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NR 360 CCN Nursing Informatics of Professional Nursing Practices Discussion
Discuss ways that nursing informatics could be applied to all areas of professional nursing practice, including clinical p ...
NR 360 CCN Nursing Informatics of Professional Nursing Practices Discussion
Discuss ways that nursing informatics could be applied to all areas of professional nursing practice, including clinical practice, administration, education, and research. Provide examples of each. What do you see as the biggest significance of nursing informatics, and why?Book: (If needed) McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett.
Pakistani Woman with Delusional Thought Processes Case Study Analysis
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concernin ...
Pakistani Woman with Delusional Thought Processes Case Study Analysis
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamics processes. At each decision point stop to complete the following: Decision #1 Which decision did you select? Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Note: Support your rationale with a minimum of five or more academic resources. Delusional Disorders Pakistani Female with Delusional Thought Processes BACKGROUND The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month. Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit. During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so. She currently weighs 140 lbs, and is 5’ 5” SUBJECTIVE Client reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down. You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman. MENTAL STATUS EXAM The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation. The PMHNP administers the PANSS which reveals the following scores: -40 for the positive symptoms scale -20 for the negative symptom scale -60 for general psychopathology scale Diagnosis: Schizophrenia, paranoid type RESOURCES § Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. § Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems... § Paz, Z., Nalls, M. & Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal. 13. 625-629. Decision Point One Start Zyprexa (olanzapine) 10 mg po orally at BEDTIME RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Client's PANSS decreases to a partial response (25%) Client comes in today with a reported weight gain of 5 pounds. When questioned further on this point, she states that she can never seem to get full from her meals so she is snacking constantly throughout the day. Decision Point Two Decrease Zyprexa to 7.5 mg BEDTIME RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Patient worsens. Her PANNS increases by 10% (negative symptoms are getting worse) but weight becomes stabilized and excessive hunger abates Husband explains that she is becoming less manageable at home and he is having to take time off from work because he is fearful of leaving her alone Decision Point Three Increase Zyprexa 10 MG orally at BEDTIME Guidance to Student Weight gain is a significant problem with Zyprexa. Next to Clozaril (clozapine), Zyprexa causes the most weight gain of all the atypical antipsychotics. This is a side effect that a significant number of clients will experience. There also appears to be an increased association of newly diagnosed diabetes mellitus in clients treated with Zyprexa. Although this can be disease related in this population, Zyprexa is above what would be considered coincidental. Risperdal is a good option, although it is dosed twice daily and compliance in this population can be problematic. There is evidence that shows giving Risperdal all at once can be efficacious and therefore could be an option down the road should compliance become an issue. Weight gain is also possible with Risperdal, but it is not as great as that seen with Zyprexa. If compliance does become an issue with this client, Risperdal has a long-acting injectable formulation, Risperdal Consta, that could be used. Remember, Risperdal Consta has to be given every 2 weeks at the provider’s office, and therapeutic blood levels take time to achieve (on average 3–6 weeks or 2–3 injections). Oral overlapping therapy is required to bridge this period of time. Another option in someone who responds to Risperdal would be Invega Sustenna (paliperidone palmitate), which is the first metabolite of Risperdal and has greater activity at the D2 receptor than Risperdal. An advantage of Invega Sustenna over Risperdal Consta is that therapeutic blood levels are attained within the first 4–7 days, and overlapping oral therapy is usually not necessary. A disadvantage is that during the initiating phase of medication, the first two doses need to be given within 4–7 days of one another. This is followed by monthly injections. There is another product on the market called Invega Trinza, which is given once every 3 months. This product is for clients who have been stabilized on Invega Sustenna for at least 4 months where the last two doses were the same strength (two months of 156 mg injections). Increasing Zyprexa to 15 mg at bedtime will only worsen the weight gain side effect. While additional benefits from increasing the dose may be possible from an efficacy standpoint, side effects always need to be taken into consideration. “First, do no harm.” Qsymia is a weight loss medication that is a combination of phentermine and topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable, and weight gain is not one of those scenarios. Secondly, phentermine has a lot of cardiovascular toxicities (such as elevated BP, HR, and increased workload on the heart).
