[SOLVED 2023] Select an adult patient that you examined during the last 4 weeks who presented with a disorder other than the disorder present in your Week 3 Case Presentation
Select an adult patient that you examined during the last 4 weeks who presented with a Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations. Please Note: All SOAP notes must be signed, and each page must be initialed by your Preceptor. Note: Electronic signatures are not accepted. When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialled and signed by your Preceptor. You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy. Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record. Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning. Ensure that you have the appropriate lighting and equipment to record the presentation. The Assignment Record yourself presenting the complex case study for your clinical patient. In your presentation: Dress professionally and present yourself in a professional manner. Display your photo ID at the start of the video when you introduce yourself. Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information). Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management. Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide: 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 patient mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms. Plan: What was your plan for psychotherapy? What was 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. Be sure to include at least 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 over? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be. Learning Resources Required Readings (click to expand/reduce) Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer. Chapter 28, “Assessing Neurocognitive Disorders (Dementia and Delirium)” Expert Answer and Explanation Schizoaffective Disorder Subjective: CC (chief complaint): “They want to kill me but people do not believe me. I can even hear them talk.” HPI: JW is a 45-years-old male of Caucasian origin who came to the healthcare facility complaining of auditory and visual hallucinations. The patient has not been prescribed any medications at the moment until screening and testing are done. He complains that he has been seeing people around his home and hearing them planning his death. She has been reporting hallucinations for the past six weeks or so. He was accompanied by his wife to the office. The wife noted that the patient has been showing catatonic behavior for the past weeks. She narrated that the patient sometimes grabs his gun and speaks to himself by saying that he will kill them before they kill him. He has also been spotted echoing words as if he is repeating someone else’s words. The wife argued that when the client is not experiencing hallucinations, he experiences a depressed mood by not eating or wanting to be near anybody. When he is moody, he wants to be isolated and away from the world. The wife noted that the symptoms have pushed him away from his work and family. He was given leave to go and sought himself out. Substance Current Use: The patient has a history of taking drugs. He reports using illicit drugs such as cocaine and meth. However, he denies using alcohol or cigarettes. Medical History: He was diagnosed with hypertension but stopped taking medications noting that “they” want to kill him using medications. Current Medications: He is not on any medications at the moment. Allergies:No allergies. Reproductive Hx:He has not been able to engage in sexual activities in the past seven months. ROS: GENERAL: Wife reports weight loss. The client reports fatigue and weakness on some occasions. Denies fever or chills. HEENT: Eyes: No eye diseases or abnormalities. Ears, Nose, Throat: He denies hearing loss or infections. He denies a runny nose, sore throat, congestion, or sneezing. SKIN: No rash. CARDIOVASCULAR: No chest pressure, edema or palpitations, chest discomfort, or chest pressure. RESPIRATORY: No difficulty breathing, sputum, or cough. GASTROINTESTINAL: No abdominal pain, diarrhea, vomiting, nausea, or anorexia. GENITOURINARY: No odd color, hesitancy, odor, urgency, or burning during urination. NEUROLOGICAL: No tingling or numbness of the legs or fingers. No dizziness, headache, ataxia, paralysis, or bowel problems. MUSCULOSKELETAL: No stiffness or pain in the joints and muscles. No muscle, back pain, joint pain, or stiffness. HEMATOLOGIC: No anemia, clotting abnormalities, or abnormal hematologic status. LYMPHATICS: No enlarged nodes. ENDOCRINOLOGIC: Denies polydipsia, cold, sweating, polyuria, or heat problems. Objective: Physical Exam: Temp 36, BP 137/90, Ht. 6’2, Wt. 145lbs, P 78, RR 18. HEENT: Head: Face is symmetrical. Cranial nerves V and VII around the head are intact. He can move facial muscles at will. The shape of the head is rounded and there are no involuntary muscle movements.Eyes: Cornea, conjunctiva, lacrimal system, anterior chamber, and pupils are intact. The eye is not painful or red. Vision intact. Lacerations positions normal. Ears: Hearing
[ANSWERED 2022] In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so
