Monthly Archives: March 2022

The Assignment (1–2 pages)

• Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
• Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
• Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

Reference

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

WK3 PRESCRIBING MEDICATIONS

Learning Resources

Required Readings (click to expand/reduce)

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

· Chapter 14, “Psychosocial Interventions”

· Chapter 15, “Psychotherapeutic Interventions”

· Chapter 16, “Psychopharmacological Interventions”

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

· Chapter 43, “Pharmacological, Medically-Led and Related Treatments”

Walden University. (n.d.). Developing SMART goals. https://academicguides.waldenu.edu/ld.php?content_id=51901492

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

· Chapter 5, “Psychopharmacology”

Required Media (click to expand/reduce)

CriticalThinkRx. (2019, June 9). Module 5: Specific drug classes: Focus on adverse effects [Video]. YouTube. https://youtu.be/Gbq6RnOsGKQ

CriticalThinkRx. (2019, June 9). Module 2: Use of psychotropics with youth_prevalence and concerns [Video]. YouTube. https://youtu.be/NRef-g4Ding

Assignment 1: Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Photo Credit: Getty Images/Ingram Publishing

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know.  https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

To Prepare

· Your Instructor will assign a specific disorder for you to research for this Assignment.

· Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

The Assignment (1–2 pages)

· Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.

· Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?

· Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.

· Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

In 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.–

Excellent 23 (23%) – 25 (25%)

Good 20 (20%) – 22 (22%)

Fair 18 (18%) – 19 (19%)

Poor 0 (0%) – 17 (17%)

• Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?–

Excellent 23 (23%) – 25 (25%)

Good 20 (20%) – 22 (22%)

Fair 18 (18%) – 19 (19%)

Poor 0 (0%) – 17 (17%)

• Explain whether clinical practice guidelines exist for this disorder and, if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.–

Excellent 23 (23%) – 25 (25%)

Good 20 (20%) – 22 (22%)

Fair 18 (18%) – 19 (19%)

Poor 0 (0%) – 17 (17%)

• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.–

Excellent 9 (9%) – 10 (10%)

Good 8 (8%) – 8 (8%)

Fair 7 (7%) – 7 (7%)

Poor 0 (0%) – 6 (6%)

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.–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3.5 (3.5%) – 3.5 (3.5%)

Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3.5 (3.5%) – 3.5 (3.5%)

Poor 0 (0%) – 3 (3%)

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/narrative in-text citations, and reference list.–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3.5 (3.5%) – 3.5 (3.5%)

Poor 0 (0%) – 3 (3%)

USE 5 REFERENCES FOR THIS ASSIGN

TOPIC – ADHD

Week 11 Discussion: Anemias

M.W. is a 69-year-old African American man and was referred to clinic for evaluation of increasing shortness of breath.

Past medical history 

Chronic renal insufficiency

Hypertension

Congestive heart failure

Diabetes mellitus type 2, poor control

Deep vein thrombosis

Alcohol abuse

Chronic obstructive pulmonary disease with respiratory failure

Family history

Noncontributory

Physical examination

Height 69 inches, weight 205 lb

Blood pressure: 138/88

Pulse 86 beats/min, regular

Lungs clear, neck supple negative for jugular venous distention

Lower extremities +1 edema

Laboratory findings

Scr = 2.8 K+ = 5.1

BUN = 56

Na+ = 147

WBC = 5.0

Hb = 8.2

Hct = 24.6

Serum ferritin 189 mg/dL

Social history

Tobacco: 52 pack-years

Alcohol: distant past

Diagnosis: Anemia Of Ckd: Answer the following questions in full sentences using APA citations. 

1. List specific goals of treatment for M.W.

2. What drug therapy would you prescribed? Why?

3. What are the parameters for monitoring success of therapy?

4. Discuss specific patient education based on the prescribed therapy.

5. List one or two adverse reactions for the selected agent that would cause you to change therapy.

6. What over-the-counter and/or alternative medications would be appropriate for M.W.?

7. What dietary and lifestyle changes would you recommended for M.W.?

Provide 3 Postings (Initial Posting and Respond to 2 Peer Based on APA Guidelines). Work must be supported by peer-reviewed article published within 5 years.

Janny Mendoza

February 13, 2022

Topic

NURS 420

Topic:

Nurse managers must work with staff to foster respect of different lifestyles. As a future manager, how can you provide culture-centered leadership to influence your team members and care for a culturally diverse patient population? Please incorporate concepts of cultural humility, sensitivity, or competence and one cultural theory into your response.  

