Consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). 

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

Week 5: 3-Minute Reflection: (2-3 paragraphs with APA format and 2 or 3 references)

Identify some examples of nursing integrity, now utilize reflective learning, and write a 3-minute reflection on a personal example of integrity in your life (work or personal)?

Also can use this article as reference: 

https://nurse.org/articles/nursing-ranked-most-honest-profession/

Required criteria:
1. Writes about the assigned topic.
2. Demonstrates strong evidence of reasoned reflection.
3. Demonstrated depth of original thought.

Required Criteria:
1) Using the template loaded under each week, answers the weekly reflection questions.
2) Uses two specific examples from the video to support writing.
3) Uses Standard English grammar and sentence structure.
4) Contains no more than 3 spelling or typographical errors.
5) Writing demonstrates original thought without an over-reliance on the works of others.

I NEED A RESPONSE TO THIS ASSIGNMENT

3 REFERENCES

William Thompson is a 38-year-old, African American, Catholic who was recently married to Luli Kim. He was a captain in the military during the Iraq war. William is a lawyer specializing in finance law and in jeopardy because of alcohol and PTSD related concerns. He became homeless when he was unable to pay his mortgage. The patient stated, hitting some hard times and needed to move back in with his brother and his brother’s wife. He also stated, they say I have PTSD but that’s another story. William is a marathon runner, plays soccer, enjoys listening to jazz, and is a novice modern art collector.

DSM-5 Criteria

According to the scenario given, the client William Thompson doesn’t have enough signs and symptoms nor enough information to officially diagnose him with PTSD.  According to the DSM 5 criteria requirement, a person being diagnosed with PTSD must have been exposed to actual or threatened death, serious injury, or sexual violence either directly or by experiencing. The traumatic event also needs to be a recurrent event, involuntary, and intrusive.  (DSM-5, 2020). Unfortunately our patient William Thompson does not meet those criteria-based on the information given and information available on patient clinical records.

Client Does Not Meet Criteria 

 As a future nurse practitioner, I will do the ethically right thing and not give my patient any diagnosis if they do not meet the criteria. I believe that labeling the patient based on family history and not on signs and symptoms is wrong. I will conduct a future mental health assessment of the patient to see what the right diagnoses are for the patient and how I can develop an effective treatment plan (Flanagan et al., 2016).

Goals of Treatment

 According to the Psychiatric Association’s practice guidelines for PTSD goals of treatment should include managing signs and symptoms; preventing Comorbid related symptoms such as depression, insomnia, substance abuse, and pain; improve functioning; improve the sense of trust and safety; protect against relapse; and transfer experience into a constructive plan of safety, prevention, and protection (Szafranski et al., 2017). The most important goal of treatment for the patient will include preventing him from committing suicide or hurting those around. The safe of the client and others should always be a priority (Flanagan et al., 2016).

Care plan Options

            As care providers, I will consider using psychotherapy with the client in conjunction with medication therapy that can manage signs and symptoms of depression, insomnia that might be preventing the client from completing his day today activities. Some medication that I will prescribe will include Zoloft to help with the mood and Ambien to help with insomnia, I will also make sure the client enroll in cognitive behavioral therapy (CBT).

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Retrieved from https://dsm-psychiatryonline-org.ezp.waldenulibrary.org/doi/full/10.1176/appi.books.9780890425596.dsm07

Flanagan, J. C., Korte, K. J., Killeen, T. K., & Back, S. E. (2016). Concurrent treatment of substance use and PTSD. Current psychiatry reports, 18(8), 70.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp. ix-x

Szafranski, D. D., Smith, B. N., Gros, D. F., & Resick, P. A. (2017). High rates of PTSD treatment dropout: A possible red herring?. Journal of Anxiety Disorders, 47, 91-98.

I need a response to this assignment 

2 references

Cognitive-Behavioral Therapy. Family Versus Individual Settings

         Cognitive-behavioral therapy (CBT) posits maladaptive behavior and dysfunctional thoughts that relate to self, others, and the

world that are rooted in illogical or irrational assumptions. This individual view of the world, self, and others are central to the

determination of emotions, thoughts, and behaviors and by changing these, behavior can also be changed.  (Wheeler, 2014). 

According to Patterson (2014), family therapy is usually focused on behavioral outcomes which when it comes to cognitive-

behavioral therapy (CBT), the term behavior tends to be the primary focus. Wheeler (2014) states that CBT can also be further broken

down into primary and secondary thinking which is a structured hierarchy. Cognitive processes are understood as

primary secondary with primary thinking recognizing negative, intermittent, and irrational thinking as an ongoing human action.

Secondary thinking views the cultural and social world in a more positive, rational, and determinant term.  

         Therapeutic alliance has been identified as one of the most important factors in individual therapy of any kind (Nichols and Davis,

2020) It is, however, more difficult to establish a therapeutic alliance in family or group therapy due to a number of different reasons

such as an increased number of participants with individual thoughts and feelings.  Assessment is a pivotal part of CBT and

the advantages of a behavioral emphasis are that it can provide definitive goals, baseline data, and a reliable way to measure

therapeutic success. Certain disadvantages are that by using a structured environment in family therapy, the active family interactions

can not be viewed. All that is seen is individual patient reports (Nichols and Davis, 2020).    

         A study by Thimm and Antonsen (2014) examined the effectiveness of group CBT for depression in a routine outpatient setting,

looking also at predictors of dropout and response. Results suggested a large reduction in anxiety and depression among

participants who received CBT with these observed results maintained at a three-month follow-up. CBT is a very effective therapy with

individual clients but can prove to be challenging in group and family settings.  The video of the Johnson Family Session (2013c) 

is an example of a group of women who had experienced similar trauma but had very different thoughts and feelings about

the experience.  The therapist may find the establishment of a trusting therapeutic alliance somewhat difficult in this situation. 

References

Laureate Education (Producer). (2013c). Johnson family session 3. (Video file). Baltimore, MD: Author

Nichols, M. & Davis, S. d. (2020). The essentials of family therapy. (7th ed.). Boston, MA: Pearson

Patterson, T. (2014). A cognitive-behavioral systems approach to family therapy. Journal of Family Psychotherapy, 25(2)

 132-144. doi.10.1080/08975353.2014.910023

Thimm. J. C. 7 Antonsen, L. (2014). Effectiveness of cognitive-behavioral therapy for depression in routine practice.

  BMC Psychiatry, 14, 292. https?doi.org/10.1188/312888-014-0292-x

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based 

  practice. New York, NY: Springer