NU 665: Assessing for Grief

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NU 665: Assessing for Grief

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Assessing for Grief: Grief and Cultural Expressions in “Minari”

The selected scene from Minari depicts the tension between Jacob and Monica and the deeper emotional struggles associated with immigration, cultural dislocation, and unfulfilled expectations.  The narrative shows grief-like symptoms through Jacob and Monica’s strained relationship despite not experiencing a direct death loss.  The characters feel significant mourning for their lost sense of self, cultural roots, and emotional support from the American community. The symbolic deaths trigger emotions that correspond to conventional grief patterns.

Symptoms of Grief

The grief symptoms Monica exhibits involve emotional fluctuations, which combine with despair as well as social isolation.  The ongoing frustration she expresses about Jacob’s monetary concerns indicates her unfulfilled desires for how her family life should be.  The question she asks about how much money Jacob spent on their children contains both remorse and destructive emotions.  The combination of her emotional tone with tears and confrontation expresses the experience of ambiguous grief, which can be defined as an invisible yet passionately experienced loss (Wheeler & Crowe, 2020).  The symptoms of grieving observed in Monica suggest she mourns her deteriorating marriage, as well as missing family members, and unpredictable immigrant challenges.

Jacob shows evidence of his grief only by his relentless pursuit of achievement.  Jacob keeps dismissing questions about his emotions through repeated explanations of his decade-long focus on “chicken butts observation.” As the eldest son in his family, he carries enormous cultural significance because Korean families often expect their male offspring to maintain economic success while hiding their vulnerable emotions.  His stoic demeanor and compulsive focus on success indicate that grief is not processed but redirected into productivity—a coping strategy that avoids confrontation with emotional pain (Wheeler & Crowe, 2020).

Cultural Comparison

In Korean culture, emotional expression—especially grief—is often regulated by social norms emphasizing restraint, duty, and harmony.  Family traditions in Korean culture would likely describe emotional pain experiences as disruptive while considering them dishonorable, especially when males display such emotions (Kang et al., 2021).  Through strong restraint, Jacob handles sorrow internally while upholding his responsibilities first.

My culture teaches people that grieving should be handled through shared emotional expressions between family members.  My family uses combined storytelling sessions along with prayer times and emotional crying when dealing with emotional hardship or death to heal themselves as a group.  Through confrontational modes of expression, Monica reveals her emotions instead of keeping them hidden, which stands as an indicator that she wants people to acknowledge her suffering and help her recover from it (Wheeler & Crowe, 2020).

Psychiatric or Adaptive?

The emotional intensity portrayed by Jacob and Monica fails to fulfill the conditions required for psychiatric illness diagnosis.  Their expressions display typical grief reactions that emerge from the challenges of immigration and domestic tensions.  Pathological grief occurs when distress lasts a long time, causes significant functional impairment, or involves psychotic elements as defined by DSM-5 criteria (Varshney et al., 2021).  The emotional distress they experience, though disruptive, is proportionate to the relational and existential pressures they face.

This case shows that grief does not exclusively occur after death, as individuals can experience it when they undergo cultural displacement and experience strained relationships and identity loss.  Under immigrant circumstances, Monica and Jacob display typical emotional responses that align with their coping methods, besides reflective influences of cultural traditions (Kang et al., 2021).  Their authentic suffering exists, yet their emotional responses represent typical human behaviors that fall within generally accepted norms.

 

 

References

Kang, J., Kang, S., Jeong, E., & Kim, E. (2021). Age and Cultural Differences in Recognitions of Emotions from Masked Faces among Koreans and Americans.  International Journal of Environmental Research and Public Health, 18(19), 10555.  https://doi.org/10.3390/ijerph181910555

Varshney, P., Prasad, G., Chandra, P. S., & Desai, G. (2021).  Grief in the COVID-19 times: Are we looking at complicated grief in the future?  Indian Journal of Psychological Medicine, 43(1), 70–73.  https://doi.org/10.1177/0253717620985424

Wheeler, K., & Crowe, M. (2020).  Interpersonal Psychotherapy.  Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-To Guide for Evidence-Based Practice, 419.

