Cancer

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Cancer

Phytochemicals

Phytochemicals are bioactive molecules derived from plants that serve as a defense mechanism for the plants themselves. Phytochemicals, identified in over a thousand varieties, may be obtained from various sources, including grains, vegetables, whole fruits, herbs, and nut. Among the essential phytochemicals are polyphenols, carotenoids, dietary fibers, saponins, phytosterols, specific polysaccharides and isoprenoids. These phytochemicals have demonstrate antidiarrheal and potent antioxidant properties, antibacterial, anthelmintic, antiviral effects and antiallergic (Dave et al., 2020). In addition, they play a role in controlling gene transcription, promoting communication across gap junctions, boosting the immune system, and offering defense against lung and prostate malignancies.

There has been an increase in the scope of functional meals due to the current emphasis placed on translational research. After being extracted from a wide variety of sources, phytochemicals significantly impact the creation of functional foods and nutraceuticals. Different phytochemicals have different levels of affinity for various solvents and other heat tolerance levels. The selection of the solvent impacts not only the quality of the recovered phytochemical but also the use of this phytochemical in the production of food and nutraceutical goods (Afrin et al., 2020). To guarantee the quality of the goods, it is necessary to extract phytochemicals from the source crop to preserve the original structure and characteristics of the phytochemicals. In light of this, it is of the utmost importance to choose an appropriate technique of phytochemical extraction.

In conclusion, phytochemicals show great potential in the context of cancer prevention via dietary means. The bioactive chemicals in plant-based foods are crucial in supplying antioxidant and anti-inflammatory characteristics. These properties may impact the pace at which cells are harmed and help prevent cancer development. Scientific progress has shown that dietary phytochemicals are crucial in reducing cancer risk. However, further study is required to completely elucidate the underlying mechanisms of phytochemicals’ anticancer actions and provide practical and rational suggestions.

References

Afrin, S., Giampieri, F., Gasparrini, M., Forbes-Hernandez, T. Y., Cianciosi, D., Reboredo-Rodriguez, P., … & Battino, M. (2020). Dietary phytochemicals in colorectal cancer prevention and treatment: A focus on the molecular mechanisms involved. Biotechnology advances, 38, 107322. https://www.sciencedirect.com/science/article/pii/S0734975018301952

Dave, A., Parande, F., Park, E. J., & Pezzuto, J. M. (2020). Phytochemicals and cancer chemoprevention. J Cancer Metastasis Treat, 6, 46. https://f.oaes.cc/xmlpdf/7c5f835e-c35c-4397-bf06-44a5473ab22f/3784.pdf

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Cancer

Contaminants and naturally occurring toxins can be carcinogenic, but the body is equipped to handle tiny doses of most kinds. The last discussion will be about cancer.

Instructions:

Look at the incidence of Cancer state by state and the Cancer Death Rate state by state at the Centers for Disease Control.

Look at this table (attached) Diet-Related Factors and Cancer at Specific Sites.

Discuss one of three factors related to diet and cancer.

– Phytochemicals

– Nitrates

– GMOs

Gynecologic Health

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Gynecologic Health

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Diagnostics and Primary Diagnosis

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

Subjective: What details did the patient provide regarding her personal and medical history?

Objective: What observations did you make during the physical assessment?

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

Very Important: Reflection notes: What would you do differently in a similar patient evaluation?

A diagnosis based significantly on laboratory reports or test results, rather than the physical examination of the patient. … Principal diagnosis. The single medical diagnosis that is most relevant to the patient’s chief complaint or need for treatment. Many patients have additional diagnoses

Diagnostic Tests Overview

Allergy testing.
Blood pressure measurement.
Blood tests.
Bone, joint and muscle tests.
Brain and nerve tests.
Biopsy (surgical removal of a tissue sample for microscopic evaluation; e.g., breast biopsy, prostate biopsy)
Cancer tests.
Digestive system tests (e.g., endoscopic procedures such as colonoscopy and barium enema)

Reference

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

Chapter 7, “Care of the Woman with Reproductive Health Problems”

“Care of the Woman with Dysmenorrhea” (pp. 366–368)

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)

NURS6521-Rheumatoid Arthritis Dosage

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NURS6521-Rheumatoid Arthritis Dosage

Question 1

A 65-year-old woman has an advanced form of rheumatoid arthritis Her treatment includes a regular dosage of methotrexate The nurse will advise her to take which of the following vitamin supplements while taking the drug?