In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating Reaching out a Solution In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so. This assignment consists of answering each of the questions listed below from the “Political Analysis and Strategies” chapter of your course textbook. Write each question as a new topic area; then follow with a paragraph or two to answer the question. Let us assume that you are a school nurse in a high school. At a recent school athletic event, a spectator suffered a cardiac arrest in the stands. A coach of the home team went into the high school to fetch the automatic emergency defibrillator (AED) only to find out that it was not readily available. In the meantime, an emergency squad arrived and resuscitated the spectator. On Monday morning, you learn of the absence of the AED only to find out that it had been locked in the custodian’s closet. Reflect on the following questions outlined in the “Political Analysis and Strategies” chapter What is the issue? Is it my issue, and can I solve it? Is this the real issue or merely a symptom of a larger one? Does it need an immediate solution, or can it wait? Is it likely to go away by itself? Can I risk ignoring it? What are the possible solutions? Are there risks to these solutions? What steps would you need to take in order to solve the issue? Does anyone else at the school need to be involved in the solution? Where is the power leverage in the school to reach the preferred solution? Reaching a solution requires the use of power vested in the nurse. Review Box 9-1 (Sources of Power) and determine which type(s) of power the school nurse has in this situation. State your reasons for your answer. On a separate reference page, cite all sources using APA format. Please note that the title and reference pages should not be included in the total page count of your paper. Expert Answer and Explanation Reaching out a Solution What is the issue? Nurses have to go through many issues that need their attention in their line of work. The problems can include but not limited to, policy-based, medical equipment based, and financial-based problems. In this scenario, the high school nurse is experiencing the issue of poor storage of medical emergency equipment. Is it my issue, and can I solve it? Poor storage of medical equipment is a nursing issue, and they should be part of the team that provides solutions. According to Lavin et al. (2015), nurses should have medical equipment readily available so that they can effectively discharge their duties. However, if the tool is out of reach, the nurses will not save lives are required of them. Is this the real issue or merely a symptom of a larger one? The inadequate storage of medical equipment is not the real issue in this situation. The problem is part of a more significant issue, which is the lack of training staff on how to handle medical equipment. If the workers are not well trained, they will not have proper knowledge of how to handle medical tools (Freeland et al., 2016). Institution managers should also be trained on how to manage health tools. Does it need an immediate solution, or can it wait? A patient might die if not given immediate first aid treatment. However, Bojarski et al. (2016) report that nurses cannot provide proper first aid when the equipment to do so is lacking. Thus, this issue should be solved immediately to avoid significant situations in the future. Is it likely to go away by itself? Poor handling of medical equipment is part of the lack of training. Thus, it cannot go by itself. On that note, nurses should be involved in solving it. Can I risk ignoring it? A nurse or any other stakeholder cannot ignore the issue of improper handling of medical equipment. Freeland et al. (2016) argue that if emergency medical tools are missing, many people can die. Therefore, the nurse should step up and handle the issue with all the resources at his or her disposal. What are the possible solutions? Are there risks to these solutions? The first possible solution to mishandling medical equipment is training staff on how to handle the tools. The custodian could have been educated to give a nurse or any person in charge of student health who was on the shift to control the automatic emergency defibrillator (AED). The second solution is employing trained personnel to handle medical equipment. The custodian of the AED was not medically trained to handle the therapeutic tool. The final solution is firing the custodian of AED for not being present during such a huge event where a person might develop a health issue. What steps would you need to take in order to solve the issue? The first step a nurse can take in solving the issue is researching, asking why the AED was not available when needed. Second is writing a report on the findings and presenting it to the revenant authorities within the school. Lastly, following up to check if his or her recommendations are being implemented. Does anyone else at the school need to be involved in the solution? Many people in the school need to be involved in solving the issue. The management should be included, and their thoughts collected. Also, the nurse should meet the finance and HR departments and discuss with them why they need to fire the current custodian and hire another person who is more qualified to handle medical equipment such as AED. Where is the power leverage in the school to reach the preferred solution? The school nurse can
[ANSWERED 2023] An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors
An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity. Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact. An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans. In this Assignment you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process 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 for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. The Assignment (1- to 2-page case study analysis) Develop a 1- to 2-page case study analysis in which you: Explain why you think the patient presented the symptoms described. Identify the genes that may be associated with the development of the disease. Explain the process of immunosuppression and the effect it has on body systems. Scenario 3: A 34-year-old Hispanic-American male with end-stage renal disease received a kidney transplant from a cadaver donor, as no one in his family was a good match. His post-operative course was uneventful, and he was discharged with the antirejection drugs Tacrolimus (Prograf), Cyclosporine (Neoral), and Imuran (Azathioprine). He did well for 3 months and had returned to his job as a policeman. Six months after his transplant, he began to gain weight, had decreased urine output, was very fatigued, and began to run temperatures up to 101?F. He was evaluated by his nephrologist, who diagnosed acute