PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW: 

1). ZERO (0) PLAGIARISM, 

2). 5 REFERENCES, NO MORE THAN 5 YEARS OR LESS THAN 5 YEARS/APA 7 WRITING STYLE/FORMAT

3). PLEASE FIND THE ATTACHED RUBRIC DETAILS, DECISION POINTS.

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.

To prepare for this Assignment:

• Review this week’s Learning Resources, including the Medication Resources indicated for this week.
• Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.

The Assignment: 5 pages

Examine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

1. dentify a clinical question related to your area of clinical practice and write the clinical foreground question in PICOT format utilizing the worksheet tool provided as a guide.
2. Describe why this is a clinical problem or an opportunity for improving health outcomes in your area of clinical practice. Perform a literature search and select five research articles on your topic utilizing the databases highlighted in Chapter 3 of the textbook (Melnyk and Finout-Overholt, 2015).
3. Identify the article that best supports nursing interventions for your topic. Explain why this article best supports your topic as you compare the article to the other four found in the literature search.

Assignment Expectations:

Length: 1000 – 1500 words
Structure: Include a title page and reference page in APA format. These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.
References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of five (5) scholarly sources are required for this assignment to support the topic.

This week we will discuss gastrointestinal and hepatobiliary disorders. Please take a look at the week 4 assignment case posted below. A copy of the midterm exam study guide is available in week 5 and week 6 resources.  

Week 4 Assignment

By Day 7 of Week 4:

Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.
• Please review the rubric.

Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

• Synthroid 100 mcg daily
• Nifedipine 30 mg daily
• Prednisone 10 mg daily

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.  

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

To Prepare

• Review the case study assigned by your Instructor for this Assignment
• Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
• Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
• Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

By Day 7 of Week 4

Write a 1-page paper that addresses the following:

• Explain your diagnosis for the patient, including your rationale for the diagnosis.
• Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
• Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

Respiratory Case Study

Do not change the format.

Save your name to the document to receive credit and for easier verification. 

List at least one reference to support your answers.

Use your own words only.

• Winter is a 4-year-old girl with a history of asthma. Her mother has brought her in an “asthma attack”. Winter is sitting in her mother’s lap and breathing rapidly through an open mouth. She has a cough that sounds congested and wheezy. The physician has already ordered a nebulized treatment containing albuterol (Proventil) and ipratropium bromide (Atrovent).
• Mr. Chung is a 68-year-old man complaining of cough, sore throat, fatigue, and weakness. His BP is 166/82, pulse is 90, respirations are 26, and temperature is 100.4 degrees.
• Jackson is a 19-year-old man who has had a sudden onset of right-sided chest pain and shortness of breath. His chest x-ray film revealed a right pneumothorax, and he is currently receiving 35% oxygen by face mask while waiting for an ambulance to transport him to the hospital for further evaluation.
• Ms. Summers is a 45-year-old homemaker. She says she has been extremely tired, easily becomes short of breath, and is unable to complete her chores without frequent rest breaks. She is pale and seems tired. Her vital signs are as follows: BP 136/78, pulse 86, respirations 24 and unlabored; temp 98.4 and pulse oximetry 98% on room air. She is now waiting for her lab results, which include a complete blood count (CBC).

Answer the following questions that pertain to the above patients.

• Which patients are experiencing problems with ventilation? Explain your answer.
• Which patient appears to be experiencing problems with hypoxia? Does the problem appear to be related to oxygenation or perfusion? Explain your answers.
• Mr. Chung has smoked two packs of cigarettes per day for 50 years. ABGs reveal a low PO2 and a high PCO2 consistent with chronic lung disease. He is diagnosed with an acute exacerbation of chronic bronchitis. He is placed on oral antibiotics and long acting bronchodilators by metered-dose inhaler (MDI). What teaching could you offer to help Mr. Chung mobilize and expectorate secretions?
• Winter receives her nebulizer treatment and markedly improves. The physician has ordered a variety of take-home medications that you must teach her mother about. The treatment plan includes a protocol based on peak expiratory flow monitoring. Discuss how you might involve Mary in her own care.
• Jackson’s chest x-ray film reveals a spontaneous pneumothorax. There is no apparent fluid in the pleural space. What chest tube systems can be used to treat his pneumothorax? Explain your thinking.
• Ms. Summers is diagnosed with severe anemia. She is hospitalized because her hemoglobin is 5.9 g/dL. How will this affect her oxygenation? What interventions would improve her fatigue?

PowerPoint Presentation

Directions:

1. Review the case study.

2. Download the provided PowerPoint template to create a presentation that includes:

· Your name on the title slide of the presentation

· Identification of two or more issues with existing system

· Identification of “work-a-round” solutions when using existing system

· Overview of standard language used only in nursing

· Overview of multidisciplinary standard language

· Set of five (5) open-ended survey questions for staff input on transitioning to the new system

· Presentation is free of spelling and grammar errors.