An understanding of the neurological and musculoskeletal systems
An understanding of the neurological and musculoskeletal systems is a critically important component of disease Module 5 Assignment: Case Study Analysis An understanding of the neurological and musculoskeletal systems is a critically important component of disease and disorder diagnosis and treatment. This importance is magnified by the impact that that these two systems can have on each other. A variety of factors and circumstances affecting the emergence and severity of issues in one system can also have a role in the performance of the other. Effective analysis often requires an understanding that goes beyond these systems and their mutual impact. For example, patient characteristics such as, racial and ethnic variables can play a role. In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health. To prepare: By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. Assignment (1- to 2-page case study analysis) A 58-year-old obese white male presents to ED with chief complaint of fever, chills, pain, and swelling in the right great toe. He states the symptoms came on very suddenly and he cannot put any weight on his foot. Physical exam reveals exquisite pain on any attempt to assess the right first metatarsophalangeal (MTP) joint. Past medical history positive for hypertension and Type II diabetes mellitus. Current medications include hydrochlorothiazide 50 mg po q am, and metformin 500 mg po bid. CBC normal except for elevated sedimentation rate (ESR) of 33 mm/hr and C-reactive protein (CRP) 24 mg/L. Metabolic panel normal. Uric acid level 6.7 mg/dl In your Case Study Analysis related to the scenario provided, explain the following: Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms. Any racial/ethnic variables that may impact physiological functioning. How these processes interact to affect the patient. Expert Answer: Alteration of Neurological and Musculoskeletal Systems Advanced practice registered nurses should be knowledgeable about the alterations in body systems. This information can help the nurses conduct a proper diagnosis and plan effective treatments. Understanding the processes of body systems that result in patient symptoms can also guide the APRNs during patient education and disease prevention. The purpose of this assignment is to examine the case study and identify the factors for diagnosis and implications for the health of the patient. Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms The nerves that connect the muscles of the toes are known as interdigital nerves. These nerves are pass between the bones of the toes to connect the toe muscles, tendons, and joints. The interdigital nerves’ longstanding irritation causes the swelling and pain on the patient’s right great toe (Raney, Thankam, Dilisio, & Agrawal, 2017). The swelling was caused by misalliance between the ability of the patient to withhold load and external load. This difference resulted from the patient’s ability to hold the load and physical exertion and posture. Pain is a sign that a certain tissue in one’s body is damaged. Raney et al. (2017) note that the body often communicates that a specific organ or tissue is damaged by sending a pain sensation to the brain to alert the patient. In the case, the patient experienced pain in his left toe because the interdigital nerves sensed high mechanical pressure on the injured and swollen toe joints and muscles. He cannot put weight on the foot because the nerves have communicated to the spinal cord, which has sent a signal to motor reflex, ordering it not to exert any pressure on the swollen toe. Any racial/ethnic variables that may impact physiological functioning The physiological functioning of the human body can be affected by various racial or ethical factors. The first factor is obesity. According to Spurr, Bally, Bullin, Allan, and McNair (2020), obesity is mostly recorded among blacks and Latinos compared to whites and Asians. The authors note that 49.6% of blacks are obese, followed by Hispanics (44.8%), whites (42.2%), and Asians (17.4%). Obesity affects cell repair and cell generation. The second variable is physical exercise. According to Ige-Elegbede, Pilkington, Gray, and Powell (2019), physical exercise activity is 6% lower among whites, 26% among African Americans, and 10% lower among Hispanics. El Khoudary et al. (2019) also performed research to understand the lean mass and muscle strength among blacks and whites. The researchers found that black males have a higher lean mass compared to white men. However, physical activity was higher among whites. How these Processes Interact to Affect the Patient Obesity highly affects physiological functioning, especially cell repair and generation (Toubal et al., 2020). However, the patient is a white male, meaning that the chances of being obese are minimal. Hence, the cells in his swollen toe are expected to generate, repair, and heal faster. Physical exercise also affects physiological functioning by increasing the effectiveness of medications and other metabolic processes (Ige-Elegbede et al., 2019). Being white, the patient is likely to work out often. Hence, he will show a positive response to hydrochlorothiazide 50 mg po q am and metformin 500 mg po bid. Lastly, the patient has a lower lean mass, increasing his chances of developing a toe condition. Conclusion The assignment has analyzed a case about a patient experiencing swollen and painful toe. The feeling is likely to result from communication between interdigital nerves, the brain, spinal cord, and toe muscles. The nerves communicated pain to alert the patient that the toe tissues are damaged. References El Khoudary, S. R., Greendale, G., Crawford, S. L., Avis, N. E., Brooks, M. M., Thurston, R. C., … & Matthews, K. (2019). The menopause transition and women’s health at midlife: a progress report from the Study of Women’s Health Across the Nation (SWAN). Menopause (New York, NY), 26(10),
Post a description of at least one potential benefit of using big data as part of a clinical system and explain why