NU 665: Assessing for Grief

Value: 100 points

Due: Create your initial post by Day 3, and reply to at least two of your peers by Day 7.

Grading Category: Discussions

Note: In this type of discussion, you will not see the responses of your classmates until after you have posted your own response to the following question.

For this discussion, watch the videos and complete the readings. Select one of the videos to focus on for the discussion.

Initial Post

  • Identify the symptoms of grief in the individual(s) in the video that you watched. How do these symptoms compare to expressions of grief in your own culture or family?
  • Assess if the individual(s) in the video that you watched has a psychiatric illness or if their symptoms are within an adaptive range for grieving for that group/culture.
  • Support and substantiate your information with evidence from the last five years.

Replies

Reply to at least two of your peers. In your reply posts, debate with at least two peers regarding their decisions. Provide other evidence that suggests their conclusions may be correct or incorrect.

Please refer to the Grading Rubric for details on how this activity will be graded.

The described expectations meet the passing level of 80%. You are directed to review the Discussion Grading Rubric for criteria which exceed expectations.

Week 14: Learning Materials

Readings

Required

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders, Text Revision (5th ed.). (DSM-5-TR) American Psychiatric Publishing, Inc. ISBN 978-0-89042-576-3 (WO 1)
    • Review and utilize throughout the course as needed.
    • Anxiety, grieving, bereavement
  • Boland, R., Verduin, M., & Ruiz, P. (2021). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (12th ed.). Wolters Kluwer.
    • Chapter 29: End of Life Issues and Palliative Care (WO 1, 2)
  • Villarreal-Davis, C. E., Watts-Figueroa, C. M., & Turner, R. (2021). Serving together: Play therapy to foster attachment for grieving military families. International Journal of Play Therapy, 30(4), 231–243. (WO 1, 2)
  • Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer.
    • Chapter 10: Interpersonal Psychotherapy

Recommended (WO 1, 2)

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Herpes 1 and 2

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Herpes 1 and 2

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Herpes 1 and 2

The information guide discussed below provides essential information about Herpes Simple Viruses 1 and 2, famously known as Herpes. In this discussion, we will look deeper into the nature of the infection, the incubation period, the primary symptoms, the gender-specific differences, the treatments, and the methods of prevention. The Herpes Simplex Virus causes Herpes. There are two main types: Herpes 1, which causes cold sores, and Herpes 2, which is the leading cause of genital Herpes (James et al., 2020).

Incubation period and the primary symptoms

The incubation period for Herpes can differ, but they naturally range from around 2 to 12 days. In this period, an ill person may not display any symptoms, but at that time, the infected person can transmit the virus to others. Herpes simplex virus type 1 (HSV-1) and herpes simplex virus type 2 (HSV-2) can cause mouth and vaginal ulcers, as well as flu-like symptoms and itching or burning sensations (James et al., 2020). These lesions, from time to time, are called ulcers, can be painful, and reappear over time. In addition to its central effects, the virus can damage many different anatomical areas, which entails ocular Herpes as well as the primary nervous system.

Gender-specific Differences

In general, men and women will have the same signs and symptoms of Herpes. Nevertheless, the occurrence of epidemics, as well as their brutality, may vary. Pregnant people who have been diagnosed with genital Herpes may need additional medical care to reduce the danger of transmitting the disease to their baby during childbirth. Even though there is no remedy for Herpes, signs can be controlled and reduced through the use of antiviral medicines such as acyclovir, valacyclovir, and famciclovir. Implementing rapid interventions during outbreaks can minimize their duration and intensity (Zhu & Viejo-Borbolla, 2021). Implementing continuous suppressive therapy has the potential to reduce the frequency of relapses.

Ways of preventing

  1. Safe sex: Regular and correct use of condoms or oral dams through sexual activity can reduce the risk of spreading the virus(Zhu & Viejo-Borbolla, 2021).
  2. Communication: Open and candid communication with your partner about herpes status is vital.
  3. Avoid close contact: Avoid kissing or having sex during an outbreak.
  4. Antiviral drugs: For people with recurrent outbreaks, daily antiviral treatment may reduce the risk of transmission.
  5. Get tested regularly: Get tested regularly to know your status and protect your partners(Zhu & Viejo-Borbolla, 2021).

