From my experience and observation as a mental health nurse, I remember a 20-year-old male patient who was admitted to my facility with a diagnosis of schizophrenia, self-harming behaviors, and substance abuse. This patient had a long history of using fentanyl, methamphetamine, and street drugs like Mexican Percocet’s. He has been admitted numerous times to our facility for substance abuse detox. This patient had been on several dosages of Clozapine which was prescribed by the provider to help with his acute case of mental illness. A week after starting his initial Clozapine medication, this patient was complaining of discomfort, chest pain and will explain to the staff that his pain was getting worse daily. The physician ordered EKG to check the activity of his heart.

Pharmacodynamics

Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Clozapine also binds to D1, D3, and D5 receptors, and has a high affinity for the D4 receptor (McEvoy, 2018). Researchers shows that it includes the limbic system.

Pharmacokinetics

              Clozapine is absorbed quickly, first-pass metabolism reduces its bioavailability to 60 to 70 percent of the administered dose; food has little effect on the bioavailability of clozapine (Patuszynski & Applegate, 2017). The eliminated half-life of clozapine averages a period of 14 hours under certain conditions, but there is considerable variability across individuals. For example, it depends on each individual own metabolism and its underlying factors (McEvoy, 2018).

Care plan

Because clozapine has an increased incidence of clozapine-induced myocarditis as well as cardiomyopathy. Patients who are currently taking clozapine will need to be monitored closely by a cardiologist. Staff must educate the patient regarding the risk that are involved with this medication. “We need to understand that there should be standardized and mandatory plans of care which should include troponin levels as well as EKGs and echocardiograms at various times during inpatient stays” (Kir et al., 2020).  “Other factors to consider would be airway clearance due to excessive salvation and neutropenia” (Okada et al., 2020). Careful patient monitoring is essential when taking clozapine therapy. It is important to educate patient to keep to their lab appointments where they could monitor blood levels.

References

 Kır, Y., Baskak, B., Kuşman, A., Sayar-Akaslan, D., Özdemir, F., Sedes-Baskak, N., Süzen, H.

S., & Baran, Z. (2020). The relationship between plasma levels of clozapine and N-desmethyclozapine as well as M1 receptor polymorphism with cognitive functioning and associated cortical activity in schizophrenia. Psychiatry Research: Neuroimaging, 303. 

Okada, T., Kumakura, J., Yasuda, M., & Suda, S. (2020). Treatment-resistant schizophrenia

successfully maintained with brexpiprazole following abrupt withdrawal of clozapine due to neutropenia. Asian Journal of Psychiatry, 47. 

Patuszynski, D., & Applegate, P. M. (2017). Suspected Clozapine-Induced Cardiomyopathy and

Heart Failure With Reduced Ejection Fraction. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 34(4), 20–22.

Read chapters 25 of the class textbook and review the PowerPoint presentations located in the PowerPoint folder. Once done answer the following questions.   

1. Mention and discuss the role of nursing in occupational health

2. Describe and discuss the four types of exposures and hazards in the work place

APA style (intext citations and references)

Plagiarism FREE

 A minimum of 3 evidence-based references no older than 5 years must be used 

800 words

 

1) Minimum 9 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)  Can  write in the first person 

              Part 1: Minimum 3 pages

              Part 2: minimum 3 pages

              Part 3: minimum 3 pages

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Can write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

     

    Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 4 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Community nursing (Reflection)

Purpose :

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the course.  

 

Organization:

a. Introduction

b. Course Reflection 

c. Conclusion

Include (Mendatory):

  

1. “Demonstrate basic knowledge of healthcare policy, finance, and regulatory environments, including local, state, national, and global healthcare trends.

2. Describe how health care is organized and financed, including the implications of business principles, such as patient and system cost factors.

3. Compare the benefits and limitations of the major forms of reimbursement on the delivery of healthcare services.

4. Examine legislative and regulatory processes relevant to the provision of health care.

5.  Cultural Competence: Awareness, Sensitivity, and Respect  

6.   Care Management, Case Management, and Home Healthcare 

7.  Community Preparedness: Disaster and Terrorism 

 

Part 2: Complementary and alternativge health care (Course reflection)

Pupose:

 The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the course.  

