enteric coated tablet Question 30 A clinic nurse is following a 9-year-old boy who is taking somatropin. Which of the following will the nurse monitor periodically? A) Antidiuretic hormone (ADH) levels B) Height C) Dehydration D) Water retention

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nurs 6600 Assignment 1: Practicum Professional Experience Plan (PPEP) 2025

Section 2: Practicum Professional Development Objectives Refer to the instructions in Week 1 to create practicum professional development objectives that meet the requirements for this course. Objective 1: Analyze three common barriers to effective communication, then compare and contrast two effective resolution strategies as defined in evidence-based literature. Objective 2: Contrast units that have success with retention and recruitment of novice nursing staff and those who have high turnover; identifying factors of influence and comparing to peer reviewed literature. Assignment 1: Practicum Professional Experience Plan (PPEP)Success comes from knowing that you did your best to become the best that you are capable of becoming. — John Wooden, My Personal Best: Life Lessons from an All-American Journey As you considered in this week’s Discussion, your experiences in the practicum can provide a vital avenue for professional development.For this Assignment, you develop a Practicum Professional Experience Plan (PPEP) to outline how your involvement in the practicum will contribute to your growth as a professional and allow you to hone your specialization knowledge and skills. The PPEP consists of two or three objectives related to professional development that you will address during your Practicum Experience. Note: In the practicum manual these are referred to as your individualized learning objectives.To prepare:As necessary, review the information related to developing objectives provided in this week’s Learning Resources.Revisit the objective(s) you crafted for this week’s Discussion, and reflect on the ideas exchanged in this forum. Refine the objective(s) as needed, making sure they reflect the higher-order domains of Bloom’s Taxonomy (i.e., Application level and above). Note: You will be developing two to three professional development objectives for this assignment.Think more deeply about areas for which you would like to gain application-level experience and/or continued professional growth. How can your experiences in the practicum help you achieve these aims?Discuss your professional aims and your proposed practicum professional development objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.Download and save the Practicum Professional Experience Plan Form provided in this week’s Learning Resources. To complete your Practicum Professional Experience Plan:Record the required information in each area of the Professional Practicum Experience Plan, including two or three objectives you will use to facilitate your professional development during the practicum. Objective 3: Develop and prioritize a one-month productivity expense report that will be used to budget upcoming expenditures and incorporate a balanced unit financial statement in accordance with previous budgets and evidence based literature. Resources Cipriano, P. F., & Murphy, J. (2011). The future of nursing and health IT: The quality elixir. Nursing Economic$, 29 (5), 286–289. Note: Retrieved from the Walden Library databases. “Technology tools will continue to revolutionize how we plan, deliver, document, review, evaluate, and derive the evidence about care” (p. 289). This article examines how nurses can use information technology to transform nursing and redesign the health care system. It focuses on the use of technology to promote quality and notes that technology can also be used to address challenges in education, research, leadership, and policy.McKimm, J., & Swanwick, T. (2009). Setting learning objectives. British Journal of Hospital Medicine, 70 (7), 406–409. Note: Retrieved from the Walden Library databases. This article clarifies the terminology associated with learning objectives and explains how learning objectives relate to professional development and the transformation from novice to expert. It also introduces common pitfalls when setting learning objectives and provides suggestions for avoiding them.Murphy, J. (2011). The nursing informatics workforce: Who are they and what do they do? Nursing Economic$, 29(3), 150–153. Note: Retrieved from the Walden Library databases. The author examines the nursing informatics workforce, explaining that professionals in this well-established specialty area can play an integral role in transforming health care.Sørensen, E. E., Delmar, C., & Pedersen, B. D. (2011). Leading nurses in dire straits: Head nurses’ navigation between nursing and leadership roles. Journal of Nursing Management, 19 (4), 421–430. Note: Retrieved from the Walden Library databases. “Successful nursing leaders navigate between nursing and leadership roles while nourishing a double identity” (p. 421). In this article, the authors examine how individuals in key professional roles negotiate between and apply nursing and leadership skills.

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