Conclusion

In summary, Herpes caused by  HSV-1 and HSV-2 virus strains is a common viral infection that affects a significant number of people. There is no remedy for the illness, but it can be successfully treated through the utilization of antiviral medications. Additionally, practicing secure sex and keeping up open communication can offer assistance to avoid infection transmission. It is vital to know the characteristics of the infection, the symptoms related to it, as well as the numerous safety measures that can be taken to maintain your wellbeing and ensure the wellbeing of others.

References

James, C., Harfouche, M., Welton, N. J., Turner, K. M., Abu-Raddad, L. J., Gottlieb, S. L., & Looker, K. J. (2020). Herpes simplex virus: Global infection prevalence and incidence estimates, 2016. Bulletin of the World Health Organization, 98(5), 315-329. https://doi.org/10.2471/blt.19.237149

Zhu, S., & Viejo-Borbolla, A. (2021). Pathogenesis and virulence of herpes simplex virus. Virulence, 12(1), 2670-2702. https://doi.org/10.1080/21505594.2021.1982373

Herpes 1 and 2

Paper details

Module 13: STI Information Guides No unread replies. No replies.  Rationale: This activity will allow you to be creative while learning about the most common types of sexually transmitted infections. Instructions: Each student in the class has been assigned an STI. Locate your name in the table below. Your job is to develop an informative guide about your STI. Your guide may be formatted as a word document or pdf file, a PowerPoint presentation or slide show, a video (see introduce yourself, discussion board, for a reminder on how to post videos to the discussion board), or any other format that makes sense to you. I encourage you to be as creative as possible with this assignment. Regardless of the format, your informational guide should include the following: What kind of organism (i.e., virus, bacteria, or ectoparasite) is your STI?  What is the incubation period for your STI?  What are the primary symptoms of your STI? Do men and women typically present the same way? If not, what are the differences?  How can the STI be treated? Is it curable? Do not limit yourself to the treatment information presented in your text; new treatments are frequently being developed. So, use the internet to see what treatments are available for your assigned STI. How can an individual prevent contraction of the STI?  Once you have completed your information guide, post it to the discussion board. Finally, you should peruse the work of your classmates. Feel free to comment on each other\’s posts. You may ask each other questions or just let your classmates know when you like what they have done. Student Assigned STI CHLAMYDIA    GONORRHEA    HERPES    SYPHILIS    HPV/Genital Warts    HEPATITIS    CRABS TRICHOMONIASIS    CHLAMYDIA    GONORRHEA    HERPES    SYPHILIS    HPV/Genital Warts    HEPATITIS    CRABS TRICHOMONIASIS    CHLAMYDIA    GONORRHEA    HERPES    SYPHILIS    HPV/Genital Warts    HEPATITIS    CRABS TRICHOMONIASIS    CHLAMYDIA

SOAP Note for Mania Case Study

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SOAP Note for Mania Case Study

Subjective

Chief Complaint (Patient’s Own Words):

I have been working hard for this company and finally discovered how to treat cancer. My GP referred me here to discuss it comprehensively.”

People Present for Appointment:

Mr. John Riley, who is the patient, came for the appointment by himself.

Patient Demographics:

Mr. John Riley is a middle-aged male who works as a car mechanic (he is employed).

History of Present Illness (HPI):

John Riley shows signs of a manic episode, which include increased energy, insomnia, grandiosity, and paranoid ideas (Chakrabarti & Singh, 2022). It has been mentioned that the symptoms had begun over the past week, and the severity seems to have significantly escalated lately. He has been obsessed with finding the ‘cure for cancer’ using arbitrary methods of numbers and charts. Because of his perception that he has much energy, he does not get tired and has reduced the amount of sleep he gets. John also complains of hearing voices, saying that “God speaks to him,” telling him how marvelous he is and how well he is doing his work. Despite such signs, John appears to have no first-hand knowledge of his state of affairs, and he boasts about feeling great and ignores all the issues his coworkers and GP have raised with him.

