Monthly Archives: May 2023

check the uploaded guidelines and pick a topic and related question do the paper with 2 reference article less than 5 years old and 3 page body and title and refence 

 APA less than 10 % similarity

Week 2 Discussion Question: Chapter 5: Common Aging Changes

Choose one aspect of the normal change of aging and discuss in one page or less the following: ·           

Part two: Discuss interventions to improve/reduce risks of adverse effects.

Follow the Guideline

Attached are the templates and examples the professor has provided to assist in helping to do the assignment and I have already started the outline as well for the GMO conspiracy theory. And I am attaching that. It just needs to be added to. I will be using this to do my speech off of. I have also attached the assignment description.

To prepare:

Review your state’s process for obtaining prescriptive authority and associated fees (Georgia)

Review the DEA website and review the process for obtaining a DEA number and associated fees.

Review and select one of the following case studies and analyze the provider information:

Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic as a nurse practitioner in a small town. She will be working with one physician at one site.

Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices as nurse practitioner.

Write 1 to 2 pages

Post a brief summary of the case study you selected and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.

Reference

Buppert, C. (2015). Prescribing. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.). (199-204). Burlington, MA: Jones & Bartlett.

 U.S. Department of Justice (n.d.). Drug Enforcement Administration: Office of Diversion Control. Retrieved from http://https://www.dea.gov/ops/diversion.shtml

Required Media

Fisher, A. S. (2015, June 5). Medical Records: What Must Be Included from a Legal Standpoint? [Video file]. Retrieved from https://www.youtube.com/watch?v=euhoL62YsSk

For this week, please answer all the below. Please state which antihypertensive (if any) you would prescribe each patient. Please state a specific medication, dosage and frequency for each, along with a sentence or two rationale.

A. 200 lb 65 yo male who is already on max dose Zestoretic (lisinopril/HCTZ). Brings in home BP log, which shows average of 160/92. Last GFR of 60. Hepatic enzymes fine. Comorbidities: chronic headaches – stress induced. (1 point)

B. A newly-diagnosed type 2 diabetic. 43 yo female. Smoker. Asthmatic. BP’s consistently 140s/90s. GFR of 80 and hepatic enzymes mildly elevated. (1 point)

C. 37 yo male. BP’s are well-controlled on 20 mg of lisinopril, however, he has developed a dry cough since starting this medication. Feels there is a correlation. (1 point)

D. 45 yo African American. BPs 150s/90s. Also suffers from gout. (1 point)

E. 78 yo male currently on ACE inhibitor and beta blocker for congestive heart failure, stage 3. Has chronic pitting ankle edema. Last potassium high-end normal. Last GFR of 40. Hepatic enzymes mildly elevated. (1 point)

F. 27 yo male. BPs 150s/90s. No significant comorbidities. (1 point)

G. You inherit a male, 55-year-old, diabetic patient with comorbid obesity, cigarette use and diabetes mellitus. His recent low density lipoprotein (LDL) is 150 mg/dL. Using the guidelines of the American Heart Association mentioned in your lecture, what is your prescribed treatment plan for this patient to lower his LDL (provide a specific medication and dose, please)? (1 point)

He calls in two weeks stating he has developed myalgias since starting the medication. What do you do for this patient? (1 point)

Developing a Care Plan—Continued

In a Microsoft Word document of 4-5 pages formatted in APA style, you will submit your final comprehensive care plan for the aggregate based on the health risks faced by the aggregate, incorporating feedback from your instructor on your Week 5 paper and your continued work.

In your paper, address the following:

• Propose two (2) priority-nursing diagnoses based on the major health risks identified during the risk assessment for the aggregate .
  • Include strategies to address the nursing diagnoses and identified risks of aggregate.
  • Support your strategies with at least two journal articles.
• Develop a disaster management plan with the following components:
  • List of disasters that might affect your aggregate (take into consideration the geographical location of the aggregate, past history, etc.).
  • Strategies for handling at least two disasters from the list.
  • Recommendations for a disaster supplies kit.

On a separate references 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.

• Use this APA Citation Helper as a convenient reference for properly citing resources.
• This handout will provide you the details of formatting your essay using APA style.
• You may create your essay in this APA-formatted template.

WEEK 13 apa format , 250 words only 1 reference please. 

Trace the history of cannabis use in medicine for the treatment and management of illness via nursing scholarly journal articles. Examine your sources for the following information below and describe the following:

1. Who are the stakeholders both in support of and in opposition to medicinal cannabis use?

2. What does current medical/nursing research say regarding the increasing use of medicinal cannabis?

3. What are the policy, legal and future practice implications based on the current prescribed rate of cannabis?

Attached below is an additional resource that details current state medical marijuana laws:

National Conference of State Legislatures- State Medical Marijuana Laws: http://www.ncsl.org/research/health/state-medical-marijuana-laws.aspx

 Respond to  your  colleagues who argued the opposite side as you by countering their  argument with evidence. Identify at least two consequences to support  your position. 