Post a description of at least one potential benefit of using big data as part of a clinical system and explain why Big Data risks and Rewards When you wake in the morning, you may reach for your cell phone to reply to a few text or email messages that you missed overnight. On your drive to work, you may stop to refuel your car. Upon your arrival, you might swipe a key card at the door to gain entrance to the facility. And before finally reaching your workstation, you may stop by the cafeteria to purchase a coffee. From the moment you wake, you are in fact a data-generation machine. Each use of your phone, every transaction you make using a debit or credit card, even your entrance to your place of work, creates data. It begs the question: How much data do you generate each day? Many studies have been conducted on this, and the numbers are staggering: Estimates suggest that nearly 1 million bytes of data are generated every second for every person on earth. As the volume of data increases, information professionals have looked for ways to use big data—large, complex sets of data that require specialized approaches to use effectively. Big data has the potential for significant rewards—and significant risks—to healthcare. In this Discussion, you will consider these risks and rewards. To Prepare: Review the Resources and reflect on the web article Big Data Means Big Potential, Challenges for Nurse Execs . Reflect on your own experience with complex health information access and management and consider potential challenges and risks you may have experienced or observed. Post a description of at least one potential benefit of using big data as part of a clinical system and explain why. Then, describe at least one potential challenge or risk of using big data as part of a clinical system and explain why. Propose at least one strategy you have experienced, observed, or researched that may effectively mitigate the challenges or risks of using big data you described. Be specific and provide examples. Big Data Risks and Rewards The Clinical Decision Support System (CDSS), Patient Portals are some of the examples of the clinical system that generate data which providers can leverage to support decision-making. In clinical settings, data is crucial in the sense that it allows providers to identify the appropriate intervention based on patient’s needs or characteristics such as their past health information, and their demographic background (Awrahman et al., 2022). In healthcare, big data represents large volume of data collected using the clinical systems, and which support the delivery of care. While this kind of data is associated with various benefits, its use poses certain risks that are worth examining. Potential Benefit of using Big Data as Part of Clinical System A key benefit of big data is that it has the potential of helping reduce adverse health events linked to medical errors. This is because analyzing this data using data analytics makes it possible for one to determine the trend of a disease or how it develops. The data analytics technology, for example, analyzes data, identifying the factors that increase the risk of medication error. Through this prediction, a provider can take appropriate measures to avert the risk of error (Dicuonzo et al., 2022). In addition, data can inform the intervention that is likely to translate into better health outcomes, lessening the possibility of choosing inappropriate intervention. Potential Challenge or Risk of using Big Data as Part of the Clinical System While the use of big data provides significant opportunities for providers to make decisions that optimize the quality of health outcomes, its use poses serious concerns part of which is data security threat. One of the key reasons for this is that hackers can hack into the clinical systems, accessing this data which include information such as clients’ personal details (Dicuonzo et al., 2022). This threat is high in a scenario in which members of the staff are ill equipped with adequate data security knowledge. In this kind of a situation, they may use weak passwords, increasing the threat of intrusion into the systems that store this data. Additionally, practices such as failure to firewalls can cause data security issues. The Strategy for Mitigating the Risks of using Big Data For an organization to cushion itself against the breach of security, it needs to conduct data security training with emphasis on educating its staff about the best practices in data management. Part of this training involves educating the staff how to use secure passwords while stressing the importance of compliance with the legal requirements linked to data privacy and confidentiality. When engaging the employees in training, one would equally need to emphasize the ethical and legal implications associated with breach of data privacy (McGonigle & Mastrian, 2022). Ensuring data security is crucial in the sense that it cushions the organization against lawsuits and negative reputation. Conclusion In conclusion, utilization of big data provides significant benefits when it comes to the delivery of care considering that it lessens the risk of medical errors as it allows clinicians to identify an intervention that is likely to help lead to better health outcomes based on the patient’s needs. However, the challenge of using large amount of data to inform clinical decisions increases the risk of data breach. To avert this problem, a hospital should train its staff, allowing them to learn the data security strategies. References Awrahman, B. J., Aziz Fatah, C., & Hamaamin, M. Y. (2022). A Review of the Role and Challenges of Big Data in Healthcare Informatics and Analytics. Computational intelligence and neuroscience, 2022, 5317760. https://doi.org/10.1155/2022/5317760. Dicuonzo, G., Galeone, G., Shini, M., & Massari, A. (2022). Towards the Use of Big Data in Healthcare: A Literature Review. Healthcare (Basel, Switzerland), 10(7), 1232. https://doi.org/10.3390/healthcare10071232. McGonigle, D., & Mastrian, K. G. (2022). Nursing informatics and the foundation of knowledge (5th ed.). Jones & Bartlett Learning. Alternative Verified Answer Big Data Analytics Big data analytics is a term used in healthcare
Mrs Franklin Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction
Mrs Franklin Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction Case Study #1 Mrs Franklin Jones was admitted from the Emergency Room to Cardiac Intensive Care one week ago with a diagnosis of acute myocardial infarction. She has recovered as expected and is moving to the cardiac step down unit today. She is talking with Nurse Julie Hernandez, as she gets settled in her new room, \”I was really surprised when I got that bad pain in my chest! I knew I had high pressure but I just didn\’t think it was that bad. I try to take my medicine like they told me to in the clinic but sometimes I forget. I guess that I need to study those papers they gave me about what foods I should eat and not eat. I better take care of myself! Momma had bad pressure and it killed her! Who knows—I may even have to learn to cook different than I was taught in Jamaica! I may have to let Tomas do the cooking. He\’s got more time at home now than I do since he lost his job. There isn\’t too much time between my shifts at the school cafeteria and my new housecleaning job. You know my sister is coming up from Jamaica to see me. I think she is bringing me some bush tea. That\’ll set me right!