Assignment:
Search in scholarly sources the similarities and difference between PhD and DNP. Post three similarities and three differences found on your research. Do not forget to include your reference.
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Note: The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.
Select one of the following as the focus for the teaching plan:
Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.
Prepare this assignment according to the guidelines found in the APA Style Guide
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Now that each one of you is very close to completing this major accomplishment in your nursing career, please share your professional development plans to keep up to date in your chosen specialty and nursing in general.
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Assignment 1: Hernandez Family Assessment
Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues. As you examine the Hernandez Family: Sessions 1-6 videos in this week’s Learning Resources, consider how you might assess and treat the client family.
Learning Objectives
Students will:
Assess client families presenting for psychotherapy
To prepare:
Review this week’s Learning Resources and reflect on the insights they provide on family assessment.
View the Hernandez Family: Sessions 1-6 videos, and consider how you might assess the family in the case study.
Note: For guidance on writing a comprehensive client assessment, refer to pages 137–142 of Wheeler (2014) in this week’s Learning Resources.
The Assignment
Address in a comprehensive client assessment of the Hernandez family the following:
Demographic information
Presenting problem
History or present illness
Past psychiatric history
Medical history
Substance use history
Developmental history
Family psychiatric history
Psychosocial history
History of abuse and/or trauma
Review of systems
Physical assessment
Mental status exam
Differential diagnosis
Case formulation
Treatment plan
Note: Any item you are unable to address from the video should be marked “needs to be added to” as you would in an actual comprehensive client assessment
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Adverse Reaction to Depakote
As a nurse working in a skilled nursing facility you will frequently see patients with dementia and Alzheimer’s disease with orders for Depakote also known as valproic acid, to manage their behaviors. I had a resident that was taking Depakote for the diagnosis of dementia with behavioral disturbance. She got into an altercation with her roommate and had to be moved which intensified her behaviors and agitation. The doctor increased her Depakote due to the increased behaviors. The resident’s behaviors improved. Later the resident began to have a decline in condition and we all believed that she was having transient ischemic attacks (TIA). The resident had a history of TIAs. We placed the resident on comfort care and discontinued all of her medications. A short time after discontinuing her medication the resident became more alert and was functioning at her prior level. Her physician believed that her decline was from the Depakote because she had no other new medications or medication changes.
Pharmacokinetics & Pharmacodynamics
Depakote is typically used to treat seizure disorders but can be used as a mood stabilizer. Many providers prefer to use Depakote for behaviors with geriatric population than antipsychotics because of their side effects. Depakote is easily absorbed when taken orally. It is rapidly distributed into plasma, extracellular water, and crosses the blood-brain barrier (Deglin, Vallerand, & Sanoski, 2009, p. 1263). Depakote binds easily to protein which results in low clearance of the medication (Ghodke-Puranik, et al., 2013). Depakote is metabolized in the liver and excreted in the urine. Depakote increases the levels of GABA, an inhibitory neurotransmitter in the CNS which is involved in controlling cortical excitability (Pravat, Krity, & Aroma, 2017). According to Puerta & Ramirez (2015), “Significant reductions in GABA levels have been described in severe cases of AD, which could be underlying the behavioral and psychological symptoms of AD.
Influencing Factor of Adverse Effect to Depakote
This patient may have been having an adverse reaction to Depakote due to impaired hepatic function. As we age the liver’s ability to metabolize many substances decreases (Siddoqui, 2017). The level of Depakote likely built up in this patient’s bloodstream related to impaired ability to metabolize the medication and the kidneys functions also decline as we age so execration may be impaired. What I have learned from this experience is that geriatric patients should have a hepatic function panel and comprehensive metabolic panel before starting to rule out impairment. A valproic acid level should be drawn during the course of treatment periodically to ensure that the medication is not at a toxic level.
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Below is my nursing assignment and this is the Professor’s instruction:
· Please write one paragraph for each question.
· Each question should be one paragraph (no less than 3 sentences and no more than 7 sentences), and well detailed.
· Plagiarized content of your assignment will get you a zero or withdrawal from class.
· Copying all or part of your classmate’s answers will earn you a zero.
· Works cited for each question is required.
· Deadline for submission is Wednesday 28th August 2019 by 6:00pm EST.
QUESTIONS:
1. Discuss one male reproductive system disorder and relate how you would plan and intervene
2. Discuss one diagnosis related to transgender care and how you would plan and intervene
3. Discuss one sexually transmitted disease in men or women and related few possible treatments
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Discussion: Assessing Musculoskeletal Pain
The body is constantly sending signals about its health. One of the most easily recognized signals is pain. Musculoskeletal conditions comprise one of the leading causes of severe long-term pain in patients. The musculoskeletal system is an elaborate system of interconnected levers that provides the body with support and mobility. Because of the interconnectedness of the musculoskeletal system, identifying the causes of pain can be challenging. Accurately interpreting the cause of musculoskeletal pain requires an assessment process informed by patient history and physical exams.
In this Discussion, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.
To prepare:
· By Day 1 of this week, you will be assigned to one of the following specific case studies for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.
· Your Discussion post should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.
Case : Ankle Pain
A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy,
· what foot structures are likely involved?
· What other symptoms need to be explored? What are your differential diagnoses for ankle pain?
· What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?
With regard to the case study you were assigned:
· Review this week’s Learning Resources, and consider the insights they provide about the case study.
· Consider what history would be necessary to collect from the patient in the case study you were assigned.
· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?
· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.
Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources.
Provide evidence from the literature to support diagnostic tests that would be appropriate for each case.
List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each.
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Minimum of 250 words with peer review reference
Identify a clinical prevention intervention to promote health and wellness for a population with which you are familiar. Have these clinical prevention interventions been successful? Why or why not?
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Provide two different examples of how research uses hypothesis testing, and describe the criteria for rejecting the null hypothesis. Discuss why this is important in your practice and with patient interactions.
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Minimum of 250 words with peer review reference
You are the nurse leader on an obstetrics unit. You have been tasked to utilize a Six Sigma approach for standardizing the discharge process. Where do you start?
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