Psychiatric Review of Systems (ROS):  

  1. Mood: Elated and expansive.
  2. Sleep: Severely impaired; the patient (John) reports no need for sleep.
  3. Energy: John displays excessive energy, often to the point of restlessness.
  4. Appetite: Not reported.
  5. Concentration: significantly impacted by the racing thoughts concerning his delusional beliefs and ideas.
  6. Thought Process: Disorganized, focused on delusional content (cure for cancer).
  7. Thought Content: Grandiose delusions, auditory hallucinations.
  8. Insight/Judgment: Fails to recognize the severity of his condition.

Medical Review of Systems:

John completely disclaims having any issue with his physical aspect of health or any concern in the recent past. No serious medical conditions were said to have been present.

Family History:

John does not disclose any information of any familial predispositions to either psychiatric or major medical conditions.

Patient Medical History:

No significant medical history was reported.

Patient Psychiatric History:

There are no records that John had psychiatric problems, nor did he receive psychiatric treatment before in his life.

Social History:

John works as a car mechanic. He reports that he is smarter than all the other employees and does not have many people to give him the much-needed social support.

Trauma History:

No reported trauma history.

Substance Use History:

John also adamantly states that he has never used alcohol or recreational substances, both currently or in the past.

Objective:

Mental Status Examination (MSE):

  1. Appearance: John looks rather scruffy but has a vibrant body language.
  2. Behavior: He fidgets, twists in his chair, consistently switch focus and always returns to his idea about the cure for cancer.
  3. Speech: Often starts acting pressured, rushes through information, speaks side topics, and often needs a reminder.
  4. Mood: Euphoric and expansive.
  5. Affect: Labile and reactive.
  6. Thought Process: Disorganized, circumstantial, and tangential.
  7. Thought Content: Grandiosity (Mr. John believes he can cure cancer and that God is telling him what to do). John says he has auditory symptoms whereby he hears God telling him his work is fantastic.
  8. Perception: Auditory hallucinations (hearing God).
  9. Insight: Poor; John does not realize that he is psychotic and that these thoughts and actions are manifestations of a psychiatric disorder.
  10. Judgment: Impaired; John shows ineffective decision-making and prioritization; he would rather spend his time on delusional material than his health.
  11. Cognition: Not formally evaluated. However, his thought process and behavior suggest weaknesses in attention and focus.
  12. Orientation: John is oriented to person, place, and time.

Vital Signs:

None is provided in the case study.

Physical Assessment:

Not relevant to the current case.

Lab Results:

None is available in the case study.

Risk Assessment:

  1. Suicide Risk: Low; John had no such feeling and showed no desire for suicide attempts through his speech but seemed to be primarily preoccupied with his delusional ideas.
  2. Homicide Risk: Low; no evidence of homicidal ideation.
  • Other Risks: Lack of sleep, which increases the risk of self-neglect, grandiosity, and possible harm from untreated mania.

Assessment:

Biopsychosocial Formulation:

  1. John Riley, a middle-aged man, exhibits signs of a manic episode: elated feelings, things feeling important and great, racing thoughts, inability to sleep, and hearing things others cannot. While he claims that he does not have genetic vulnerabilities or any family history of mental illness, it cannot be stated that this is true. This is because John has had considerable difficulty accepting the delusions as false and has a limited understanding of his problem. The presented symptoms might be aggravated by psychosocial factors, such as job-related demands and an absence of social support in his case. All these factors make the clinical presentation of the disease rather intricate and necessitate an integrated strategy for assessment and management. John’s case nicely illustrates many of the issues associated with acute manic episodes and their management, and the lack of insight that some patients may have is one of the key issues (Luo et al., 2019). In patient care planning, John will require treatment addressing both the presenting complaints and the possible underlying psychosocial causes.
  2. According to the medical history, the patient is not suffering from any diseases that would cause him to exhibit these mannerisms. Nonetheless, if he continues not to sleep, this might have some implications for his physical health.