\” Using Leininger‘s Culture Care Model, what factors in the story shared by Mrs. Franklin-Jones should be considered by Nurse Hernandez when planning for the patient\’s discharge? Why is the theory of Culture Care Diversity important in the delivery of nursing care for all patients? Using Leininger\’s Theory of Culture Care Diversity and Universality, develop a plan of care for Mrs. Franklin-Jones. Discuss the strengths and limits to Leininger’s Theory. Case Study #2 Claude Jean-Baptiste is recovering from post-hip replacement surgery and has been transferred to the Rehabilitation Institute adjacent to the hospital. When he enters the unit, he sees welcoming signs written in several languages including his own, Creole. Since there are no nurses on that shift that speak Creole, they use a language line to ask for translation services. During this initial nursing assessment, the translator informs Mr. Jean-Baptiste that the nurses invite him to have a relative at his side so that they can be sure to understand and meet his needs. He is asked about Haitian customs and beliefs that they might honor. Mr. Jean-Baptiste is encouraged to bring food and spiritual care items, and to share the warmth of his culture with the nursing staff. Discuss assumptions of the Transpersonal Caring relationship. What is the nurse\’s role? How is love, as defined by Watson, evident in this caring moment? How can the nurse creatively use self to create a healing environment? Discuss the strengths and limits to Watson’s Theory. The Transcultural Nursing Theory and the Transpersonal Caring Relationship Theory Case Study One – Mrs Franklin The transcultural Nursing Theory or Cultural Care Theory is a nursing theory developed by Madeleine Leininger in 1995. The theory involves understanding and knowing different cultures considering healthcare and nursing illness caring activities, values, and beliefs to offer efficacious and meaningful nursing care services to individuals according to their health-disease context and cultural values (Busher Betancourt, 2016). According to the theory, different cultures across the globe have different values and beliefs about health and illness and have different modes of caring. This part of the assignment uses a case study to apply the theory in nursing care. Factors to Consider When Planning Mrs. Franklin-Jones’ Plan According to P. Sagar and D. Sagar (2018), Leininger developed various factors that should be considered by nurses when planning care. These factors include economic, educational, political, cultural beliefs, values, and lifeways, social and kinship, religious and philosophical, and technological factors. Based on the model and the case, Nurse Hernandez should consider various factors when planning to discharge the patient. The first factor the nurse should consider is the educational factor. Mrs. Franklin-Jones tells the nurse that “she needs to study the papers they gave her about what foods she should eat and not eat.” Therefore, the nurse should educate the patient about the foods to eat before discharging her to avoid readmission. The nurse should also factor in the patient’s kinship characteristics. The patient noted that her mother died of HBP, and thus the nurse should provide the interventions that should prevent her from suffering HBP (Busher Betancourt, 2016). The nurse should also consider the patient’s economic factors. Information about the patient’s economy can help the nurse recommend interventions that suit her financial status. Information about economic status can also help the nurse plan care that will not interfere with her job schedule and prevent her from forgetting to take her medications. Importance of the Theory The theory of Culture Care Diversity is so vital in care delivery. This theory can help a nurse understand the patient’s culture under his or her care and deliver care based on the patient’s values and beliefs. For instance, in the case, the theory has helped Nurse Hernandez identify that Mrs. Franklin-Jones lacks education about the foods to eat and not to eat. As a result, Hernandez effectively plans an intervention to improve the patient’s knowledge. Another importance of this theory is that it can be used to improve the relationship between nurses and patients. When nurses understand patients’ values and beliefs, they will provide care that respects their values, hence improving their relationship (P. Sagar & D. Sagar, 2018). Lastly, the theory is significant because it can improve patients’ satisfaction. Patients who feel that caregivers respect their norms, beliefs, traditions, and values will be highly satisfied with the services (Albougami et al., 2016). A Plan of Care for Mrs. Franklin-Jones The first step of the care plan is health assessment. The health assessment will be done by analyzing the patient’s personal and medical history and physical, sexual, cultural, and emotional factors. Assessment results will be used to provide a diagnosis. The second step is outlining the expected outcomes of the plan. Third, interventions to solve the
Advanced registered nurses work in highly collaborative environme
Advanced registered nurses work in highly collaborative environments and must collaborate with interdisciplinary teams in order to provide excellent patient care Nursing Roles Graphic Organizer Example Advanced registered nurses work in highly collaborative environments and must collaborate with interdisciplinary teams in order to provide excellent patient care. Besides knowing the role and scope of one’s own practice, it is essential to understand the role and scope of other nurse specialties to ensure effective collaboration among nurses, the organization, and other professionals with whom advanced registered nurses regularly interact. Use the “Nursing Roles Graphic Organizer Template” to differentiate how advanced registered nurse roles relate to and collaborate with different areas of nursing practice. Compare your future role with one of the following: nurse educator; nurse leader; family nurse practitioner; acute care nurse practitioner; graduate nurse with an emphasis/specialty in public health, health care administration, business, or informatics; clinical nurse specialist; doctor of nursing practice. Indicate in the appropriate columns on the template which roles you are comparing. Make sure to compare the following areas of practice in your graphic organizer: Ethics Education Leadership Public Health Health Care Administration Informatics Business/Finance Specialty (e.g., Family, Acute Care) Include any regulatory bodies or certification agencies that provide guidance or parameters on how these roles incorporate concepts into practice. You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content. Ensure that the country in the source is relevant to your paper. Sources cited should be generalizable to the population being studied or discussed. 