A) Vitamin A
B) Vitamin B
C) Vitamin C
D) Vitamin D

Question 2

To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should

A) administer calcium supplements.
B) position the patient in the side-lying position.
C) administer carbohydrates.
D) monitor for nausea and vomiting.

Question 3

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics The patient’s care provider has begun treatment with gabapentin (Neurontin) How is the addition of this drug likely to influence the management of the patient’s existing drug regimen?

A) The patient may be required to temporarily hold her other medications until a stable serum level of gabapentin is achieved.
B) It is unlikely to influence the patient’s other medications because gabapentin does not interact with other drugs.
C) Gabapentin is contraindicated with the use of exogenous insulin.
D) The patient’s medication-related risk for renal failure must be assessed prior to the use of gabapentin.

Question 4

A nurse is caring for a patient who has been diagnosed with hypothyroidism Levothyroxine (Synthroid) has been prescribed Before the drug therapy is started, the nurse will assess for which of the following?

A) History of taking anticoagulant drugs
B) Allergy to seafood
C) Hirsutism
D) The patient’s age

Question 5

A nurse is caring for a male patient who has a spinal cord injury due to a motorcycle accident He has been taking dantrolene (Dantrium) for 2 weeks The nurse will monitor which of the following?

A) Prothrombin time and partial thromboplastin time
B) Urine specific gravity
C) Alanine aminotransferase and total bilirubin levels
D) Follicle-stimulating hormone levels

Question 6

A nurse is assessing a patient who has come to the emergency department complaining of back spasms The patient states that he has a history of opioid addiction and does not want to take any drug that “puts me at risk of becoming physically dependent” Which of the following medications would the nurse question, if ordered?

A) Methocarbamol (Robaxin)
B) Orphenadrine (Norflex)
C) Cyclobenzaprine (Flexeril)
D) Metaxalone (Skelaxin)

Rheumatoid Arthritis Dosage

Question 7

A 40-year-old woman with a diagnosis of fibromyalgia has been prescribed cyclobenzaprine (Flexeril) as an adjunct to her existing drug regimen What nursing diagnosis should the nurse prioritize when updating the nursing care plan for this patient?

A) Risk for Injury related to CNS depressant effects
B) Diarrhea related to anticholinergic effects
C) Altered Nutrition, Less than Body Requirements, related to appetite suppression
D) Impaired Swallowing related to increased muscle tone

Question 8

A nurse is working with a 57-year-old man who is a former intravenous drug abuser He has been prescribed a weekly dosage of methotrexate for his rheumatoid arthritis Which of the following will the nurse include in her teaching plan for this patient?

A) Avoid high-fat foods
B) Drink plenty of water every day
C) Take the tablets before bedtime
D) Avoid red meat

Question 9

Following an assessment by her primary care provider, a 70-year-old resident of an assisted living facility has begun taking daily oral doses of levothyroxine Which of the following assessment findings should prompt the nurse to withhold a scheduled dose of levothyroxine?

A) The resident has not eaten breakfast because of a recent loss of appetite
B) The resident’s apical heart rate is 112 beats/minute with a regular rhythm
C) The resident had a fall during the night while transferring from her bed to her bathroom
D) The resident received her annual influenza vaccination the previous day

Question 10

A nurse is caring for a 61-year-old man who has had a severe attack of gout while in the hospital for food poisoning The nurse administers colchicine intravenously in order to

A) avoid aggravating the gastrointestinal tract.
B) ensure quick distribution of the drug.
C) prevent the risk of infection or bleeding.
D) minimize the risk of depressed bone marrow function.