kidney transplant rejection. Excellent Good Develop a 1- to 2-page case study analysis, examining the patient symptoms presented in the case study. Be sure to address the following: Explain why you think the patient presented the symptoms described. Points Range: 28 (28%) – 30 (30%) The response accurately and thoroughly describes the patient symptoms. The response includes accurate, clear, and detailed reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. Points Range: 25 (25%) – 27 (27%) The response describes the patient symptoms. The response includes accurate reasons, with explanation for the symptoms supported by evidence and/or research, as appropriate, to support the explanation. Identify the genes that may be associated with the development of the disease. Points Range: 23 (23%) – 25 (25%) The response includes an accurate, complete, detailed, and specific analysis of the genes that may be associated with the development of the disease. Points Range: 20 (20%) – 22 (22%) The response includes an accurate analysis of the genes that may be associated with the development of the disease. Explain the process of immunosuppression and the effect it has on body systems. Points Range: 28 (28%) – 30 (30%) The response includes an accurate, complete, detailed, and specific explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition. Points Range: 25 (25%) – 27 (27%) The response includes an accurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition. NURS 6501 Module 1 assignment Case Study Analysis Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. Points Range: 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. Points Range: 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation Points Range: 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors. Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. Points Range: 5 (5%) – 5 (5%) Uses correct APA format with no errors. Points Range: 4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors. Fair Poor Points Range: 23 (23%) – 24 (24%) The response describes the patient symptoms in a manner that is vague or inaccurate. NURS 6501 Module 1 assignment Case Study Analysis The response includes reasons for the symptoms, with explanations that are vague or based on inappropriate evidence/research. Points Range: 0 (0%) – 22 (22%) The response describes the patient symptoms in a manner that is vague and inaccurate, or the description is missing. The response does not include reasons for the symptoms, or the explanations are vague or based on inappropriate or no evidence/research. Points Range: 18 (18%) – 19 (19%) The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease. Points Range: 0 (0%) – 17 (17%) The response includes a vague or inaccurate analysis of the genes that may be associated with the development of the disease is missing. Points Range: 23 (23%) – 24 (24%) The response includes a vague or inaccurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition. Points Range: 0 (0%) – 17 (17%) The response includes a vague or inaccurate explanation of the pathophysiological processes that may be associated with the development of the diagnosed condition, or the analysis is missing. Points Range: 3 (3%) –
[ANSWERED 2023] You will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach
You will identify an issue or opportunity for change within your healthcare organization You will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach. To Prepare: Reflect on the four peer-reviewed articles you critically appraised see below Reflect on your current healthcare organization and think about potential opportunities for evidence-based change Create an 8- to 9-slide PowerPoint presentation in which you do the following: Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.) Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general. Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered. Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation. Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change. Be sure to provide APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking. Add a lessons learned section that includes the following: A summary of the critical appraisal of the peer-reviewed articles you previously submitted An explanation about what you learned from completing the evaluation table (1 slide) An explanation about what you learned from completing the levels of evidence table (1 slide) An explanation about what you learned from completing the outcomes synthesis table (1 slide) Expert Answer and Explanation I am currently working in a nursing and rehabilitation center, which mainly deals with patients with diverse needs. Our main task is to ensure that patients receive safe and quality care that will assist them regain independence and functionality like they were before their illness. The current organizational culture is unsupportive of the change with poor leadership, lack of accountability, and laxity by staff being some of the factors contributing to this culture. Currently the organization is having high number of cases of falls and other safety issues, which has drastically affected the facility’s rating, patient outcomes and to some extent even work satisfaction of the employees working within the facility. This problem can be attributed to lack of urgency shown by the staff when answering call-lights and alarms Scope: The issue mainly affects patients under admission, where at times they require help from the nurses but laxity of the nurses to respond to call lights and alarms, delay the help they require, which in most instances lead to adverse outcomes, like patient falls. The issue also mainly revolves around nursing unit, who are supposed to be at the forefront in responding to alarms and call lights. The change needed should therefore target at improving the response of nurses in tending to the sensory alarms and call lights to improve patient outcomes. The stakeholders involved in the change include the following; The