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 not required to submit this assignment to LopesWrite. Nursing Roles Graphic Organizer Example Family Nurse Practitioner (FNP) Nurse Educator Observations (Similarities/Differences) Ethics FNPs prioritize ethical principles that center on patient autonomy, beneficence, and nonmaleficence, particularly when dealing with complex care decisions such as chronic disease management and medication adherence (Schlunegger et al., 2023). They frequently face ethical dilemmas related to balancing patient preferences with evidence-based treatment recommendations. Nurse Educators, on the other hand, uphold ethics in academic and professional contexts (Schlunegger et al., 2023). They are tasked with ensuring fairness, promoting academic integrity, and preparing students to practice ethically in diverse clinical settings. Nurse Educators focus on academic integrity, fairness, and fostering ethical behaviors among students. They are responsible for creating an environment where students can thrive both academically and professionally, emphasizing the importance of honesty and transparency (Bourne et al., 2021). Their ethical responsibilities also extend to ensuring the curriculum aligns with accreditation standards and promotes equity, ensuring all students, regardless of background, have access to quality education and resources to succeed in their studies and future nursing careers. FNPs focus on patient-centered care ethics, while Nurse Educators emphasize academic and equity-based ethics. Education FNPs undergo rigorous academic and clinical preparation, requiring a master’s or doctoral degree in nursing. Their education focuses heavily on clinical skills, advanced pharmacology, pathophysiology, and patient care across the lifespan. They must also complete at least 500 hours of supervised clinical practice to meet certification standards (Schlunegger et al., 2023). Conversely, Nurse Educators focus on developing competencies in teaching strategies, curriculum design, and assessment methodologies. Nurse Educators need advanced degrees in nursing education or a related field, emphasizing teaching methodologies, curriculum development, and assessment strategies (Bourne et al., 2021). This advanced education equips Nurse Educators with the tools necessary to design effective educational programs that cater to the evolving needs of nursing students. Certification options include the NLN’s Certified Nurse Educator (CNE) credential, which validates the educator’s proficiency in nursing education and enhances their credibility in academic settings. FNPs require extensive clinical training; Nurse Educators focus on pedagogical expertise. Leadership Both FNPs and Nurse Educators exhibit leadership, albeit in different domains. FNPs often serve as clinical leaders by coordinating patient care, collaborating with interdisciplinary teams, and advocating for healthcare policies that improve patient outcomes (Schlunegger et al., 2023). They also take on leadership roles in implementing practice improvements within healthcare settings. Nurse Educators, in contrast, lead by mentoring students, influencing curriculum development, and participating in academic governance. Nurse Educators lead in academic settings by mentoring students, developing innovative teaching methods, and influencing nursing education policies. Their leadership extends beyond classroom teaching, as they guide the next generation of nurses, ensuring they develop not only clinical expertise but also the professional behaviors necessary for success (Bourne et al., 2021). Additionally, they have a voice in shaping educational policies that directly impact the quality and accessibility of nursing education. Both roles exhibit leadership but in distinct settings: clinical for FNPs and academic for Nurse Educators. Public Health FNPs directly engage with public health by delivering primary care services, managing chronic illnesses, and promoting preventive care in underserved populations. They address social determinants of health and advocate for equitable access to care (Schlunegger et al., 2023). Nurse Educators, while not directly involved in patient care, contribute to public health indirectly by training nurses who will enter various specialties. Nurse Educators contribute indirectly to public health by training future nurses to provide competent and culturally sensitive care (Bourne et al., 2021). They teach students to be aware of the diverse needs of patient populations and to adapt their care based on cultural, social, and environmental factors. FNPs directly engage in patient-centered public health, while Nurse Educators train future public health providers. Health Care Administration FNPs collaborate with healthcare administrators to develop and implement care delivery models that improve efficiency and quality of care (Melo et al., 2023). They often play a role in decision-making processes related to patient care standards
NRS-493 Individual Success Plan Example
NRS-493 Individual Success Plan Example Individual Success Plan (ISP) Planning is the key to successful completion of this course and program-related objectives. The Individual Success Plan (ISP) assignment requires early collaboration with the course faculty and your course preceptor. Students must establish a plan for successful completion of The required 50 community direct clinical practice experience hours, 50 leadership direct clinical practice hours, and 25 indirect clinical experience hours. Completion of work associated with program competencies. Work associated with completion of the student’s capstone project change proposal. Students will use the “Individual Success Plan” to develop an individual plan for completing practice hours and course objectives. As a part of this process, students will identify the number of hours set aside to meet course goals. Student expectations and instructions for completing the ISP document are provided in the “NRS-493 Individual Success Plan” resource, located in the Study Materials and in the assignment instructions. Students should apply concepts from prior courses to critically examine and improve their current practice. Students are expected to integrate scholarly readings to develop case reports that demonstrate increasingly complex and proficient practice. After the ISP has been developed by the student and approved by the course faculty, students will initiate a preconference with the faculty and preceptor to review the ISP. NRS-493 Individual Success Plan Example NRS-493 Individual Success Plan REQUIRED PRACTICE HOURS: 100 Direct Clinical Experience (50 hours community/50 hours leadership) – 25 Indirect Clinical Experience Hours. P R A C T I C E E X P E R I E N C E Complete Contact Information Student Information GCU Name: E-mail: Phone Number: Course Faculty Information GCU Name: E-mail: Phone Number: Practicum