Question 11

A patient receives 25 units of NPH insulin at 7AM At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction?

A) After breakfast
B) Before lunch
C) Late afternoon
D) Bedtime

Question 12

A male patient is to begin glyburide (Diabeta) for type 2 diabetes Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s

A) blood pressure.
B) potassium level.
C) use of alcohol.
D) use of salt in his diet.

Question 13

A male patient with a diagnosis of relapsing-remitting multiple sclerosis is in the clinic to discuss with the nurse the possibility of self-administration of glatiramer During the patient education session for self-administration, the nurse will emphasize

A) the need to rotate the injection site of the drug.
B) the need to avoid crushing the tablet.
C) the need to place the tablet under the tongue.
D) the need to use only the thigh muscle for the drug injection site.

Rheumatoid Arthritis Dosage

Question 14

A diabetic patient being treated for obesity tells the nurse that he is having adverse effects from his drug therapy The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy Which of the following adverse effects would need the nurse’s immediate attention?

A) Decreased libido
B) Increased blood glucose
C) Dry eyes
D) Jittery feeling

Question 15

A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant) What special instructions should the nurse include in the patient teaching for this situation?

A) Wash hands before and after taking the medicine
B) Keep track of any gastrointestinal tract infections
C) Monitor glucose levels closely
D) Note the time the medicine is taken each day

Question 16

A 13-year-old patient has juvenile arthritis He has recently had oral surgery and was told by the surgeon to take aspirin for the pain The nurse will monitor for which of the following?

A) Bronchoconstriction
B) Hepatotoxicity
C) Aplastic anemia
D) Agranulocytosis

Question 17

A nurse has been invited to speak to a support group for persons with movement disorders and their families Which of the following statements by the nurse addresses the chronic nature of these diseases and the relevant drug therapies?

A) “Drug therapy can consist of one or more drugs to eliminate the symptoms of these diseases.”
B) “Drugs do not cure these disorders; they instead enhance quality of life.”
C) “Persons of all cultures are treated similarly and respond in similar ways to treatment.”
D) “Drugs used to treat these disorders always pose a risk of severe liver and kidney dysfunction.”

Question 18

A patient in need of myocardial infarction prophylaxis has been prescribed sulfinpyrazone for gout Which of the following will the nurse monitor the patient most closely for?

A) Hypothermia
B) Hypotension
C) Renal dysfunction
D) Bleeding

Question 19

A nurse is developing a care plan for a patient who has multiple sclerosis An expected outcome for the patient who is receiving glatiramer would be a decrease in

A) chest pain.
B) fatigue.
C) breathing difficulties.
D) heart palpitations.

Rheumatoid Arthritis Dosage

Question 20

A 32-year-old female patient is taking tizanidine (Zanaflex) for spasticity related to her multiple sclerosis The nurse will inform the patient and her husband that the adverse effect that poses the greatest safety risk to the patient is

A) constipation.
B) dry mouth.
C) fatigue.
D) hypotension.

Question 21

A 34-year-old male patient is prescribed methimazole (MMI)The nurse will advise him to report which of the following immediately?

A) Vertigo
B) Intolerance to cold
C) Loss of appetite
D) Epigastric distress

Question 22

A 43-year-old woman was diagnosed with multiple sclerosis 2 years ago and has experienced a recent exacerbation of her symptoms, including muscle spasticity Consequently, she has been prescribed Dantrolene (Dantrium)In light of this new addition to her drug regimen, what teaching point should the woman’s nurse provide?

A) “This will likely relieve your muscle spasms but you’ll probably develop a certain amount of dependence on the drug over time.”
B) “We’ll need to closely monitor your blood sugar levels for the next week.”
C) “There’s a small risk that you might experience some hallucinations in the first few days that you begin taking this drug.”
D) “You might find that this drug exacerbates some of your muscle weakness while it relieves your spasticity.”