organization leadership – The organization leadership should show interest in the change given the impact of the issue on the performance of the organization. In support of the change, they should allocate the necessary resources needed to implement the change, and also be at the forefront in leading the change. Another stakeholder are the nurses, nurse practitioners and physicians who are in charge of delivering care to patients. They are supposed to actively participate in resolving the issue with the aim of improving patient outcomes. Technicians will also be among the stakeholders involved. Their role will be to ensure that the monitoring systems are properly functional to avoid false positives and false negatives which end up causing alarm fatigue and laxity by nurses to respond (Baker & Rodger, 2020). Quality assurance team should also be part of the initiative, with their role being to provide oversight on whether the change is meeting the intended quality- related outcomes The patients are also key stakeholders involved given that impact of the change in their outcomes. Some of the risks attached to implementing the proposed change include change resistance from nurses which will affect the success of the project. The other risk is increased nurse workload from what is currently is due to the requirement to increase their level of responses to sensory alarms and call lights. As it currently is, the nurses and other care providers have a lax attitude to respond to call lights and sensory alarms. One of the main causes of laxity to respond to sensory alarms and call lights by nurses can be attributed to alarm fatigue (Baker & Rodger, 2020). Studies have indicated that sensory alarms fatigue is caused by faulty monitoring systems, inadequate training on how to respond to the sensory alarms and organizational factors including poor culture and leadership (Bach et al. , 2018). Therefore the evidence based change that is suggested is to train nurses and introduce an online monitoring system that will reduce the number of false alarms, in turn improving response times and reducing alarm fatigue. The suggested intervention is linked with various studies as being effective including studies by Bach et al. (2018) and Ruskin and Hueske-Kraus (2015). To facilitate knowledge transfer for the change the following plan will be used. The first step is knowledge creation which will entail collection of evidence on good practices which can assist to improve nurse response times to sensory alarms. Knowledge will be created by collecting evidence on the current practice and its impact on patient outcomes and comparing it with best practices, through which the change initiative will be created. The second step is to disseminate the knowledge to various stakeholders using various platforms including through meetings, print media and group discussion. The third stage is organizational adoption which will involve training on the best
[ANSWERED 2023] Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing
Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing Topic 3 DQ 1 Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing. Based on some real-life experiences, explain whether you agree or disagree with this research. Expert Answer and Explanation Nursing Education and Positive Patient Outcome According to the American Association of Colleges of Nursing (AACN), an organization that has since championed nursing education across the US, education has improved positive patient outcomes by impacting nurses with skills and knowledge to provide quality and safe care. The organization notes that healthcare professionals with Bachelor of Science in Nursing (BSN) degrees can provide safe care as stipulated by federal, state, or local level governments. BSN nurses are prized for their leadership, critical thinking, health promotion, and case management abilities. These skills are critical in the provision of quality care. Melnyk et al. (2018) found that nursing education level is linked with positive patient outcomes. The authors found that nurse education was related to lower failure-to-rescue rate and lower mortality in their study. The researchers recommended that nurses should increase their education for them to provide quality care. I agree, will the research. In real-life experience, lowly skilled healthcare professionals often refer patients to highly skilled caregivers to help clients. Another study done by Zhang and Cui (2018) found that highly educate nurses can help reduce the rate of falls, hospital-acquired infections, and high mortality. For instance, high educated and qualified healthcare professionals have the skills and knowledge they can use to perform proper surgical procedures, hence reducing the rate of surgical site infections. As a result, the patient being operated by qualified and highly educated healthcare professionals will have high patient satisfaction and positive outcomes, such as high bed turnover. Leadership skills are also fundamental when it comes to positive patient outcomes. Nursing leaders can make effective decisions and design policies that can improve patient outcomes. References Melnyk, B. M., Gallagher‐Ford, L., Zellefrow, C., Tucker, S., Thomas, B., Sinnott, L. T., & Tan, A. (2018). The first US study on nurses’ evidence‐based practice competencies indicates major deficits that threaten healthcare quality, safety, and patient outcomes. Worldviews on Evidence‐Based Nursing, 15(1), 16-25. https://doi.org/10.1111/wvn.12269 Zhang, J., & Cui, Q. (2018). Collaborative learning in higher nursing education: A systematic review. Journal of Professional Nursing, 34(5), 378-388. https://doi.org/10.1016/j.profnurs.2018.07.007 Alternative Expert Answer and Explanation The correlation between nursing education and positive patient outcomes According to research, nursing education results in positive patient outcomes. This is because nurses, when they decide to increase their knowledge, they become aware of new and