Preceptor Information Practice Setting Name: E-mail: Phone Number: ISP Instructions Use this form to develop your Individual Success Plan (ISP) for NRS-493, the Professional Capstone and Practicum course. An individual success plan maps out what you, the RN-to-BSN student, needs to accomplish in order to be successful as you work through this course and complete your overall program of study. You will also share this with your preceptor at the beginning and end of this course so that he or she will know what you need to accomplish. In this ISP, you will identify all of the objectives and assignments relating to the 100 direct clinical practice experience hours and the 25 indirect clinical practice hours you need to complete by the end of this course. Use this template to specify the date by which you will complete each assignment. Your plan should include a self-assessment of how you met all applicable GCU RN-to-BSN Domains & Competencies (see Appendix A). General Requirements Use the following information to ensure successful completion of each assignment as it pertains to deliverables due in this course: Use the Individual Success Plan to develop a personal plan for completing your clinical practice experience hours and self-assess how you will meet the GCU RN-to-BSN University Mission Critical Competencies and the Programmatic Domains & Competencies (Appendix A) related to that course. Show all of the major deliverables in the course, the topic/course objectives that apply to each deliverable, and lastly, align each deliverable to the applicable University Mission Critical Competencies and the course-specific Domains and Competencies (see Appendix A). Completing your ISP does not earn clinical practice experience hours, nor does telephone conference time, or time spent with your preceptor. Within the Individual Success Plan, ensure you identify all graded course assignments and indirect clinical assignments listed in the table on the next page. Topic Graded Assignment Indirect Clinical Assignments Topic 1 1. Individual Success Plan 2. Reflection Journal Entry 1. List of potential topics for the change proposal Topic 2 1. Topic Selection Approval Paper 2. Reflection Journal Entry 1. Search the literature for supporting journal articles 2. Summary of topic category; community or leadership Topic 3 1. PICOT Question Paper 2. Reflection Journal Entry 1. List of objectives Topic 4 1. Literature Evaluation Table 2. Reflection Journal Entry 1. List of measurable outcomes Topic 5 1. Reflection Journal Entry 1. Summary of the strategic plan 2. Midterm Evaluation Tool Topic 6 1. Literature Review Table 2. Reflection Journal Entry 1. List of resources Topic 7 1. Reflection Journal Entry 1. Summary of the evaluation plan 2. Remediation-if required Topic 8 1. Benchmark Written Capstone Project Change Proposal 2. Reflection Journal Entry Topic 9 1. Reflection Journal Entry 1. Professional Presentation Topic 10 1. Finalized ISP 2. Scholarly Activity Summary 3. Benchmark-Reflection Journal Summary 1. Summary of presentation 2. Final Clinical Evaluation Tool 3. Practice Clinical Evaluation Tool-Agency 4. Practice Clinical Evaluation Tool-Preceptor Application-based Learning Course Assignments List of Current Course Objectives Assignment Date Due Self-Assessment: Programmatic Domains & Competencies (see Appendix A) Self-Assessment: GCU RN-to-BSN University Mission Critical Competencies (see Appendix A) Date Assignment Completed By typing in his/her signature below, the student agrees to have read, understood, and be accountable for the instructions, assignments, and hours shown above and that all questions have been satisfactorily answered by the faculty. Preceptors will sign upon initial receipt and at the end of the course to confirm that assignments have been complete with your guidance. Student Signature Name: Date: Preceptor Signature [Upon Initiation of Course] Name: Date: Preceptor Signature [Upon Completion of Course] Name: Date: APPENDIX A: GCU RN-to-BSN Domains & Competencies University’s Mission Critical Competencies How does this Individual Success Plan support the GCU Mission? MC1: Effective Communication: Therapeutic communication is central to baccalaureate nursing practice. Students gain an understanding of their ethical responsibility and how verbal and written communication affects others intellectually and emotionally. Students begin to use nursing terminology and taxonomies within the practice of professional and therapeutic communication. Courses require students to write scholarly papers, prepare presentations, develop persuasive arguments, and engage in discussion that is clear, assertive, and respectful. MC2: Critical Thinking: Courses require students to use critical thinking skills by analyzing, synthesizing, and evaluating scientific evidence needed to improve patient outcomes and professional practice. MC3: Christian Worldview: Students will apply a Christian worldview within a global society and examine ethical issues from the framework of a
Review the video Case Study Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar
Review the video Case Study Sherman Tremaine. You will use this case as the basis of this Assignment. Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders Psychotic disorders change one’s sense of reality and cause abnormal thinking and perception. Patients presenting with psychotic disorders may suffer from delusions or hallucinations or may display negative symptoms such as lack of emotion or withdraw from social situations or relationships. Symptoms of medication-induced movement disorders can be mild or lethal and can include, for example, tremors, dystonic reactions, or serotonin syndrome. For this Assignment, you will complete a focused SOAP note for a patient in a case study who has either a schizophrenia spectrum, other psychotic, or medication-induced movement disorder. To Prepare Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating schizophrenia spectrum, other psychotic, and medication-induced movement disorders. Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations. Review the video Case Study Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar. Consider what history would be necessary to collect from this patient. Consider what interview questions you would need to ask this patient. The Assignment Develop a focused SOAP note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template: Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, and list them in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy. Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old). By Day 7 of Week 5 Submit your Focused SOAP Note. Submission and Grading Information To submit your completed Assignment for review and grading, do the following: Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name. Click the Week 5 Assignment Rubric to review the Grading Criteria for the Assignment. Click the Week 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area. Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click Open. If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. Click on the Submit button to complete your submission. Expert Answer and Explanation Schizophrenia soap note Subjective: CC (chief complaint): “I do not bother anyone and people outside my window do not leave alone.” HPI: Sherman Tremaine is a 53-years-old African American male who was asked to come for mental health assessment by his sister. The patient complains that he does not bother anybody but people outside his window to not leave him alone. he says that the people outside his window watch him. He says that he can hear these people and see their shadow. He also says that these people were sent to watch him by the government. He also complains of sleeping problems and people follow him everywhere. Substance Current Use: He smokes cigarette (12 packets of cigarettes weekly) and a bit of marijuana. Medical History: Current Medications: Used Haldol, Thorazine, and Seroquel. Takes metformin currently for diabetes. Allergies: No allergies. Reproductive Hx: No problems with reproductive system. ROS: GENERAL: No fever, weakness, fatigue, chills, or weight loss/gain. HEENT: Eyes: No visual problem. Ears, Nose, Throat: No hearing pain, loss, sneezing, runny nose, congestion, or sore throat. SKIN: No itching or rash. CARDIOVASCULAR: No chest pain, edema, no chest pressure palpitations, or chest discomfort. RESPIRATORY: No cough or shortness of breath. GASTROINTESTINAL: No abdominal pain, nausea, or vomiting. GENITOURINARY: No urination problems. NEUROLOGICAL: No headaches or any other neurological problems. MUSCULOSKELETAL: No joint pain or muscle pain. HEMATOLOGIC: No anemia. LYMPHATICS: No enlarged nodes ENDOCRINOLOGIC: No sweating, heat, or cold problems. Objective: Vital signs: T 35.7, Ht. 5’9, Wt. 159lbs, HR 80, RR 20, BP 130/95 Chest/Lungs: Regular heart rhythm and rate. No murmurs. Heart/Peripheral Vascular: No wheezes. Lungs clear. Diagnostic results: CT-Scan-pending. The test will be used to rule out any physical symptoms that might cause hallucinations and delusions. Positive and Negative Syndrome Scale (PANSS): Baandrup et al. (2022) noted that PANSS is a valid, scalable, and reliable tool for screening for people with schizophrenia. The authors found that the tool is 98% effective. The patient scored 19.9 on positive
Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient
Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient Assignment assessing diagnosing and treating adults with mood disorders In this Assignment you will assess, diagnose, and devise a treatment plan for a patient in a case study who is presenting with a mood disorder. To Prepare Review this week’s Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating mood disorders. Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations. Review the video, Case Study: Petunia Park. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar. Consider what history would be necessary to collect from this patient. Consider what interview questions you would need to ask this patient. Consider patient diagnostics missing from the video: Provider Review outside of interview:Temp 98.2 Pulse 90 Respiration 18 B/P 138/88Laboratory Data Available: Urine drug and alcohol screen negative. CBC within normal ranges, CMP within normal ranges. Lipid panel within normal ranges. Prolactin Level 8; TSH 6.3 (H) The Assignment Develop a Focused SOAP Note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template: Subjective: What details did the patient provide regarding their chief complaint and symptomatology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case. Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy. Reflection notes: What would you do differently with this client if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention that takes into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.). Expert Answer and Explanation Bipolar II Disorder Evaluation Subjective: CC: ” I have a history of taking medications and then stopping them. I don’t think I need them. I really feel like the medication squashes who I am.” HPI: Patient PP is a 25-year-old female patient who has come for a mental health assessment. The patient reports having problems with medication adherence, indicating her lack of need for the medication, stating that it “squashes” who she is. The patient also reports having been hospitalized as a teenager for going four to five days without sleep and hearing things during the period. Since then, she has been hospitalized four times, with the current hospitalization being the past spring. She notes that she has previously been diagnosed with bipolar, anxiety, and depression. She also notes that she tried to use some medications like Zoloft, Seroquel, and another one which she only recalls the name to start with the letter “L”. The patient explains that her prescribed medications seem to present some side effects. The patient also notes that she has once had some suicidal tendencies before. She also reports engaging in sexual intercourse with multiple partners since it elevates her moods. She also reports missing work due to feeling too depressed. Substance Current Use and History: The patient reports smoking at least a packet of cigarettes a day, which she doesn’t intend to stop. She also reports having stopped using alcohol at 19 years. The patient also reports having a bad history of marijuana use which made her stop. She denies using cocaine, stimulant, inhalants, hallucinogens, and sedative medications. She also denies using any pain pills or opiate medications. Family Psychiatric/Substance Use History: The patient reports having a family background with psychiatric and substance use issues. She indicates that her mother was bipolar with suicidal tendencies. She reports that her father was imprisoned for 8 to 10 years due to drug-related problems, and she considers her brother to also have mental issues though not hospitalized. Psychosocial History: The patient was raised by her mother and her older brother. She currently lives with her boyfriend and at times her mother who is infuriated by her sexual habits. Her father is imprisoned and has not heard from him for some time. She has never been married before or had any children. She is currently working in her aunt’s stores albeit irregularly due to her occasional depressed moods. She is currently studying cosmetology and loves to paint and write. Medical History: The patient has Polycystic ovary syndrome (PCOS) and hypothyroidism. Current Medications: the patient is currently under birth control pills for PCOS and an unnamed medication for hypothyroidism. She is also currently using some medication for her mental illness which she only remembers the first letter being “L.” She notes to have previously used Zoloft and Seroquel. Allergies:No allergies reported by the patient Reproductive Hx:The patient reports having her regular menses once a month, with the last one being sometime last month. She is diagnosed and under medication for PCOS. She reports being sexually active and with multiple partners ROS: GENERAL: Varying levels of eating and sleeping depending on the mood. HEENT: negative for head traumas, hearing, sight, smell, neck, or throat problems. SKIN: Negative for dryness, itching, or rashes. CARDIOVASCULAR: Negative for CV issues. RESPIRATORY: Negative for respiratory symptoms. GASTROINTESTINAL: Negative for GI pain, diarrhea, nausea, or