Question 23

A patient with type 1 diabetes has been admitted to the hospital for orthopedic surgery and the care team anticipates some disruptions to the patient’s blood glucose levels in the days following surgery Which of the following insulin regimens is most likely to achieve adequate glycemic control?

A) Small doses of long-acting insulin administered four to five times daily
B) Doses of basal insulin twice daily with regular insulin before each meal
C) Large doses of rapid-acting insulin combined with long-acting insulin each morning and evening
D) Divided doses of intermediate-acting insulin every 2 hours, around the clock

Question 24

During long-term desmopressin therapy in a 48-year-old woman, it will be most important for the nurse to assess which of the following?

A) The patient’s environment
B) The patient’s diet
C) The condition of the patient’s skin
D) The condition of the patient’s nasal passages

Question 25

A 49-year-old woman has been diagnosed with myalgia The physician has recommended aspirin The patient is concerned that the aspirin will upset her stomach The nurse will encourage the patient to

A) crush the tablet before swallowing.
B) swallow the tablet whole.
C) swallow the tablet with milk or food.
D) avoid drinking milk for 3 hours after swallowing the tablet.

Question 26

A nurse will instruct a patient taking allopurinol to take each dose

A) at night.
B) first thing in the morning.
C) after a meal.
D) before a meal.

Question 27

The nurse is conducting a medication reconciliation of a new resident of a long-term care facility The nurse notes that the resident takes allopurinol on a daily basis for the treatment of gout What is the primary purpose of this drug?

A) To balance urate concentration and prevent gout attacks
B) To promote the remodeling of damaged synovium
C) To potentiate the metabolism of dietary purines
D) To achieve pain relief in joints affected by gout

Question 28

A nurse is teaching a patient about his newly prescribed drug, colchicine, for gout The nurse will instruct the patient to avoid which of the following foods?

A) Green beans
B) Shrimp
C) Eggs
D) Milk

Question 29

A nurse is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium) The patient is a 38-year-old-male and the foreman for a construction company In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions?

A) Eat a high-protein diet
B) Decrease the dosage if any adverse effect is experienced
C) Wear appropriate clothing and sunscreen whenever he is in direct sunlight
D) Have a complete blood cell count done weekly

Question 30

A 33-year-old man has developed acute gouty arthritis He has been prescribed colchicine When developing a care plan for this patient, which factor will be most important for the nurse to consider?

A) Dietary habits
B) Work environment
C) Typical daily fluid intake
D) Ethnicity

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Functional Family Assessment in Nursing Practice Explained

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Functional Family Assessment in Nursing Practice Explained

Family-Focused Functional Assessment Questionnaire

Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following:

Values/Health Perception
Nutrition
Sleep/Rest
Elimination
Activity/Exercise
Cognitive
Sensory-Perception
Self-Perception
Role Relationship
Sexuality
Coping

Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.

Upon completion of the interview, write a 1000- 1250 word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.

Include the following in your paper:

Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment.
Summarize the overall health behaviors of the family. Describe the current health of the family.
Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified.
Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.

Prepare this assignment according to the APA , NO PLAGIARISM PLEASE

Family Assessment Questions

Interview Question

1. Values, health perception: How healthy is your family? Do you always try to follow doctor’s recommendations when given?
2. Nutrition: Do you read labels for nutrition value? What kind of snacks do you eat?
3. Sleep/Rest: How much sleep do you get a night? Does anyone snore?
4. Elimination: Do you all have normal bowel movements? How often?
5. Activity/Exercise: How much exercise do you get in a typical week? What types of exercise do you do?
6. Cognitive: Do you ever get confused? How are decisions made?
7. Sensory-Perception: How is your eyesight? Is taste a problem?
8. Self-Perception: Do you feel hopeful about the future? What do you think of yourself?
9. Role Relationship: How is your marital relationship? How do you discipline?
10. Sexuality: How often do you have sex? Is there any sexual dysfunction?
11. Coping: What methods do you use to deal with stress? Have there been any prominent stressful events in your life lately?