Three Differential Diagnoses:

  1. Bipolar I Disorder, Current Episode Manic with Psychotic Features (Primary Diagnosis): John fits perfectly into the mania episode; he was grandiose, had elevated energy levels, pressured speech, and lack of sleep. It also includes delusions that distort the regular perception of the real world. The option of auditory stimuli also indicates paranoid symptoms in addition to manic episodes. The presence of manic symptoms along with psychotic features significantly supports the diagnosis of a manic episode that can be associated with bipolar disorder or another mood disorder with psychotic symptoms (Fu-I et al., 2019).
  2. Schizophrenia Spectrum and Other Psychotic Disorders: As less likely though, John’s symptoms of persecutory delusions and hallucination suggest a psychotic disorder. It becomes more important if the subsequent assessments reveal the continuous presence of psychotic symptoms. If there are other reasons for the symptoms, then other conditions should be suspected; however, if the symptoms persist on a chronic basis, the client may be suffering from a psychotic disorder (Parker et al., 2020). More evaluation and follow-up over time will enable a proper diagnosis and treatment intervention.
  • Substance/Medication-Induced Psychotic Disorder: Even though John stated that he does not abuse substances, performing a substance-specific toxicology test is required to exclude other substance abuse-related possibilities. The extended testing procedure would give an independent confirmation or otherwise of John’s self-claimed non-use of substances (Fu-I et al., 2019). Unless screening for substance use is done, it becomes impossible to rule out substances in their present state or manifestations.

Primary Diagnosis:

Bipolar I Disorder, Current Episode Manic with Psychotic Features (DSM-5 code: 296.44).

Medical Diagnoses:

None were reported in the case study.

Obstacles to Treatment:

John can be seen to lack good insight about his condition, and his delusional symptomatic presentation may make him less willing to seek treatment.

Plan:

Pharmacologic Treatment:

  1. Prescribe mood stabilizer Lithium at an initial dose of 300 mg daily and increase depending on response and side effects. Lithium, however, needs frequent blood level surveillance to maintain therapeutic concentrations and prevent toxic effects (Kishi et al., 2022).
  2. Prescribe some antipsychotic medicine (e.g., Olanzapine, 5 mg at night) to manage the psychotic features to regulate John’s state of mind.
  • Medication Education: John needs to be enlightened on the consequences of non-compliance to mood stabilizers and antipsychotic medications, the necessity of blood tests when taking Lithium, and possible complications, including sedation, increased weight, and shakes (Kishi et al., 2022).

Non-pharmacologic Treatment:

  1. Psychoeducation: John and his family should learn about bipolar disorder, especially how to go about a manic episode.
  2. Cognitive Behavioral Therapy (CBT): Once anchored, CBT may assist in further resolving other symptoms that include grandiosity, delusions, and impaired insight that John presents with.

Laboratory Orders:

  1. Pre-lithium blood tests like complete blood count, renal function test, thyroid profile, and serum electrolyte test to look for any relative contraindications (Kishi et al., 2022).
  2. During the treatment, periodic checkups of Lithium levels in the blood and thyroid function.

Referrals:

  1. Consult a psychiatric social worker to help cope with psychosocial demands and to guide you on how to find appropriate support in society.
  2. Patients are referred to individual therapy to help manage their symptoms as they continue their day-to-day activities (Kishi et al., 2022).

Follow-up: 

  1. Subsequent appointment in 1 week to evaluate the efficacy of administered medication, any adverse effects, and symptom control.
  2. The follow-ups should be continuous and include assessments of mood status, medication compliance, and safety issues.

Rationale for Treatment Plan:

The use of Lithium as a mood stabilizer and Olanzapine as an antipsychotic are both prescribed commonly in cases of manic episodes with psychotic symptoms. Lithium is chosen because of its ability to stabilize mood, while Olanzapine treats psychotic manifestations (Kishi et al., 2022). Where possible, it is important to constantly observe the patient and ensure that symptoms of mania do not worsen and any potentially dangerous behaviors arising from untreated mania, such as sleeplessness, are avoided.

References

Chakrabarti, S., & Singh, N. (2022). Psychotic symptoms in bipolar disorder and their impact on the illness: a systematic review. World journal of psychiatry, 12(9), 1204.

