Nursing  W5-Depression Case Study

Replies (if have time for at least one replie today, I appreciate)(Miami Easter time)

 
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Nursing  SOAP NOTE 4/ GASTRO-ESOPHAGEAL REFLUX DISEASE WITHOUT ESOPHAGITIS

Faculty Comments:  Faculty Comments: Points DescriptionSubjective5 Chief complaint stated in patient’s own words.10 HPI, PMH, PSH, Family History, Social Habits,10 Contains all systems relevant information to make assessment with normal and abnormal findings.20 Objective present and contains all pertinent objective information available (drug allergies, physical findings, drug list, etc)20 Assessment presents justification for Main or Primary diagnosis15 Assessment rules out other potential disorders5 Plan contains discussion of therapy options with pros and cons of each. Also10 Plan stated as directives (start, stop, non-pharmacologic and pharmacologic treatment etc)5 Plan include monitoring and follow upComments: please explain the3 differential dignosis in further notes

 
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Nursing  Discussion question due tomorrow at 2:00 pm 150 words min. no plagerism three refrences

The ethos of scientism and postmodernism has exacerbated the perceived philosophical and cultural tension between science and religion. What is your perception of this tension? Use the lecture and the topic readings to support your response

 
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Nursing  Trends in Healthcare Policy

Using a Health Policy Model to Develop a Change in Policy to Improve the Public’s HealthIn a Microsoft Word document of 2-3 pages formatted in APA 7 style, you will focus on the methods to develop a change in policy to improve the public’s health by using a health policy model.Suppose you want to initiate a policy of taxing sugared sodas/pop/beverages in your community. In your paper, address each of the following criteria:Use the Longest’s policy cycle model to structure your proposed policy.What arguments would you use to make the case for the policy?What argument(s) would your opponents make?How would you go about getting buy-in for your proposed policy?What stakeholder groups need to be involved in promoting your policy?Include a ConclusionOn a separate references page, cite all sources using APA 7 format.Please note that the title and reference pages should not be included in the total page count of your paper.

 
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Nursing  Literature Review

Take a moment to review the details of this assignment below and gather any necessary files. Once you’re ready to submit your assignment, move on to Step 2.Assessment DescriptionThe purpose of this assignment is to prove that the research support for the proposed solution is sufficient, compelling, relevant and from peer-reviewed professional journal articles. You will gather a minimum of 12 current, peer-reviewed journal articles based on your topic. They must be newer than 5 years old. Complete the attached summary template for each article. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention should be summarized in this table.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 LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

 
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Nursing  Research article

Select a research article, other than the articles from your assignments, from the GCU library. Provide an overview of the study and describe the strategy that was used to select the sample from the population. Evaluate the effectiveness of the sampling method selected. Provide support for your answer. Include the article title and permalink in your post.One paragraph required with one reference

 
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Nursing  Discuss the difference between research utilization and evidence based practice

250 word minimum, APA FORMAT, 1 scholarly reference

 
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Nursing  Leadership Health Care Organizations Practicum

Topic: Servant Leadership From a Christian Perspective: In the Real WorldLeadership Journal: HumilityJournaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.Unlike a personal journal of thoughts and feelings, this Leadership Journal is a record of your activities, assessments, and learning related to this academic experience.Journal entries should include a record of the number of hours spent with your nurse leader each week.Write a journal entry of 750-1,500 words on the subject of humility, including the following:1. Provide observations and thoughts on the activities in Weeks 13-14.2. Describe an interaction or decision point this semester in which your nurse leader demonstrated humility or a missed opportunity to promote the success of others.3. Summarize your practicum experience with your nurse leader. What insight into your own leadership style were you able to see? What do you believe was the most important thing you learned in this experience?4. Utilizing servant leadership principles, outline a plan to improve your own success as a leader. Identify specific steps you plan to take to create this improvement.5. Reflect on at least two things you learned from the “Issue of Humility” video

 
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Nursing  Advanced Pharmacology