NOTE( my position is against the issue of diagnosing pediatric bipolar depression disorder)

Please cite References

                                                       Main Post

Pediatric Bipolar Depression

The  American Psychiatric Association (2013) requires one manic episode or  one hypomanic episode along with one depressive episode for a diagnosis  of Bipolar Disorder. There has been some controversy over using the  diagnosis of Pediatric Bipolar Disorder (PBD) due to what some believe  was over-diagnosis resulting in a higher prevalence of the disorder in  the United States, showing up to a 40-fold increase in the diagnosis in  the previous decade (Van Meter, Moreria & Younstrom, 2019).  

Arguing FOR the Diagnosis

While  there was some debate for a period of time regarding over-diagnosis of  PBD, Van Meter et al. (2019) suggest that rates of pediatric bipolar  disorder are not increasing and the rate is not higher in the United  States once meta-analysis is utilized to critically evaluate previous  data. Some previous criticism of PBD resulted in the APA (2013)  establishing the newer diagnosis of Disruptive Mood Disregulation  Disorder which addressed the primary issue of children presenting for  treatment with significant and pervasive irritability. An important  distinction that must be made is the difference between PBD and DMDD:  PBD has discrete episodes of irritability (mania) whereas in DMDD the  irritability is chronic and nonepisodic (Findling & Chang, 2018). 

With  no other diagnosis available in the past, it is possible that some of  these kids ended up with a PBD diagnosis for what was likely DMDD;  still, this fact does not negate the necessity for a PBD diagnosis to be  available. In fact, between 50-66% of adults with well-documented  bipolar disorder report having had symptoms prior to age 19 (Findling  & Chang, 2018). As has been well-established, earlier treatment and  intervention result in better outcomes (McGorry & Mei, 2018).

The  International Society for Bipolar Disorders Task Force (Goldstein et  al., 2017) found that the previous studies which resulted in much of the  debate appeared to be more influenced by training, conceptualization,  and insurance as opposed to true differences in prevalence. While the  Task Force acknowledges the need for more studies to more accurately  assess for hypomania and differentiation of PBD from non-mood  psychopathology, a need to recognize and diagnose PBD still remains.  McGorry and Mei (2018) make the case for earlier intervention for PBD  due to the fact that (1) earlier treatment is more effective, and (2)  recurrence is often associated with structural  changes in the brain.  Considering this fact, and the new understanding that previous  “over-diagnosis” was probably not actually over-diagnosis, recognizing  and treating PBD remains a critical piece of pediatric psychiatry. 

My Takeaway

When  I began reading about pediatric bipolar disorder, I was initially  inclined to think that it would be difficult to differentiate PBD from  normal childhood mood swings. However, the more I read, the more clear  it became that by accurately diagnosing PBD, the better the outcomes.  Also, one thing that I noticed in several studies was the necessity for a  “structured interview” in the diagnostic process. I have not seen that  done in real life, but it inspired me enough that I found a handbook and  manual, the Structured Clinical Interview for DSM-V, from the American Psychiatric Association Publishing arm that I purchased for my own resources (https://www.appi.org/Products/Interviewing/SET-of-SCID-5-CV-and-SCID-5-CV-Users-Guide).  The bottom-line, for me, is to make sure that I remain open to what new  research shows and to remember that I will never know everything and  that I can always learn something new.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Findling, R.L. & Chang, K.D. (2018). Improving the Diagnosis and Treatment of Pediatric Bipolar

Disorder. Journal of Clinical Psychiatry, 79(2), 62-69. 

Goldstein, B.I., Birmaher, B., Carlson, G.A., DelBello, M.P., Findling, R.L., Fristad, M., 

Kowatch, R.A., Miklowitz, D.J., Nery, F.G., Perez-Algorta, G., Van Meter, A., Zeni, C.P.,

Correll, C.U., Kim, H.W., Wozniak, J., Chang, K.D., Hillegers, M. & Youngstrom, E.A. 

(2017). The International Society for Bipolar Disorders Task Force report on pediatric

bipolar disorder: Knowledge to date and directions for future research. Bipolar Disorders,

19, 524-543. Doi: 10.111/bdi.12556.

Van Meter, A., Moreira, A.L., & Youngstrom, E. (2019). Updated Meta-Analysis of 

Epidemiologic Studies of Pediatric Bipolar Disorder. Journal of Clinical Psychiatry, 80(3),

e1-e11. doi: 10.4088/JCP.18r12180.

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 Statistics shows that 48% of no fatal injuries from occupational assaults in the United States occurred in health care and social services particularly mental health workers. Mention and discuss at least 3 precipitating factors for violent behavior in institutions?