Fu-I, L., De S Gurgel, W., Caetano, S. C., Machado-Vieira, R., & Wang, Y. P. (2019). Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode. Brazilian Journal of Psychiatry, 42(2), 168–174. https://doi.org/10.1590/1516-4446-2019-0455

Kishi, T., Ikuta, T., Matsuda, Y., Sakuma, K., Okuya, M., Nomura, I., … & Iwata, N. (2022). Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials. Molecular psychiatry, 27(2), 1136-1144.

Luo, C., Chen, H., Zhong, S., Guo, H., Li, Q., Cai, W., De Girolamo, G., Zhou, J., & Wang, X. (2019). Manic episode, aggressive behavior and poor insight are significantly associated with involuntary admission in patients with bipolar disorders. PeerJ, 7, e7339. https://doi.org/10.7717/peerj.7339

Parker, G., Spoelma, M. J., Tavella, G., Alda, M., Hajek, T., Dunner, D. L., O’Donovan, C., Rybakowski, J. K., Goldberg, J. F., Bayes, A., Sharma, V., Boyce, P., & Manicavasagar, V. (2020). The bipolar disorders: A case for their categorically distinct status based on symptom profiles. Journal of Affective Disorders, 277, 225–231. https://doi.org/10.1016/j.jad.2020.08.014

SOAP Note for Mania Case Study

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PSY665 Week 1 Assignment

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PSY665 Week 1 Assignment

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PSY665 Week 1 Assignment Latest 2017 November
QUESTION

Details:

In 1,000-1,250 words, describe a hostile work environments, by doing the following:

Research hostile work environments and how they affect employees.
Describe what makes up a hostile work environment.
Explain the various ways employees are affected by hostile work environments.
Provide at least three things that HR professionals can do to avoid having hostile work environments.
Use two to four scholarly sources to support your explanations.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

NU636-7B: Treating Hypertensive Urgencies

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NU636-7B: Treating Hypertensive Urgencies

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NU636-7B: Treating Hypertensive Urgencies

Discussion Prompt

Utilize the information provided in the scenario to create your discussion post.
Construct your response as an abbreviated SOAP note (Subjective Objective Assessment Plan).
Structure your ‘P’ in the following format:  [NOTE:  if any of the 3 categories is not applicable to your plan please use the ‘heading’ and after the ‘:’ input N/A]

Therapeutics: pharmacologic interventions, if any – new or revisions to existing; include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention]
Educational: health information clients need in order to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit
Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making

Support the interventions outlined in your ‘P’ with scholarly resources.

Please be sure to validate your opinions and ideas with citations and references in APA format.
The post and responses are valued at 40 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.
Estimated time to complete: 2 hours
Peer Response: Unit 2
Instructions:

Read the SOAP notes constructed by your course colleagues.
Review the ‘P’s posted by your peers from your advanced practice nursing role perspective – educator, leader or practitioner.  From your advanced practice mindset reflect on a discussion you would like to have with two of your course colleagues about their ‘P’.
Post a response individually to each of them that expresses your advanced practice nursing role perspective of their ‘P’.
Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example – if you are a nurse educator (clinical or academic) what are your thoughts about the patient education provided in the ‘P’, or do you want to comment on the fact that a peer put N/A for educational, etc.?’; if you a nurse leader what are your thoughts about the risk profile or cost effectiveness of the ‘P’, or adherence to the Patient Bill of Rights, etc.?; if you are a nurse practitioner did your peer develop a ‘P’ that aligns with Evidence Based Practice (EPB)/Clinical Practice Guidelines (CPG) and/or the basic sciences, etc.?

Custom NU636-7B Unit 2 Discussion 1 – Treating Hypertensive Urgencies Herzing

NU636-7B: Treatment of COPD

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NU636-7B: Treatment of COPD

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NU636-7B: Treatment of COPD

Discussion Prompt
Scenario: You are seeing an 89-year-old male who has a history of smoking 2 packs of cigarettes a day for 69 years.