DISCUSSION 1TO.Disorder: DepressionI chose to complete the scenario on a 70-year-old male presenting with symptoms of depression.Background information:70-year-old Hispanic maleDeath of mother at a young ageOccasional back pain & stiff shouldersInsomniaPoor concentrationMontgomery Asberg Depression Rating Scale 51 I indicates (severe depression).I would not prescribe phenelzine 15mg TID because it’s an MAOI and could interact with common tyramine foods such as processed meats, cheese, & avocado commonly found in the diet of Hispanic people.Common barriers to treatment of depression in Hispanics include lack of information about mental health services, fewer linguistically & culturally trained providers representative of the Hispanic community (Camacho et al.,2018).SSRIs are the first-line treatment for major depression (McCance & Huether, 2019).I chose to treat the patient with an SNRI (Venlafaxine). I believe it would benefit the patient by treating his to major depression & chronic pain. Other benefits of Venlafaxine include it is deemed to have fewer side effects, is safe in older adults, and has fewer drug interactions.Venlafaxine (Effexor) can be used to treat major depression & chronic pain (McCance & Huether, 2019).I decided to start the patient on Effexor (Venlafaxine) 37.5mg 1 PO QD.Pathophysiology of Venlafaxine: Venlafaxine was found to be effective in managing depression by blocking Norepinephrine and serotonin reuptake. It also has weak blocking of dopamine reuptake (McCance & Huether, 2019).As a result of this, the patient returns in 4wks with no change in depressive symptoms. I later decided to increase the dose to 75mg PO QD. A second Montgomery Depression screening was completed, the patient scored a 38.Next, the Client returns to the clinic in 4wks,reports improvement of depressive symptoms.Rosenthal & Burchum (2021) explain a clinician has the following options if the first dose is ineffective: increase the dose of the first drug, switch to another drug in the same class, switch to another drug in a different class, or add an atypical antidepressant as a second drug.To prevent a relapse, I would continue the therapy for 4 to 9 mos.  I would educate the patient on continuing therapy even if there are no symptoms. I would encourage the patient to attend Behavioral Health counseling and include his family members in his plan of care. Camacho et al. (2018) suggest recruiting a bilingual psychotherapist to help promote a welcoming & safe environment for a patient to express emotions. Frequent monitoring of the patient would be necessary, to observe for s/s of suicidal ideation.References:Camacho, D., Estrada, E., Lagomasino, I. T., Aranda, M. P., & Green, J. (2018). Descriptions of depression and depression treatment in older Hispanic immigrants in a geriatric collaborative care program. Aging & Mental Health, 22(8), 1056–1062. https://doi-org.ezp.waldenulibrary.org/10.1080/13607863.2017.1332159McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s pharmacotherapeutics for advanced practice nurses and physician assistants (2nd ed.) St. Louis, MO: Elsevier.DISCUSSION 2L.The psychological disorder that was presented in my presentation was bipolar I disorder. A female of Korean decent presented with bipolar disorder in a manic state. She had been recently hospitalized and discharged on lithium for mania. Prior to her follow up in the clinic the patient had decided to discontinue the medication on her own which had exacerbated her condition. When presenting to the clinic, she was labile and euphoric. I had made the decision to start her on Risperdal 1 mg orally BID. After this decision point, she returned to the clinic accompanied by her mother and was very sedated and lethargic. The mother had stated that she had been like this for about a week after her left office visit. Though I was happy that she continued to take her medication and it was obviously controlling some of her symptoms, that obviously had been too strong of a dosage. This is most likely because of her CYP2D6*10 allele from her Korean descent, simply her genetics which led her course of treatment following differently. At the second office visit, I had decided to decrease the Risperdal to 1 mg at HS With another follow-up visit in four weeks again. When the client had returned, she was much less sedated, and showing symptoms of improvement. Her young mania rating scale had been priest from 22 for 16, which was a 25% decrease in her presenting symptoms. At this point I had advised the patient to continue the same dose of Risperdal and reassess again in another 4 weeks. I wanted to see how the patient would respond while on this same dose of Risperdal as the CYP2D6*10 allele gives her a slower clearance of Risperdal from her system which is most likely what had resulted in higher than normal levels of sedation. Puangpetch et. al. 2016 states that CYP2D6 is associated with plasma concentrations of risperidone as it is a poor metabolizer and showed more serious adverse events than those without this allele. This is why the patient’s symptoms while on this medication were of that extreme for a relatively low dose especially to start with. Vuppalaanchi also states that the metabolism of risperidone specifically is again by CYP2d6 and is also is responsible for up to 20% of drugs that undergo biotransformation and is a poor metabolizer.ReferencesBipolar Therapy. (2020). http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_04/index.htmlPuangpetch, A., Vanwong, N., Nuntamool, N., Hongkaew, Y., Chamnanphon, M., & Sukasem, C. (2016). CYP2D6 polymorphisms and their influence on risperidone treatment. Pharmacogenomics and personalized medicine, 9, 131–147. https://doi.org/10.2147/PGPM.S107772Vuppalanchi, R. (2011). Metabolism of Drugs and Xenobiotics. Retrieved from https://doi.org/10.1016/B978-0-443-06803-4.00004-6

 
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Nursing  Nursing Termpaper outline and class discussion (APA format and zero plagiarism).

(A)This is part 1 of your required term paper. In this part, you are to choose a topic as your focus. Choose a topic that will incorporate 3-4 of the concepts discussed within this course (such as ethics, leadership, communication, and quality) and write a short 50 word or less summary of what you plan to address. Then, develop an outline of information that you plan to include (Refer to the Outline Template and Grading Rubric). The provided outline template can be downloaded, and your information inserted into the outline. (see Outline Templates and Grading rubric attached below). Be sure to remove any wording that is not pertinent to your own work.Topics to Choose from:1.Healthy Work Environment; how methods to resolve conflicts in the workplace are developed. How might patient care be affected when conflicts are present among nursing staff?2. Emergency preparedness and response; how it relates to an emergency health threat such as a bioterrorism incident or the current CPVID-19 pandemic. How might patient care be affected, and policies and procedures changed?3. Latent Errors: discuss the factors that may lead to latent errors involving nurses. How might patient care be affected?(B)In this discussion forum, you assigned the responsibility of examining the Self-Care Deficit Theory of Dorothea Orem. Please apply Orem’s theory to the case scenario provided below. In your discussion, include the role of the nurse in providing care to this patient and appropriate interventions to be used to help him meet his needs. Be sure to provide a rationale for your actions/interventions.Case Scenario:George is a 70-year-old patient who has been assigned to you as his community-based nurse case manager. George has severe congestive heart failure, peripheral vascular disease, and no family or social support. George had 15 admissions to the hospital and 35 visits to the emergency department this year from noncompliance with his medication and diet regimen. He receives a monthly social security check, which he spends on food, bingo, and medications (in that order)Please refer to the Discussion Board rubric when writing your post. See attached below.

 
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