BIB350 GCU Outline the Major Points of Numbers Chapter 11 to 20 Paper
Part of the exegetical task is not simply reading and interpreting texts, but also teaching and applying texts. Ma ...
BIB350 GCU Outline the Major Points of Numbers Chapter 11 to 20 Paper
Part of the exegetical task is not simply reading and interpreting texts, but also teaching and applying texts. Make an outline of a teaching session for a Bible study. Outline the major points of Numbers chapter 11-20 and note the following:
Examine Visual Information Processing
Write a 1,200- to 1,500-word paper in which you examine visual
information processing.Address the following in your pape ...
Examine Visual Information Processing
Write a 1,200- to 1,500-word paper in which you examine visual
information processing.Address the following in your paper:
Describe visual information processing.Explain two conditions that impair visual information processing.Discuss current trends in the research of visual
information processing and how they advance understanding of visual
information processing.Include at least two scholarly articles.
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Socw6311 Responses
Identify the stage or stages of the program to which your colleague’s selected question The program you discussed was an ...
Socw6311 Responses
Identify the stage or stages of the program to which your colleague’s selected question The program you discussed was an early intervention program ...
University of Maryland Global Campus Mona Lisa Artwork Discussion
Describe a favorite work of visual art and include a picture of it in your post. Your selection may come from the entire r ...
University of Maryland Global Campus Mona Lisa Artwork Discussion
Describe a favorite work of visual art and include a picture of it in your post. Your selection may come from the entire range of visual arts, anything from a famous painting in a museum to an iconic architectural masterpiece to a handmade basket or an especially well-designed object. The only restriction is that you need to have seen the actual work of art, rather than a photo or online image. Describe the medium it represents within the scope of visual arts. Tell us about its maker or designer. What year is it from? Where is it located? What was its intended function? What is its significance to you? Does this particular piece help you understand something about reality or is it intended to be more of an illusion pointing to something we don't really quite understand, like a shadow on the wall of the cave as in the Allegory of the Cave we looked at last week?Use at least two of the vocabulary, concepts or techniques from the Learning Resources or the module to say something more about this piece of art. Underline or bold the vocabulary, concept or technique you use as a interpretative tool in your post
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NR 360 CCN Nursing Informatics of Professional Nursing Practices Discussion
Discuss ways that nursing informatics could be applied to all areas of professional nursing practice, including clinical p ...
NR 360 CCN Nursing Informatics of Professional Nursing Practices Discussion
Discuss ways that nursing informatics could be applied to all areas of professional nursing practice, including clinical practice, administration, education, and research. Provide examples of each. What do you see as the biggest significance of nursing informatics, and why?Book: (If needed) McGonigle, D. & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett.
Pakistani Woman with Delusional Thought Processes Case Study Analysis
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concernin ...
Pakistani Woman with Delusional Thought Processes Case Study Analysis
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamics processes. At each decision point stop to complete the following: Decision #1 Which decision did you select? Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Note: Support your rationale with a minimum of five or more academic resources. Delusional Disorders Pakistani Female with Delusional Thought Processes BACKGROUND The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month. Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit. During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so. She currently weighs 140 lbs, and is 5’ 5” SUBJECTIVE Client reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down. You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman. MENTAL STATUS EXAM The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation. The PMHNP administers the PANSS which reveals the following scores: -40 for the positive symptoms scale -20 for the negative symptom scale -60 for general psychopathology scale Diagnosis: Schizophrenia, paranoid type RESOURCES § Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. § Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems... § Paz, Z., Nalls, M. & Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal. 13. 