He quit smoking cold turkey when he was 78 years old.
He is in your office for a general health evaluation.  He reports ongoing challenges with ‘belching’ but other than that he conveys that he is feeling pretty good.
He is on no routine medications.
During your interview with the patient you note that he utilizes pursed lip breathing.  At times you note a faint ‘whistling’ sound associated with his respiratory effort.
In conducting your review of systems he reports a cough, particularly in the mornings, productive for thick clear to white sputum.
When queried about shortness of breath he does indicate that he gets SOB more easily than he used to.
His breath sounds are course and diminished in the lower lobes bilaterally.

Please develop a discussion that responds to each of the following prompts.  Where appropriate your discussion needs to be supported by scholarly resources.  Be sure to include in-text citations in the context of the discussion and provide a full reference citation at the end of the discussion.
Initial post
Utilize the information provided in the scenario to create your discussion post.
Construct your response as an abbreviated SOAP note (Subjective Objective Assessment Plan).
Structure your ‘P’ in the following format:  [NOTE:  if any of the 3 categories is not applicable to your plan please use the ‘heading’ and after the ‘:’ input N/A]
Therapeutics: pharmacologic interventions, if any – new or revisions to existing; include considerations for OTC agents (pharmacologic and non-pharmacologic/alternative); [optional – any other therapies in lieu of pharmacologic intervention]
Educational: health information clients need in order to address their presenting problem(s); health information in support of any of the ‘therapeutics’ identified above; information about follow-up care where appropriate; provision of anticipatory guidance and counseling during the context of the office visit
Consultation/Collaboration: if appropriate – collaborative ‘Advanced Care Planning’ with the patient/patient’s care giver; if appropriate -placing the patient in a Transitional Care Model for appropriate pharmacologic and non-pharmacologic care; if appropriate – consult with or referral to another provider while the patient is still in the office; Identification of any future referral you would consider making
Support the interventions outlined in your ‘P’ with scholarly resources.
Please be sure to validate your opinions and ideas with citations and references in APA format.
The post and responses are valued at 40 points. Please review post and response expectations. Please review the rubric to ensure that your response meets criteria.
Estimated time to complete: 2 hours
Peer Response: Unit 3
Treatment of COPD
Instructions:

Read the SOAP notes constructed by your course colleagues.
Review the ‘P’s posted by your peers from your advanced practice nursing role perspective – educator, leader or practitioner.  From your advanced practice mindset reflect on a discussion you would like to have with two of your course colleagues about their ‘P’.
Post a response individually to each of them that expresses your advanced practice nursing role perspective of their ‘P’.

Use scholarly resources relevant to your advanced practice nursing role to support the key elements of the peer discussions you construct. [For example – if you are a nurse educator (clinical or academic) what are your thoughts about the patient education provided in the ‘P’, or do you want to comment on the fact that a peer put N/A for educational, etc.?’; if you a nurse leader what are your thoughts about the risk profile or cost effectiveness of the ‘P’, or adherence to the Patient Bill of Rights, etc.?; if you are a nurse practitioner did your peer develop a ‘P’ that aligns with EBP/CPG guidelines and/or the foundational basic sciences, etc.?
Please be sure to validate your opinions and ideas with citations and references in APA format.
Custom NU636-7B Unit 3 Discussion 1 – Treatment of COPD Herzing

NU670-8D: Depression & Anxiety Case Study

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NU670-8D: Depression & Anxiety Case Study