Citations:

Dauvrin, M., & Lorant, V. (2015). Leadership and cultural competence of healthcare professionals: a social network analysis. Nursing research, 64(3), 200–210. https://doi.org/10.1097/NNR.0000000000000092

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare (Basel, Switzerland), 5(4), 73. https://doi.org/10.3390/healthcare5040073

Yeager, K. A., & Bauer-Wu, S. (2013). Cultural humility: essential foundation for clinical researchers. Applied nursing research : ANR, 26(4), 251–256. https://doi.org/10.1016/j.apnr.2013.06.008

Stubbe D. E. (2020). Practicing Cultural Competence and Cultural Humility in the Care of Diverse Patients. Focus (American Psychiatric Publishing), 18(1), 49–51. https://doi.org/10.1176/appi.focus.20190041

For this assignment, you will need to evaluate your practice experiences and detail a time when you cared for a client with a chronic illness or disability.

• Background information on the individual you cared for (without violations of HIPAA) and their chronic disease or disability. Describe it in sufficient detail to create a clear picture of the situation.
• Describe the care required for this client. (Highlight the differences in care/needs between this client and others you have cared for without this disease/disability.)
• Discuss your (the nurse’s) legal and ethical responsibility in relation to this client/group. What influence can a professional nurse exert on this issue from a legislative or policy standpoint? (Think about current legislation, current ethical issues, or possible legislative needs for this client or others with similar issues.)
• What could/should you have done differently in caring for this client? (Consider insights you have now that may have altered your interactions and what you might do differently today.)  * Described how the care provided would differ with new knowledge of disability and chronic disease. Thoughtful response with clear examples.
• Describe the impact this situation has had on your career/nursing practice. (Consider what others could learn for use in a future situation or interaction.) *Thoughtful response with clear examples.

APA format, 3 references,  3-4 pages. 

Week 2 Assignment: Religion and Ethics

Required Resources
Read/review the following resources for this activity:

· Textbook: Chapters 3, 4

· Lesson

· Minimum of 2 scholarly sources (in addition to the textbook)

Instructions
Review the following ethical dilemmas:

1. John Doe has decided to clone himself. He is sterile. He cannot find anyone to marry him. He wishes to have children. He knows that he will not be able to love a child that is adopted or not connected directly to him biologically. He will be making use of a new procedure that involves taking his skin cells to produce a twin. The twin starts out as an embryo and grows into a child. The child in this case will have the same genetic information as John Doe. John Doe and his child will be twins.

2. Jane Doe is eighteen. For as long as she can remember she has been sexually attracted to other females. Her parents belong to a religion that has a religious text stating that God forbids one to be a lesbian. This religion goes on further to say that lesbians will be punished in the afterlife. Jane Doe is debating whether she should tell her parents about her sexual attraction. She has not yet decided if she should come out to her parents and live as a lesbian now that she is a legal adult.

3. Joe and Mary are a couple. Before becoming sterile, they had a child. This child died of a rare disease. Joe and Mary miss their child terribly. They have heard that there is a new IVF procedure that can ensure that they can have another child. However, their religion forbids using IVF.
Use the resources assigned for this week and additional research,

Instructions
Select two of the situations above and then address 2 of the following:

1. What is the relation between ethics and religion? Formulate and investigate the relation.

2. For each case, determine the ethical path of conduct. Then, determine what paths of conduct would be unethical

3. For each case, what would an emotivism say to appraise what you determine is the ethical form of conduct?

4. For each case, would a natural law ethicist agree with what you say is the ethical form of conduct? Why or why not?

5. Articulate, explain, and evaluate in each case an approach that makes use of divine command ethics.

Writing Requirements (APA format)

· Length: 2-3 pages (not including title page or references page)

· 1-inch margins

· Double spaced

· 12-point Times New Roman font

· Title page

· References page (minimum of 2 scholarly sources)

Face to Face—You and Your New Job in Customer Service

You have assumed a new role in customer service at United Booksellers. The organization has been heralded for its high-quality service and friendly atmosphere. The facilities are nice, and the efficiency and helpfulness of the employees are notable. Each store has its own coffee shop where patrons can relax and read. The organization employs 3,000 people and provides extensive customer service training before employees are allowed to interact with customers.

Assignment Details

Answer the following questions in 1,000 words or more using APA style and at least 2 references :

1. Are there any indicators of United Booksellers’ service culture? If so, what are they?
2. As an employee of United Booksellers, in what ways do you feel that you could contribute to the organizational culture?
3. If you were a customer, what kind of service would you expect to receive at United Booksellers? Why?