Family Assessment The family chosen for this assignment are family friends who agreed to conduct the interview and discuss any health issues they had. Because some of the questions were fairly invasive into their private lives, no names are given.

NURS 6630

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NURS 6630

Week 4: Therapy for Patients With Major Depressive Disorder (MDD)

Case Study An African American Child Suffering From Depression NURS 6630

Mood disorders can impact every facet of a human being’s life, making the most basic activities difficult for patients and their families. This was the case for 13-year-old Jeanette, who was struggling at home and at school. For more than 8 years, Jeanette suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues.

As a PNP working with pediatric patients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.

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This week, as you examine antidepressant therapies, you explore the assessment and treatment of three populations: pediatrics, adults, and geriatrics. The focus of your assessment tool, a decision tree, will specifically center on one of the most vulnerable populations, pediatrics. Please remember, you must also consider the ethical and legal implications of these therapies. You will also complete a Quiz on the concepts addressed throughout this module.

Learning Objectives

Students will:

Assess patient factors and history to develop personalized plans of antidepressant therapy across the lifespan
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in pediatric, adult, and geriatric patients requiring antidepressant therapy
Synthesize knowledge of providing care to pediatric, adult, and geriatric patients presenting for antidepressant therapy
Analyze ethical and legal implications related to prescribing antidepressant therapy to patients across the lifespan. Case Study An African American Child Suffering From Depression NURS 6630

Learning Resources

Required Readings (click to expand/reduce)

Baek, J. H., Nierenberg, A. A., & Fava, M. (2016). Pharmacological approaches to treatment-resistant depression. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 44–47). Elsevier.

Fava, M., & Papakostas, G. I. (2016). Antidepressants. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 27–43). Elsevier.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Howland, R. H. (2008a). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 21–24. https://doi.org/10.3928/02793695-20080901-06

Howland, R. H. (2008b). Sequenced Treatment Alternatives to Relieve Depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(10), 21–24. https://doi.org/10.3928/02793695-20081001-05. Case Study An African American Child Suffering From Depression NURS 6630

Lorberg, B., Davico, C., Martsenkovskyi, D., & Vitiello, B. (2019). Principles in using psychotropic medication in children and adolescents. In J. M. Rey & A. Martin (Eds.), IACAPAP e-textbook of child and adolescent mental health. https://iacapap.org/content/uploads/A.7-Psychopharmacology-2019.1.pdf

Case Study An African American Child Suffering From Depression NURS 6630 Magellan Health. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf

Poznanski, E. O., & Mokros, H. B. (1996). Child depression rating scale—Revised. Western Psychological Services.

Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. https://doi.org/10.1002/da.22171

Yasuda, S. U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417–423. https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf

Medication Resources (click to expand/reduce)

IBM Corporation. (2020). IBM Micromedex.

https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments. Case Study An African American Child Suffering From Depression NURS 6630

Review the following medications:

amitriptyline bupropion citalopram clomipramine desipramine desvenlafaxine doxepin duloxetine escitalopram fluoxetine fluvoxamine	imipramine ketamine mirtazapine nortriptyline paroxetine selegiline sertraline trazodone venlafaxine vilazodone vortioxetine

Optional Resources (click to expand/reduce)

El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. https://doi.org/10.1007/s00787-014-0558-3

Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. https://doi.org/10.1111/jpc.12655

Seedat, S. (2014). Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2),

iii–v. https://doi.org/10.2989/17280583.2014.938497

Assignment: Assessing and Treating Pediatric Patients With Mood Disorders

When pediatric patients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders.

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 pediatric patients requiring antidepressant therapy.

The Assignment: 5 pages

Examine Case Study: An African American Child Suffering From Depression. 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.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

Why did you select this decision? Be specific and support 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.