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NU670-8D: Depression & Anxiety Case Study
Instructions
Complete a full intake on this patient and then develop a treatment plan using the template offered.
Patient History
The patient is a 59-year-old married woman with 5 grown children
She is moderately overweight (BMI 30) and was diagnosed with non-insulin-dependent diabetes 10 years ago; she is fairly well managed on an oral hypoglycemic medication (glipizide 10 mg twice per day)
Two years ago, the patient experienced 2 tremendous stressors: her oldest child developed leukemia (now in remission), and her mother and father both passed away
She suffered a significant and impairing major depressive episode that went untreated until recently
This was her fifth episode of depression; she experienced 2 major depressive episodes as a teenager, and she developed postpartum depression and anxiety following the births of 2 of her children
Four months ago, after she was too fatigued to get out of bed, she sought treatment for the first time in her life
After receiving education and support from her clinician, she reluctantly agreed to take Paxil 30 mg/day
The patient has experienced a near-complete resolution of her symptoms in the last 6 months; however, she has developed side effects and wants to discontinue the medication
Specifically, she has increased appetite and has correspondingly gained 7 pounds in the last 4 months, with an increase in HgA1c of 1 full percentage point
She also reports excess daytime sedation and anorgasmia (very unusual for her)
What options can you offer to manage these side effects? Be specific
What education should you give the patient about stopping this medication abruptly?
What is your treatment plan?
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NU670-8D

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Discussion Prompt

Side effects are a common reason that patients discontinue medications. List one common side effect for each medication and one potential way to manage it.

Amitriptyline
Bupropion
Fluoxetine
Paroxetine

Some potential side effects from antidepressants can be serious; what is the difference between neuroleptic malignant syndrome (NMS) and serotonin syndrome? How are they treated?
Are any antidepressants approved for or preferred in postpartum depression?
Which class of antidepressants (if any) are generally recommended to be used in geriatrics?
Side effects are a common reason that patients discontinue medications. List one common side effect for each medication and one potential way to manage it.

Review prescribing guidelines for benzodiazepines for anxiety in your state. Are there any limitations for APRN’s to prescribe? How do the numbers of scripts written by APRN’s compare to those of physicians?
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:

Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
References and citations should conform to APA standards.
Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
Plagiarism is never acceptable – give credit when credit is due – cite your sources.

Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
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NU670-8D Unit 6

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NU670-8D Unit 6
Instructions

Please complete the questions listed below in the assignment.

Provide supporting Documentation and Resource Links.
This must be at least 2-3 pages paper, APA format.

Submit to the dropbox by the due date.

Questions
Determine if your practice state is an independent practice state for APRNs using the AANP map (Links to an external site.).
Look up the APRN prescribing regulations in your state.
What are the safe prescribing recommendations for APRN’s in your state? This will vary depending on the level of practice authority.
Does your state have a Prescriptions Drug Monitoring Program? If so, explain. If not, please describe current legislation regarding this topic.
What are the barriers to APRN’s prescribing in your state?
What local or national organizations are available for you to join to support the cause for advancing practice/prescribing for APRN’s?

Give a minimum of two (2) APA references to support your findings.  Be sure to follow APA format.
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NU670-8D Unit 8

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NU670-8D Unit 8

Discussion: Unit 8
Unit 8 Discussion – Reflection
Please respond to the following questions based upon these course objectives:

Understand and be able to articulate the fundamentals of neurotransmission as it relates to prescribing psychotropic medications for clients with acute and chronic mental health conditions.
Discuss major categories of psychotropic drugs, their rationale for use, mechanisms of action, common side effects, and drug interactions.
Discuss evidence to support and the appropriate use of complimentary alternative medications in patients that are experiencing acute and chronic mental health conditions seeking adjunctive or monotherapy treatment while considering cultural and genetic factors as well as patient values.
Utilize clinical assessment tools associated with diagnosing and prescribing for psychiatric disorders and begin to utilize these tools in clinical settings to assist with diagnosis and treatment of chronic mental health conditions.
Propose psychotherapeutic medication for selected patients keeping in mind safety concerns while utilizing knowledge of current mental health, medical concerns, age, gender, cultural factors, genetic factors, ethical concerns, patient values, and prescriptive authority impact decision making.
Utilize research and provide basic diagnostic and psychopharmacology education to your client and his/her family when prescribing.
Understand ethical and legal considerations and controversies in current pharmacological treatment of mental health patients.

Please answer the following questions with supporting examples and full explanations.

For each of the learning objectives, provide an analysis of how the course supported each objective.
Explain how the material learned in this course, based upon the objectives, will be applicable to the professional application.

Provide evidence (citations and references) to support your statements and opinions. Responses to these questions are due by Tuesday at 11:59 AM.
All references and citations should in APA format.
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