better methods that can be used in handling patients. By so doing, the quality of services that they will be offering their patients improves (Cotterill-Walker, 2022). During the current time, diseases have evolved, and the old practices in offering care that had been effective for decades most of them are turning out to be obsolete and they cannot be relied on. When a nurse fails to educate themselves on these changes, they will continue to offer substandard services, and their patients will continue to suffer as a result. Due to this fact, it is recommended for nurses to always update themselves on the new information that will help better the services that they offer. Current research that links patient safety outcomes to advanced degrees in nursing Research conducted by Doctor Aiken in Medical Care proved that a 10 percent increase in the proportion of BSN-prepared nurses led to a reduction in the risk of death by 5 percent (Dubois, 2019). This research was conducted with the intensions of figuring out whether nursing education had a positive effect on patient outcomes. The findings were true that education helped nurses in offering better and improved services. My opinion on the research I agree with the outcomes of the research since the more a nurse was informed, the more likely they were to offer better services to their patients, unlike those who failed to increase their knowledge in their field of expertise. References Cotterill-Walker, S. M. (2022). Where is the evidence that master’s level nursing education makes a difference to patient care? A literature review. Nurse Education Today, 32(1), 57-64. Dubois, C. A., D’amour, D., Tchouaket, E., Clarke, S., Rivard, M., & Blais, R. (2019). Associations of patient safety outcomes with models of nursing care organization at unit level in hospitals. International Journal for Quality in Health Care, 25(2), 110-117. Topic 3 DQ 2 Discuss the difference between a DNP and a PhD in nursing. Discuss which of these you would choose to pursue if you decide to continue your education to the doctoral level and explain why. Expert Answer and Explanation DNP and a PhD Doctorate of Nursing Practice (DNP) degree is an educational program aimed to produce nurses in advanced clinical practice. Nurses who have undergone the DNP program have the highest level of nursing knowledge and expertise. They can work either in leadership roles or in clinical settings (Fullerton, Schuiling, & Sipe, 2019). On the other hand, a Doctor of Philosophy in Nursing (PhD) degree is an educational program that focuses on improving the knowledge of nurses in science and research. This degree is meant to prepare masters degree nurses in nursing research by proving them will skill in research and knowledge in science. The fundamental difference between DNP and PhD in nursing is that DNP focuses on improving nurses’ knowledge in clinical practice while PhD aims at improving advanced nurses’ skills in healthcare research and knowledge in healthcare science (Hartjes et al. 2019). Another difference is that nurses with PhD certificates can teach research in nursing schools, but DNP nurses cannot teach the same subject. If I chose to pursue advanced nursing education, I would go for DNP. My dream was to become a healthcare professional so that I can provide care to my family and
[ANSWERED 2023] Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been
Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been For Week 2, you will examine how patient factors may influence pharmacokinetic and pharmacodynamic processes of pharmacotherapeutics used in the treatment of cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. When writing your Week 2 Assignment, consider the following scenario: Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Atenolol 12.5 mg daily Doxazosin 8 mg daily Hydralazine 10 mg qid Sertraline 25 mg daily Simvastatin 80 mg daily Evidence-based clinical practice guidelines are fundamental to clinical practice, as they assist providers with clinical decision making. I have attached some applicable guidelines below for your reference. I would strongly suggest you review the applicable guidelines prior to making treatment recommendations for the case study. 2014 Evidence-Based Guideline for Mgmt of HTN in Adults_JNC8.pdf 2017 ACC-AHA Guideline Mgmt HTN in Adults.pdf 2018 AHA-ACC Guideline on Mgmt Blood Cholesterol.pdf 2017 ACC-AHA-HFSA Guideline Mgmt HF.pdf ASH 2018 Guidelines Mgmt of VTE_Optimal Anticoag.pdf 2019 AHA-ACC-HRS Guideline for Mgmt A Fib.pdf 2017 AHA-ACC Guideline Mgmt Valvular Heart Disease.pdf Week 2: Cardiovascular System Alterations of the cardiovascular system can cause serious adverse events and may lead to death when not treated in a timely and safe manner. Unfortunately, many patients with cardiovascular disorders are unaware until complications appear. In clinical settings, patients often present with symptoms of several cardiovascular disorders, making it essential for you, as the advanced practice nurse, to be able to recognize these symptoms and recommend appropriate drug treatment options. This week, you examine the impact of patient factors that may lead to changes in pharmacokinetic and pharmacodynamic processes on patient drug therapy for cardiovascular disorders. You also explore ways to improve drug therapy plans for cardiovascular disorders based on patient factors and overall health needs. Learning Objectives Students will: Analyze the influence of patient factors on pharmacokinetic and pharmacodynamic processes Analyze the impact of changes in pharmacokinetic and pharmacodynamic processes on patient drug therapies Evaluate drug therapy plans for cardiovascular disorders Assignment: Pharmacotherapy for Cardiovascular Disorders …heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease… —Murphy et al., 2018 Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today. As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors. Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm To Prepare Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece. Review the case study assigned by your Instructor for this Assignment. Select one the following factors: genetics, gender, ethnicity, age, or behavior factors. Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes. Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy. Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient. By Day 7 of Week 2 Write a 2- to 3-page paper that addresses the following: Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned. Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples. Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements. Grading Rubric Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.–Levels of Achievement: Excellent 23 (23%) – 25 (25%) The response accurately and completely explains in detail how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Good 20 (20%) – 22 (22%) The response provides a basic explanation of how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Fair 18 (18%) – 19 (19%) The response inaccurately or vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient. Poor 0 (0%) – 17 (17%) The response inaccurately and vaguely explains how the factor selected might influence the pharmacokinetic and pharmacodynamic processes in the patient, or is missing. Feedback: Describe how changes in the processes might impact the patient‘s recommended drug therapy. Be specific and provide examples.–Levels of Achievement: Excellent 27 (27%) – 30 (30%) The response accurately and completely describes in detail how changes in the processes might impact the patient‘s recommended drug therapy. Accurate, complete, and aligned examples are provided to support the response. Good 24 (24%) – 26 (26%) The response accurately describes how changes in the processes might impact the patient‘s recommended drug therapy. Accurate examples may be provided to support the response. Fair 21 (21%) – 23 (23%) The response inaccurately or vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy. Inaccurate or vague examples are provided to support the response. Poor 0 (0%) – 20 (20%) The response inaccurately and vaguely describes how changes in the processes might impact the patient‘s recommended drug therapy, or is missing. Inaccurate and vague examples may be provided to support the response, or is missing. Feedback: Explain how you might improve the patient‘s drug therapy plan,
[ANSWERED 2022] A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams. In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting. To prepare: Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case. Review the following case study: Case 1: Back Pain A 42-year-old male reports pain in his lower back for the past month. The pain sometimes radiates to his left leg. In determining the cause of the back pain, based on your knowledge of anatomy, what nerve roots might be involved? How would you test for each of them? What other symptoms need to be explored? What are your differential diagnoses for acute low back pain? Consider the possible origins using the Agency for Healthcare Research and Quality (AHRQ) guidelines as a framework. What physical examination will you perform? What special maneuvers will you perform? Case 2: Ankle Pain A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing? Case 3: Knee Pain A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform? With regard to the case study you were assigned: Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study you were assigned. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. Rubric Detail Excellent Good Fair Poor Main Posting 45 (45%) – 50 (50%) “Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. Supported by at least three current, credible sources. Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 40 (40%) – 44 (44%) “Responds to the Discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module. At least 75% of post has exceptional depth and breadth. Supported by at least three credible sources. Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style. 35 (35%) – 39 (39%) “Responds to some of the Discussion question(s). One or two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with two credible sources. Written somewhat concisely; may contain more than two spelling or grammatical errors. Contains some APA formatting errors. 0 (0%) – 34 (34%) “Does not respond to the Discussion question(s) adequately. Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible sources. Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style. Main Post: Timeliness 10 (10%) – 10 (10%) Posts main post by Day 3. 0 (0%) – 0 (0%) N/A 0 (0%) – 0 (0%) N/A 0 (0%) – 0 (0%) Does not post main post by Day 3. First Response 17 (17%) – 18 (18%) “Response exhibits synthesis, critical thinking, and application to practice settings. Provides clear, concise opinions and ideas that are supported by at least two scholarly sources. Demonstrates synthesis and understanding of Learning Objectives. Communication is professional and respectful to colleagues. Responses to faculty questions are fully answered, if posed. Response is effectively written in standard, edited English. 15 (15%) – 16 (16%) “Response exhibits critical thinking and application to practice settings. Communication is professional and respectful to colleagues. Responses to faculty questions are answered, if
[ANSWERED 2023] Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family
Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family. DQ1: Expert Answer and Explanation Cognitive Issue One common cognitive issue within the community setting is dementia. Dementia is characterized by the gradual deterioration of the brain with regards to thinking, memory, behavior, and the overall ability to undertake daily activities. Various elements constitute the risk factors of dementia among the general population. One of the main risk factors for dementia is the advancement in the age of an individual (Booker et al., 2016). Aging causes increased cell death within the brain leading to severe impacts of dementia on the patient. Other factors include genetics based on family history, smoking or alcohol use, cholesterol, and atherosclerosis (the buildup of plaque). These factors can either be preventable through lifestyle changes while others cannot be prevented such as aging or genetic affiliation. Severe dementia can lead to Alzheimer’s disease which is irreversible and can have significant symptoms to the patent. There are various ways in which a nurse can conduct disease prevention and health promotion for the patient and family. To begin with, sensitizing the patient and family on the non-preventable risks such as age and genetics are important in creating acceptance and support caring for the patients (Smith, 2016). Concerning the preventable risks, it is essential for nurses to provides patient awareness of the measures that can be taken to avoid the risks of getting the disease. for instance, sensitizing on lifestyle changes, improved exercises for the overweight or obese, and avoidance of smoking and use of alcohol can help promote health among the population. To address disease prevention, the nurses and healthcare practitioners can conduct community care where early diagnosis is conducted to identify the illness in its early stages and treat it before it gets severe and irreversible. References Booker, A., Jacob, L. E., Rapp, M., Bohlken, J., & Kostev, K. (2016). Risk Factors For Dementia Diagnosis In German Primary Care Practices. International Psychogeriatrics, 28(7), 1059-1065. Doi: https://doi.org/10.1017/S1041610215002082 Smith, G. E. (2016). Healthy cognitive aging and dementia prevention. American Psychologist, 71(4), 268. Doi: https://doi.org/10.1037/a0040250 DQ 1: Alternative Answer Health Promotion for Dementia Cognitive issues come in different types, and each type can have unique symptoms. One of these issues is the dementia, and it is characterized by various symptoms. A personal with this cognitive condition will experience the loss of their memory, and they may experience challenges performing various familiar tasks including coming up with solutions to problems. Manifestation of the symptoms of this condition additionally include the inability of one to understand visual information, and they may not speak or write in a coherent manner (Rakesh et al., 2017). Besides, people with this cognitive disorder misplace things.Various factors can alter one’s cognitive functioning, and ultimately cause this cognitive disorder. Certain classes of medications, for instance, can induce this disorder, and the risk may be high if one has to take medications to treat a lifetime illness such as Human Immunodeficiency Viral (HIV) infections. A class of pharmacological drugs that can increase one’s exposure to this condition is the anticholinergic medication. Still, the HIV infection, can cause this disorder if this infection progresses to an advanced stage (Carmeli & Imam, 2014). Encephalopathy describes a condition in which this infection adversely damages the brain. However, physical injuries as well as a number of diseases including the Parkinson’s can cause one to develop this disease. The health promotion for dementia patients should focus on the prevention of the cognitive decline for at risk populations. It is important to recommend to the patient a diet that can improve their memory, and fish as well as fruits are known to be effective in terms of improving one’s memory. Another prevention is conducting medical examinations to identify the presence of certain medical conditions which can increase one’s risk of developing the disorder. It is also imperative to promote awareness to help at risk populations be aware of how they can prevent injuries (Budson & Solomon, 2015). Involving the family in planning for the treatment can be helpful in the sense that it encourages adherence to clinical instructions. References Budson, A. E., & Solomon, P. R. (2015). Memory Loss, Alzheimer’s Disease, and Dementia E-Book: A Practical Guide for Clinicians. Amsterdam: Elsevier. Carmeli, E., & Imam, B. (2014). Health promotion and disease prevention strategies in older adults with intellectual and developmental disabilities. Frontiers in public health, 2, 31. doi:10.3389/fpubh.2014.00031. Rakesh, G., Szabo, S. T., Alexopoulos, G. S., & Zannas, A. S. (2017). Strategies for dementia prevention: latest evidence and implications. Therapeutic advances in chronic disease, 8(8-9), 121–136. doi:10.1177/2040622317712442. Discuss characteristic findings for a stroke and how it affects the lives of patients and their families. Discuss the nurse’s role in supporting the patient’s psychological and emotional needs. Provide an example. DQ 2: Expert Answer and Explanation Impact of Stroke The occurrence of a stroke happens when the overall supply of blood to the parts of the brain is reduced or interrupted which prevents the brain tissues from being supplied with sufficient nutrients and oxygen. Without brain cell oxygenation, they begin to die after a few minutes leading to a stroke and potentially cause permanent brain damage (He et al., 2018). There are two main causes of stroke including hemorrhagic stroke (evidenced by leaking or bursting artery due to head injuries or trauma from accidents) or ischemic stroke (evidenced by a blocked artery either by a clot or due to fat deposits inside the arteries). There are characteristics and symptoms associate with stroke with the prime including difficulty in speaking, paralysis in one side of the body, headache, and difficulties in walking. These symptoms vary in different stroke patients depending on the affected part of the brain (He et al., 2018). Risk factors associated with stroke can be divided into either lifestyle risk factors or medical risk factors. Lifestyle factors include obesity, physical inactivity, and use of alcohol or
[ANSWERED 2023] Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.).
Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Research a health care organization or network that spans several states with in the United States (United Healthcare, Vanguard, Banner Health, etc.). Assess the readiness of the health care organization or network you chose in regard to meeting the health care needs of citizens in the next decade. Prepare a 1,000-1,250 word paper that presents your assessment and proposes a strategic plan to ensure readiness. Include the following: Describe the health care organization or network. Describe the organization\’s overall readiness based on your findings. Prepare a strategic plan to address issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction. Identify any current or potential issues within the organizational culture and discuss how these issues may affect aspects of the strategic plan. Propose a theory or model that could be used to support implementation of the strategic plan for this organization. Explain why this theory or model is best. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 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 required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Expert Answer and Explanation Health Organization Evaluation The performance of the health care sector is dependent on multiple factors. These factors can be evaluated to ensure that there are seamless operations and all aspects of care are conducted without discrepancies. The complexity of operations within the healthcare sector increases with an increase in the size and magnitude of the facility (Grube et al., 2018). An organization that spans a wide location or has multiple outlets in different regions might have challenges that should be addressed on time. In this regard, these types of organizations have to demonstrate increase readiness and preparedness when attending to patients of different issues to ensure the proper attainment of organizational goals. Preparedness is an important aspect of any organization and it can be an essential attribute to aid with strategic planning and addressing new events. The United Health Group One of the healthcare organizations that span multiple states is the United Health Group. The headquarters of the organization is based in Minnetonka, Minnesota from where the main operations are supervised and executed. The organization has been listed in the Fortune 100 as one of the leading healthcare institutions in the US (Enos, 2020). The organization is focused on improving the overall value of health care consumers through the creation of measures to reduce the cost of healthcare. Similarly, the company is also addressing the need to improving the quality of care provided to the patients by advocating for health and wellness. The advocacy is essential towards the streamlining of healthcare services and ensuring all the health care experiences for the customer are met with high satisfaction. On average, the United Health Group provides comprehensive services to more than 26.4 million Americans both in healthcare delivery and other medical plans. Besides offering medical services, the United Health Group acts as a medical insurance entity offering affordable pans to the patients. These plans are categorized into different segments including national employers mid-sized employers, public sector employers, individuals, and businesses (Jelalian et al., 2020). These plans are crucial for the patient as they can be used to cushion the burden that would have otherwise been felt from the out-of-pocket payments. Other services offered by the organization are the Medicare and retirement plans offered to the elderly individuals within the community. the program serves approximately 12.5 million senior citizens and other individuals that are eligible for the Medicare and retirement program (Enos, 2020). The other service that the facility provides is the community and state where services are offed contingent to the state in which the facility is located. These programs are directed to the community members who can benefit from the services provided by the organization. Readiness of the United Health Group Based on these findings, the United Health Group has been able to implement multiple readiness plans that have proven to be effective (Li et al., 2020). Over the years the United Health Group has put in place measures to ensure that there is convenience for patients when seeking medical care of the financing for acquired medication. The current movement is the shift from treatment and healing to the use of health promotion and prevention which is likely to help reduce cost and improve the quality of life (Grube et al., 2018). In compliance with the new model of care, the United Health Group partnered with the YMCA to create the JOIN for ME movement. the movement seeks to sensitize overweight and obesity among children and advocate for healthy body weight and the need to watch one’s diet (Jelalian et al., 2020). According to the program, the children were taught the best practices to engage in in order to reduce the chances of becoming overweight. Some of the key issues addressed include the reduction of time spent watching TV and engaging in physical activities such as walking and playing outside with other children for muscle activity. Another preparedness activity that the organization facilitated is the UnitedHealthcare Hearing which helps the patients to have affordable medical care within the plans it provides. The United Health Group doubles as both a health care facility as well as an insurance company to manage and administer patient finances and insurance covers (UnitedHealth Group, 2019). The company came up with a system called My Healthcare Cost Estimator which provides the clients with a number of comparative expenses analyses obtained from different health care providers. The information helps the patient to choose the facility to use based on their finances and quality of care (UnitedHealth Group, 2019). Strategic Plan for the Organization Network Growth The organization
[ANSWERED 2023] 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
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