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632).All papers submitted must use this formatting.

Therapy for Pediatric Clients with Mood Disorders
An African American Child Suffering From Depression

BACKGROUND INFORMATION

The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.

Client complained of feeling “sad”
Mother reports that teacher said child is withdrawn from peers in class
Mother notes decreased appetite and occasional periods of irritation
Client reached all developmental landmarks at appropriate ages
Physical exam unremarkable
Laboratory studies WNL
Child referred to psychiatry for evaluation

MENTAL STATUS EXAM

Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.

You administer the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)

RESOURCES

§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.

Decision Point One

Select what you should do:

Begin Zoloft 25 mg orally daily

Begin Paxil 10 mg orally daily

Begin Wellbutrin 75 mg orally BID

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
Click the Week 4 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 4 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
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Module 2: Disorders With Affective Components

As a psychiatric nurse practitioner (PNP), does that research finding surprise you? How do PNPs ensure that effective psychopharmacologic treatments are prescribed to address the prevalence of affective disorders?

Consider for example that current treatments are sub-optimal, resulting in poor patient responses and uncertain modes-of-action (Plant, 2017). While it is no surprise that mental health medicine and clinical approaches are constantly evolving, novel insights into the underlying mechanisms of how affective disorders arise, remain. Additionally, the use of psychopharmacologic treatments may not always be consistent with a patient’s preferred treatment plan. Thus, your skills and understanding of how to assess and treat patients with affective disorders are important in ensuring positive patient outcomes and may also contribute to the research needed to connect clinical observations to the neuroscience, physiology, and pharmacologic processes needed to treat these disorders.

Reference:
Plant, N. (2017). Can a systems approach produce a better understanding of mood disorders? Biochimica et Biophysica Acta, 1861(1), 3335-3344. https://doi.org/10.1016/J.BBAGEN.2016.08.016

What’s Happening This Module?
Module 2, Disorders With Affective Components, is a 6-week module. During Week 4, you will begin applying your assessment and therapy skills as you engage in your first Assignment assessing and treating pediatric patients with mood disorders. In Week 5, you will continue to apply your assessment and therapy skills as you assess and treat patients presenting with bipolar disorders. As you engage with the decision tree exercises, reflect on the critical decision-making skills that you, as a psychiatric nurse practitioner, are making, as these skills are essential to your current and future practice. In Week 6, you will assess and treat patients presenting with anxiety and posttraumatic stress disorder (PTSD). You will also complete your Midterm Exam. During Week 7, you will assess and treat patients presenting with schizophrenia. In Week 8, you will complete a Short Answer Assessment in which you will synthesize your understanding of sleep/wake disorders. You will also continue to apply your assessment and therapy skills as you assess and treat patients presenting with sleep/wake disorders. During Week 9, you will examine psychopharmacologic therapies for patients with ADHD/ODD and you will complete a Quiz to test your understanding of the content explored in this module

Grading Criteria

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Week 4 Assignment Rubric

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Submit your Week 4 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 4

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Week 4 Assignment

Rubric Detail

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Name: NURS_6630_Week4_Assignment_Rubric

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Excellent

Point range: 90–100
Good

Point range: 80–89
Fair

Point range: 70–79
Poor

Point range: 0–69
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.

9 (9%) – 10 (10%)
The response accurately, clearly, and fully summarizes in detail the case for the Assignment.

The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.

8 (8%) – 8 (8%)
The response accurately summarizes the case for the Assignment.

The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.

7 (7%) – 7 (7%)
The response inaccurately or vaguely summarizes the case for the Assignment.

The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.

0 (0%) – 6 (6%)
The response inaccurately and vaguely summarizes the case for the Assignment, or is missing.

The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
Decision #1 (1–2 pages)

• 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.

18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

16 (16%) – 17 (17%)
The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

0 (0%) – 13 (13%)
The response inaccurately and vaguely explains the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.
Decision #2 (1–2 pages)