 Organization:

a. Introduction

b. Course Reflection 

c. Conclusion

Include (mandatory):

1.  Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions and describe the process of changing current practice.

2. Promote factors that create a culture of safety and caring. 

3. Promote achievement of safe and quality outcomes of care for diverse populations. 

4. Apply quality improvement processes to effectively implement patient safety initiatives and  monitor performance measures, including nurse-sensitive indicators in the microsystem of care.  

5.  Define complementary and alternative practices as identified by current health paradigms. 

6. Discuss history for complementary and alternative medicine. 

7. Given case studies, describe the extent to which complementary and alternative health practices are encouraged and used among multiple cultures.   

Part 3: Crisis intervention (Course reflection)

Pupose:

 The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the course.  

 Organization:

a. Introduction

b. Course Reflection 

c. Conclusion

Include (mandatory):

  

1. “Integrate theories and concepts from liberal education into nursing practice.

2. Synthesize theories and concepts from liberal education to build an understanding of the human experience. 

3. Use skills of inquiry, analysis, and information literacy to address practice issues.

4. Use written, verbal, non­verbal, and emerging technology methods to communicate effectively.

5.  Crisis of Lethality 

6.  The Intervention and Assessment Models  

7.  Telephone and Online Crisis Counseling 

 

1) Minimum 9 full pages (Follow the 3 x 3 rule: minimum three paragraphs per part)

 

Parts 3, 4 and 5 must be different. Different writing and perspective, but always answering questions objectively

              Part 1: Minimum 3 pages

              Part 2: minimum 3 pages

              Part 3: minimum 1 page

              Part 4: Minimum 1 page

              Part 5: minimum 1 page

Submit 1 document per part

2)¨******APA norms

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

    Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 3 references per part not older than 5 years

   Part 1 and 2: Minimum 4 references not older than 5 years

5) Identify your answer with the numbers, according to the question. Start your answer on the same line, not the next

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Ethical and Nursing (Course reflection)

Purpose :

  

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the course.  

Organization:

a. Introduction

b. Course Reflection 

c. Conclusion

Include (Mendatory):

  

1. Identify the different legal and ethical aspects in the nursing practice (ACCN Essential V; QSEN: patient-centered care, teamwork and collaboration).

2. Analyze the legal impact of the different ethical decisions in the nursing practice (ACCN Essential V; QSEN: patient- centered care, teamwork and collaboration).

3. Understand the essential of the nursing law and ethics (ACCN Essential V; QSEN: patient-centered care, teamwork and collaboration).

4. Promote the image of nursing by modeling the values and articulating the knowledge, skills, and attitudes of the nursing profession.

5. Demonstrate professionalism, including attention to appearance, demeanor, respect for self and others, and attention to professional boundaries with patients and families as well as among caregivers.

6. Demonstrate an appreciation of the history of and contemporary issues in nursing and their impact on current nursing practice.

7. Reflect on one’s own beliefs and values as they relate to professional practice.

8. Identify personal, professional, and environmental risks that impact personal and professional choices, and behaviors 

Part 2: Nursing and aging (Course reflection)

Purpose :

  

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the course.  

Organization:

a. Introduction

b. Course Reflection 

c. Conclusion

Include (Mendatory):

1. The students will identify the physiological process of aging. 

2. The students will be able to differentiate the adaptative human response to the aging process. 

3. The student will be able to manage and care older adults and their families.  

4.. Implement holistic, patient centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health illness continuum, across the lifespan, and in all healthcare settings. 

5. Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network. 

6. Deliver compassionate, patient centered, evidence-based care that respects patient and family preferences.  

Parts 3, 4 and 5 must be different. Different writing and perspective, but always answering questions objectively

Part 3: Health care policy 1

1. Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? 

2. Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays. 

Part 4: Health care policy 2

1. Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? 

2. Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays. 

Part 5: Health care policy 3

1. Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? 

2. Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays. 

Discuss the correlation between nursing education and positive patient outcomes. Include current research that links patient safety outcomes to advanced degrees in nursing. Based on some real-life experiences, explain whether you agree or disagree with this research.

Wednesday 9