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family
Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family Assignment: Ethical and Legal Implications of Prescribing Drugs What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient? How might different state regulations affect the prescribing of this drug to this patient? These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives every day. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. Additionally, it is important to ensure that the treatment plans and administration/prescribing of drugs is in accordance with the regulations of the state in which you practice. Understanding how these regulations may affect the prescribing of certain drugs in different states may have a significant impact on your patient’s treatment plan. In this Assignment, you explore ethical and legal implications of scenarios and consider how to appropriately respond. To Prepare Review the Resources for this module and consider the legal and ethical implications of prescribing prescription drugs, disclosure, and nondisclosure. Review the scenario assigned by your Instructor for this Assignment. Search specific laws and standards for prescribing prescription drugs and for addressing medication errors for your state or region, and reflect on these as you review the scenario assigned by your Instructor. Consider the ethical and legal implications of the scenario for all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario, including whether you would disclose any medication errors. By Day 7 of Week 1 Write a 2- to 3-page paper that addresses the following: Explain the ethical and legal implications of the scenario you selected on all stakeholders involved, such as the prescriber, pharmacist, patient, and patient’s family. Describe strategies to address disclosure and nondisclosure as identified in the scenario you selected. Be sure to reference laws specific to your state. Explain two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario, including whether you would disclose your error. Be sure to justify your explanation. Explain the process of writing prescriptions, including strategies to minimize medication errors. You will also evaluate and analyze ethical and legal implications and practices related to prescribing drugs. As advanced practice nurses, almost every clinical decision you make will have ethical or legal implications. Your ethical and legal knowledge is fundamental to your ability to resolve the multitude of challenging issues encountered in practice. This week you have an assignment to write a paper – you will explore the ethical and legal implications of the following scenario, and consider how to appropriately respond: Scenario options Scenario 1: As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult. Scenario 2: A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway. Scenario 3: You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident. Scenario 4: During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life. Please refer to the Course Schedule for specific assignments and due dates for this week. Have a wonderful week! Expert Answer and Explanation Ethical Issues in Drug Prescriptions Ethical and Legal Implications of the Scenario The given scenario highlights ethical issues that are involved when prescribing drugs to patients, especially if the patients are either family members or friends. The first ethical consideration falls under the ethical principle of beneficence and non-malfeasance. When prescribing drugs to family members or friends without being objective, it will be difficult for the prescriber to ascertain whether the drug will be of help or detrimental to the patient’s health which may not adhere to the ethical principles of beneficence and non-malfeasance (Ghazal, Saleem & Amlani, 2018). Following due procedure when prescribing drugs for any patient is vital in reducing the chances of prescription errors. The legal implications of the decision to prescribe will arise when harm has been done to the patient, and proper disclosure and prescription procedures were not adhered to. Strategies to Address Disclosure and Nondisclosure According to Ghazal, Saleem, and Amlani (2018), one of the biggest ethical dilemmas encountered by most healthcare practitioners is whether to disclose or not to disclose medical errors. However, according to the statutory bill of rights, regarding patients’ rights, a healthcare provider is requested to disclose any incident of a medical error to the patient. One of the strategies to address disclosure and non-disclosure in my state is by encouraging honesty in practice whereby both the patient and the prescriber ought to understand that errors in healthcare, at times, happen, and finding a solution to the errors committed is what is important. Encouraging the use
You are participating in the customization and implementation of a barcode medication administration system. In a 500-word APA essay, analyze how the process flow will
You are participating in the customization and implementation of a barcode medication administration system. In a 500-word APA essay, analyze how the process flow You are participating in the customization and implementation of a barcode medication administration system. In a 500-word APA essay, analyze how the process flow will change from the current manual process to a barcode process and identify potential problem areas and possible solutions. Additionally, include a workflow diagram (Process Flowchart) from the manual process to the barcode process. The resources to get started on this project are in the Additional Resources for this module. REQUIRED SOURCE McGonigle, D., & Mastrian, K. (2017). Nursing Informatics and the Foundation of Knowledge (4th ed.). Jones & Bartlett Learning. ISBN: 978-1284121247. Assignment Expectations Length: 500 words; answers must thoroughly address the questions in a clear, concise manner. Structure: Include a title page and reference page in APA style. These do not count towards the minimum word count