Case Study, Mohr:  CHAPTER 2, Neuroscience: Biology and Behavior

In completing the case study, students will be addressing the following learning objectives:

Discuss neuroplasticity and how this concept relates to mental health and mental illness.

Briefly explain the importance of interaction between genes and environment, the role of endophenotypes, and the stress-diathesis model of psychiatric illness.

1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s grades.  Michael plans to apply to medical school and thinks that the lower GPA may prevent his acceptance to medical school.  For the last 2 weeks, Michael has skipped most classes because he has insomnia and fatigue.  Michael is now very depressed and has been thinking of suicide.  He took a loaded gun from his father’s gun cabinet and then wrote a suicide note to his family.  At the last moment, he telephoned 911 and told them of his suicide plan.  The police came, took the gun away, and then took Michael to the city hospital to be admitted for psychiatric treatment.   In the admission interview with the psychiatric nurse, Michael said that his pastor thought that only weak-willed people experienced depression and that it was a punishment for personal sins and the sins of one’s ancestors.  Michael told the nurse that he must be weak-willed and will never be able to accomplish anything.  The psychiatric nurse explained that multiple factors are the cause of depression.  The nurse told Michael that one theory holds that an imbalance of neurotransmitters, or chemical messengers of the brain, occurs in depression.  Neurotransmitters influence the individual’s emotions, thoughts, and subsequent behavior.  Recent research implies that neurobiology, heredity, as well as Psychological and environmental factors may be involved in the development and progression of depression. 

(Learning Objectives: 5, 6)

a. Will Michael think that the psychiatric nurse’s explanation for the cause of depression is more correct than that of his pastor?

b. Michael asks the nurse why he has to have psychotherapy. He states that he only needs to take a couple of pills to get better. How should the nurse respond to Michael’s question and comment?

c. Develop an assessment question for each of the following possible causes of Michael’s    development of depression:

              Genetic, Environment and Stress.

 

Identify a research or evidence-based article that focuses comprehensively on a specific intervention or new diagnostic tool for the treatment of diabetes in adults or children.

 

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

 

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

 

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

 

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

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

Select a patient who you examined during the last 3 weeks. With this patient in mind, address the following in a SOAP Note:

• Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent, as well as possible reasons for these discrepancies.
• Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.
• Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?
• Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan.
• Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

Post with a description of two patients. Remember, you do not need a complete assessment of all body systems, just the body system we are studying this week. Your post needs to be at least 250 words, and requires full references in APA format for any resource you use.

You have two very ill patients this week, and each of them presents a very complicated case. First, you have a patient with an ongoing problem that has resisted diagnosis. He was en route to an evaluation with a neurologist, but on the way to the hospital suddenly fell into a coma (a state of involuntary unconsciousness due to illness or injury) and had to be brought in to your medical facility by ambulance.

You will use at least 10 medical terms to describe this patient, and to refer to the original underlying problem the patient had in the first place. Use the nervous system medical word elements chart and the medical, surgical, and diagnostic terms chart on from your textbook to get you started on the medical terms you will need. You can include specific drugs used in neurological disease as you list at least 3 tests and procedures used. 

 

Discussion: Identifying and Engaging Stakeholders for Strategic Planning

 

Stakeholders can facilitate the success, or failure, of a strategic plan.

 

Identifying internal and external stakeholders and building productive relationships should be an intentional and well-conceived part of the strategic planning process. As a nurse leader-manager involved in strategic planning, it is important that you consider who could be impacted by a proposed change and how the change may affect individuals’ roles, responsibilities, and relationships. It is also essential to think about which stakeholders may be able to offer expertise, capital, and/or sway to help exercise the strategic plan and generate buy-in.

 

In this Discussion, you identify stakeholders who can assist with carrying forward a strategic plan.

Your Instructor has assigned you to a small group for this Discussion. Craft your stakeholder description independently; through the collegial exchange that follows, you will offer each other suggestions for refinement. As in Weeks 2 and 3, use this small group Discussion to delve deeply into the concepts being presented as they are foundational to this course.

 

To prepare:

 

Reflect on a planned change effort you have experienced.

Consider the following questions:

• How do you think stakeholder involvement may have impacted the outcome of this planned change?
• Were the right stakeholders involved? Did the stakeholders help to carry out the plan as needed?
• Should other stakeholders have been engaged? If so, how could relationships with additional stakeholders have been cultivated to better support the plan?
• How does reflecting on this instance of planned change inform your perspective on what is needed to engage stakeholders to successfully promote other strategic changes?

Review the Mountain View Health Center case study, and reflect on the focus of your postings in the Week 2 Discussion 2 and the Week 3 Discussion.

 

Conduct additional research as necessary to strengthen your understanding of the process of involving stakeholders in strategic planning and to deepen your thinking about the organization. For instance, you may research organizations with similarities to Mountain View, and examine information related to stakeholder involvement.

 

Consider the following questions:

 

• Which internal and external stakeholders should be involved in strategic planning related to this case study?
• What assets and/or perspectives would each of these stakeholders offer to the process?
• What role would each potential stakeholder play in helping to move forward a strategic plan?
• When and how should the stakeholders become involved?
• How would you cultivate relationships with these stakeholders to produce the best possible results?
• How would the appropriate selection of stakeholders and their involvement promote the likelihood of successful adoption and implementation of a strategic plan?

Post a description of internal and external stakeholders who should be involved in strategic planning at Mountain View Health Center. Propose strategies for cultivating relationships with these stakeholders. Explain how their involvement would promote the likelihood of success for the strategic plan.

 

Read a selection of your colleagues’ responses.

Respond to at least two of your colleagues on two different days by analyzing the selection of stakeholders and the strategies outlined for engagement.

 

Required Readings

 

Sare, M. V., & Ogilvie, L. (2010). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.

Chapter 6, “Strategic Planning: Why It’s Not Just for the Boardroom Anymore” (pp. 105–115)

 

Chapter 11, “Eight Cautionary Tales of Strategic Planning” (pp. 215–226)

 

Note: You are only required to read the “Hail, Hail, the Gang Is Not All Here” section of the chapter this week.

 

These chapters address stakeholder involvement in strategic planning.

Galunic, C., & Hermreck, I. (2012). How to help employees ‘get’ strategy. Harvard Business Review, 90(12), 24.

Retrieved from the Walden Library databases.

 

This article addresses the influence of senior management/leadership on employees’ understanding of and commitment to organizational strategy.

Harmon, R. B., Fontaine, D., Plews-Ogan, M., & Williams, A. (2012). Achieving transformational change: Using appreciative inquiry for strategic planning in a school of nursing. Journal of Professional Nursing, 28(2), 119–124.

Retrieved from the Walden Library databases.

 

The authors discuss stakeholder involvement and other aspects of the strategic planning process engaged in by the University of Virginia School of Nursing.

Murphy-Hoefer, R., Andrade, M. S., Maines, D. E., & Martin, M. (2011). Stakeholder input in establishing an evaluation plan for tobacco counter-marketing campaigns. American Journal of Health Education, 42(2), 66–73.

Retrieved from the Walden Library databases.

 

As you read this article, consider how stakeholder involvement may contribute to successful strategic planning.

Required Media

 Laureate Education (Producer). (2013b). Case study: Mountain View Health Center [Interactive media]. Retrieved from CDN database. (NURS 6241)

 

This interactive multimedia piece presents a case study of an organization, with information about the types of activities performed there, organizational structure, strategic priorities, and financial allocations. You will use this as a resource for this week’s Discussion