625-629. Decision Point One Start Zyprexa (olanzapine) 10 mg po orally at BEDTIME RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Client's PANSS decreases to a partial response (25%) Client comes in today with a reported weight gain of 5 pounds. When questioned further on this point, she states that she can never seem to get full from her meals so she is snacking constantly throughout the day. Decision Point Two Decrease Zyprexa to 7.5 mg BEDTIME RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Patient worsens. Her PANNS increases by 10% (negative symptoms are getting worse) but weight becomes stabilized and excessive hunger abates Husband explains that she is becoming less manageable at home and he is having to take time off from work because he is fearful of leaving her alone Decision Point Three Increase Zyprexa 10 MG orally at BEDTIME Guidance to Student Weight gain is a significant problem with Zyprexa. Next to Clozaril (clozapine), Zyprexa causes the most weight gain of all the atypical antipsychotics. This is a side effect that a significant number of clients will experience. There also appears to be an increased association of newly diagnosed diabetes mellitus in clients treated with Zyprexa. Although this can be disease related in this population, Zyprexa is above what would be considered coincidental. Risperdal is a good option, although it is dosed twice daily and compliance in this population can be problematic. There is evidence that shows giving Risperdal all at once can be efficacious and therefore could be an option down the road should compliance become an issue. Weight gain is also possible with Risperdal, but it is not as great as that seen with Zyprexa. If compliance does become an issue with this client, Risperdal has a long-acting injectable formulation, Risperdal Consta, that could be used. Remember, Risperdal Consta has to be given every 2 weeks at the provider’s office, and therapeutic blood levels take time to achieve (on average 3–6 weeks or 2–3 injections). Oral overlapping therapy is required to bridge this period of time. Another option in someone who responds to Risperdal would be Invega Sustenna (paliperidone palmitate), which is the first metabolite of Risperdal and has greater activity at the D2 receptor than Risperdal. An advantage of Invega Sustenna over Risperdal Consta is that therapeutic blood levels are attained within the first 4–7 days, and overlapping oral therapy is usually not necessary. A disadvantage is that during the initiating phase of medication, the first two doses need to be given within 4–7 days of one another. This is followed by monthly injections. There is another product on the market called Invega Trinza, which is given once every 3 months. This product is for clients who have been stabilized on Invega Sustenna for at least 4 months where the last two doses were the same strength (two months of 156 mg injections). Increasing Zyprexa to 15 mg at bedtime will only worsen the weight gain side effect. While additional benefits from increasing the dose may be possible from an efficacy standpoint, side effects always need to be taken into consideration. “First, do no harm.” Qsymia is a weight loss medication that is a combination of phentermine and topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable, and weight gain is not one of those scenarios. Secondly, phentermine has a lot of cardiovascular toxicities (such as elevated BP, HR, and increased workload on the heart).
BIB350 GCU Outline the Major Points of Numbers Chapter 11 to 20 Paper
Part of the exegetical task is not simply reading and interpreting texts, but also teaching and applying texts. Ma ...
BIB350 GCU Outline the Major Points of Numbers Chapter 11 to 20 Paper
Part of the exegetical task is not simply reading and interpreting texts, but also teaching and applying texts. Make an outline of a teaching session for a Bible study. Outline the major points of Numbers chapter 11-20 and note the following:
Examine Visual Information Processing
Write a 1,200- to 1,500-word paper in which you examine visual
information processing.Address the following in your pape ...
Examine Visual Information Processing
Write a 1,200- to 1,500-word paper in which you examine visual
information processing.Address the following in your paper:
Describe visual information processing.Explain two conditions that impair visual information processing.Discuss current trends in the research of visual
information processing and how they advance understanding of visual
information processing.Include at least two scholarly articles.
4 pages
Socw6311 Responses
Identify the stage or stages of the program to which your colleague’s selected question The program you discussed was an ...
Socw6311 Responses
Identify the stage or stages of the program to which your colleague’s selected question The program you discussed was an early intervention program ...
University of Maryland Global Campus Mona Lisa Artwork Discussion
Describe a favorite work of visual art and include a picture of it in your post. Your selection may come from the entire r ...
University of Maryland Global Campus Mona Lisa Artwork Discussion
Describe a favorite work of visual art and include a picture of it in your post. Your selection may come from the entire range of visual arts, anything from a famous painting in a museum to an iconic architectural masterpiece to a handmade basket or an especially well-designed object. The only restriction is that you need to have seen the actual work of art, rather than a photo or online image. Describe the medium it represents within the scope of visual arts. Tell us about its maker or designer. What year is it from? Where is it located? What was its intended function? What is its significance to you? Does this particular piece help you understand something about reality or is it intended to be more of an illusion pointing to something we don't really quite understand, like a shadow on the wall of the cave as in the Allegory of the Cave we looked at last week?Use at least two of the vocabulary, concepts or techniques from the Learning Resources or the module to say something more about this piece of art. Underline or bold the vocabulary, concept or technique you use as a interpretative tool in your post
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