for this assignment. References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims. Format: Save your assignment as a Microsoft Word document (.doc or .docx). Expert Answer and Explanation The Customization and Implementation of a Barcode Medication Administration System Healthcare barcode solutions are vital when it comes to providing safe and quality data. Wilson et al. (2020) note that barcode solutions help track patient medication, modernize the patient admission procedure, track patient admission, and identify the clients when they are in hospital. The barcode system can also reduce medical errors by ensuring that the nurses administer the right medication. The purpose of this assignment is to analyze how my organization’s flow process with the transition from the current manual to a barcode process, and identify the potential problem areas and solutions. Analysis of the Current Process The current process is a manual process where information is processed manually. The majority of the activities are done manually with paper and pen. For instance, when a patient enters the hospital, they will be admitted manually and their names entered into the system using pen and paper (Samadbeik et al., 2017). Also, in the current process, the input is collected in a tray and the person in charge is required to apply their brain to reply to the inquiries. This type of data management can encourage medical errors, especially when the person making data entry is exhausted or tired. For instance, the nurse at the admission point can mistype the name of the patient, hence leading to a medication administration error. Patient privacy can also be breached if data in the “tray” or the file cabinet is accessed by unauthorized individuals. Manual data management is tiring because it involves repeating the same process many times. Manual data processing also takes too much space (McGonigle & Mastrian, 2017). Hospitals applying this process need a huge scape to design file cabinets that can be used to store data. Information in manual data processing can easily be lost or damaged. Making changes to data created by hand is hard and this can create a lot of inconveniences. Diagram of the New Process Discussion of the New Process Healthcare professionals have been developing electronic data management systems to solve the flaws in the manual data processing system. Barcode system that solves most of the flaws experienced in manual data processing. As seen in the diagram above, the barcode system can help a nurse determine whether the medication provided by the pharmacists is indeed prescribed to a specific patient, hence preventing prescription error (McGonigle & Mastrian, 2017). In the diagram, if the medication does not match the patient barcode, then the drugs will be returned and the correct order made. The barcode system can also solve the issue of space because all the data will be stored on the computer hardware. In some situations, data can be stored in a cloudscape. Barcode data processing can also improve the time where the patient can get care. The barcode process can cause various problems in healthcare. One of the issues is that nurses can lose creativity because of the overdependence of electronic systems to perform nursing services (Jimenez, 2017). This problem can be solved by exposing nurses to constant training and education to improve their knowledge and skills. Conclusion Barcode data can improve care by reducing time for accessing care, improving quality and safety of care by reducing medical errors, and improve the safety of patient data. References Jimenez, M. (2017). Effects of Barcode Medication Administration: Literature Review. Proceedings of the Northeast Business & Economics Association. http://web.a.ebscohost.com/ehost/detail/detail?vid=0&sid=94e40e24-1d39-4b2e-b98e-1f88c6267265%40sdc-v-sessmgr01&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#AN=134235278&db=bth McGonigle, D., & Mastrian, K. (2017). Nursing Informatics and the Foundation of Knowledge (4th ed.). Jones & Bartlett Learning. ISBN: 978-1284121247. Samadbeik, M., Shahrokhi, N., Saremian, M., Garavand, A., & Birjandi, M. (2017). Information processing in nursing information systems: An evaluation study from a developing country. Iranian Journal of Nursing and Midwifery Research, 22(5), 377. doi: 10.4103/ijnmr.IJNMR_201_16 Wilson, N., Jehn, M., Kisana, H., Reimer, D., Meister, D., Valentine, K., … & Clarke, H. (2020). Nurses’ perceptions of implant barcode scanning in surgical services. CIN: Computers, Informatics, Nursing, 38(3), 131-138. doi: 10.1097/CIN.0000000000000579 Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level assignment writers.Use Coupon: NEW30 to Get 30% OFF Your First Order FAQs BCMA Barcode Medication Administration In today’s fast-paced healthcare environment, patient safety and efficient care delivery are of utmost importance. One significant advancement that has revolutionized the healthcare industry is the implementation of BCMA, which stands for Barcode Medication Administration. BCMA is a technology-driven process that utilizes barcodes to ensure accurate and secure medication administration. This article delves into the intricacies of BCMA, its benefits, challenges, and its impact on patient care. Introduction Medication errors have long been a concern in healthcare settings. These errors can lead to adverse events, patient harm, and even fatalities. To address this issue, healthcare providers are constantly seeking innovative solutions to enhance patient safety and improve medication administration processes. One such solution that has gained significant attention
Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD.
Katie is an 8 year old Caucasian female who is brought to your office today by her mother Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. Different people may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for patients across the life span. For this Assignment, you consider how you might assess and treat patients presenting with ADHD. 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 with ADHD. Examine Case Study A Young Caucasian Girl with ADHD. 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. CASE STUDY BACKGROUND Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition. The parents give you a copy of a form titled “Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work. Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father. SUBJECTIVE Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.” Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time. MENTAL STATUS EXAM The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation. Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation RESOURCES § Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291. 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