What were the most important concepts you learned in week 1? Why are these concepts important? How will they prepare you for your future role as a nurse practitioner? In what ways do you feel prepared for your new role? In what ways do you feel unprepared?
UTI(Urinary tract infection)
due 9-12-23 @10am
Discuss the elements of informed consent. Provide a clinical example about what can happen when some elements are not adhered to.
Advanced Psychopharmacology and Health Promotion
Unit 7 Discussion
Peer Response. Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-20-23.
Instructions:
Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:
· Compare and contrast your initial posting with those of your peers.
· How are they similar or how are they different?
· What information can you add that would help support the responses of your peers?
· Ask your peers a question for clarification about their post.
· What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
JS1
Which antipsychotics are considered first-generation, and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?
The first-generation antipsychotic (FGA) medications include chlorpromazine, fluphenazine, droperidol, loxapine, haloperidol, pimozide, perphenazine, thioridazine, prochlorperazine, thiothixene, and trifluoperazine. FGA drugs exert their therapeutic effects by antagonizing dopamine (D2) receptors, specifically addressing the positive symptoms associated with schizophrenia. According to Chokhawala & Stevens, 2023), first-generation antipsychotics are considerably more likely to elicit extrapyramidal movements (i.e., tardive dyskinesia) than second-generation and are thus used less commonly. Second-generation antipsychotic (SGA) medicines have antagonistic effects on the D2 receptor but are often called serotonin-dopamine antagonists. There is also some evidence to suggest that antipsychotics of the second generation provide better symptom management than those of the first generation (Chokhawala & Stevens, 2023). The efficacy of second-generation antipsychotics in addressing the negative symptoms of schizophrenia surpasses that of first-generation antipsychotics, while also demonstrating use in managing the positive symptoms of the disorder.
Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.
Tardive dyskinesia (TD) is a collection of involuntary, repeated movements resulting from disrupting or blocking dopamine receptors. Involuntary motions may range from akathisia and dystonia to buccolingual stereotypy and myoclonus to chorea and tics (Paudel et al., 2023). There is currently no therapy available for TD. However, there are a variety of therapy methods available for reducing symptoms. While other drugs may also contribute to TD, conventional antipsychotics are the most common culprits. Paudel et al. (2023) provide a cautious estimate that around 5% of individuals experience TD annually when on conventional antipsychotics. Statistically speaking, older people have a far greater incidence rate.
Tardive dyskinesia, athetosis, acute dystonia, and tics are all instances of involuntary movements, as stated by Paudel et al. (2023). Repetitive muscular contractions, known as tics, often affect only one part of the body and are sometimes suppressed. Acute dystonia is characterized by sustained, repeated muscular contractions typically triggered by an intentional activity. Slow, writhing motions are characteristic of athetosis, often affecting the arms and hands.
References
Chokhawala, K., & Stevens, L. (2023). Antipsychotic medications. In StatPearls [Internet]. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK519503
Links to an external site.
Paudel, S., Donovan, A. L., Petriceks, A., Vyas, C. M., Van Alphen, M. U., & Stern, T. A. (2023). Drug-Induced Abnormal Involuntary Movements: Prevalence and Treatment. The Primary Care Companion for CNS Disorders, 25(3), 47041.
https://www.psychiatrist.com/pcc/effects/drug-induced-abnormal-involuntary-movements-prevalence-and-treatment/
Links to an external site.
SY-2
Which antipsychotics are considered first-generation and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?
Both first-generation antipsychotics and second-generation antipsychotics are used for the treatment of psychiatric disorders such as schizophrenia. First-generation antipsychotics, also known as typical antipsychotics, such as phenothiazines (perphenazine, prochlorperazine), and butyrophenones (haloperidol) are classified by their chemical structure (Chokhawala, 2023). Whereas second-generation antipsychotics also known as atypical antipsychotics such as risperidone, olanzapine, quetiapine, aripiprazole, and clozapine are classified based on pharmacological proprieties (Chokhawala, 2023).
First-generation antipsychotics tend to be used less often than second-generation antipsychotics due to their long list of adverse effects that include extrapyramidal side effects, anticholinergic side effects (dry mouth, urinary retention, constipation), prolonged QT intervals, sedation, as well as the rare but fatal neuroleptic malignancy syndrome (Chokhawala, 2023). In comparison, second-generation antipsychotics have a decreased risk of extrapyramidal side effects but are associated with weight gain and metabolic syndrome, therefore patients should be monitored for diabetes, dyslipidemia, and weight gain (Chokhawala, 2023). Although second-generation antipsychotics tend to be the drug of choice when it comes to treating psychiatric disorders, and this is mainly due to the less severe side effects, this does not necessarily indicate that it is more effective. A study done by Fabrazzo et al. (2022) showed that second-generation antipsychotics showed no clear evidence of their effectiveness on cognitive deficit, however, it did prove to be more effective than first-generation antipsychotics in treating negative symptoms, relapse-free survival, and hospitalization rate.
Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.
Tardive Dyskinesia
(TD) is a disorder characterized by repetitive movement such as facial and tongue movement, tongue protrusion, facial grimacing, chewing, and quick, jerking limb movements. These movements are involuntary and can range in severity (slight tremor to full body movement) thus, making daily function difficult. Its main cause is long-term use of antipsychotics, and this disorder tends to be irreversible (Bergman & Soares-Weiser, 2018).
Acute Dystonia is a neurological symptom characterized by muscle contractions that cause repetitive movements by arms, legs, neck, face, or abnormal posture (Stahl, 2022). The cause of this reaction is due to a dopaminergic-cholinergic imbalance in the basal ganglia (Lewis, 2023). Early intervention can prevent the onset and development of dystonia and neurological damage and treatments include benzodiazepines, baclofen, muscle relaxants, and dopamine depletes (VMAT-2 inhibitors) (Bledsoe et al., 2020).
Akathisia and Tics syndromes are seen in patients treated with D2 blockers and are characterized by inner restlessness and mental unease (Stahl, 2022). Akathisia is a neuropsychiatric syndrome characterized by the inability to remain still and it typically involves the lower extremity (Patel, 2023). Tics on the other hand such as Tourette syndrome are neurodevelopmental disorders characterized by motions, noise, and words and are involuntary (Jones, 2023).
References
Bergman, H., & Soares-Weiser, K. (2018). Anticholinergic medication for antipsychotic-induced tardive dyskinesia.
Cochrane Database of Systematic Reviews,
2018(1). https://doi.org/10.1002/14651858.cd000204.pub2
Bledsoe, I. O., Viser, A. C., & San Luciano, M. (2020). Treatment of dystonia: Medications, neurotoxins, neuromodulation, and rehabilitation.
Neurotherapeutics,
17(4), 1622–1644. https://doi.org/10.1007/s13311-020-00944-0
Chokhawala, K. (2023, February 26).
Antipsychotic medications. StatPearls – NCBI Bookshelf.
https://www.ncbi.nlm.nih.gov/books/NBK519503/Links to an external site.
Fabrazzo, M., Cipolla, S., Camerlengo, A., Perris, F., & Catapano, F. (2022). Second-Generation Antipsychotics’ Effectiveness and Tolerability: A Review of Real-World Studies in Patients with Schizophrenia and Related Disorders.
Journal of Clinical Medicine,
11(15), 4530. https://doi.org/10.3390/jcm11154530
Jones, K. S. (2023, May 8).
Tourette syndrome and other TIC disorders. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499958/
Lewis, K. (2023, May 1).
Dystonic reactions. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531466/#:~:text=An%20acute%20dystonic%20reaction%20is,to%20abnormal%20movements%20or%20postures.
Stahl, S. M. (2021).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).
Patel, J. (2023, July 24).
Akathisia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519543/#:~:text=Akathisia%20is%20defined%20as%20an,usually%20involves%20the%20lower%20extremities.
Case Study 3 & 4 (10 Points)
Students much review the case study and answer all questions with a scholarly response using APA and include 2 scholarly references. Answer both case studies on the same document and upload 1 document to Moodle.
Case Studies will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)
Turn it in Score must be less than 25 % or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25 %. Copy-paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.
due 10-7-23 @10am
Assignment Content
1.
Top of Form
Presentation: Create a visual to accompany your presentation outline. This is PowerPoint presentations. The presentation must be interactive and allow for student questions. The presentation should follow what is presented in the outline in a clear and organized fashion. Please include the following topics/components in your presentation:
· Topic Overview: Definitions and components
· Relate topic to patient safety
· Include two nursing priorities that relate to your topic
· Include three nursing interventions that relate to your topic
· Provide a conclusion/review of your topic
· Allow time for student/instructor questions
NOTE Bottom of Form
Create FIVE NCLEX questions on the topic of your presentation with rationales and references
Give a 1 Page description of your clinical issue of interest Diabetes Type 1 . This clinical issue will remain the same for the entire course and will be the basis for the development of your PICOT question. Describe your search results in terms of the number of articles returned on original research and how this changed as you added search terms using your Boolean operators. Finally, explain strategies you might make to increase the rigor and effectiveness of a database search on your PICO(T) question. Be specific and provide examples
Conc of Pathophys Case Study 1
***This assignment utilizes TurnItIn. When you submit this assignment to the assignment drop box, it will automatically be submitted to TurnItIn. You will receive an Originality Score along with an Originality Report that should be carefully reviewed. If revisions need to be made to your assignment, you will be able to make additional submissions, and you will quickly receive updated Originally feedback.
Assignment Instructions:
· Review the case study scenario below and the client's family history and medical profile information from unit 1.
· Next, write a 6-8-page paper analysis of the client (including title and reference page) according to the assignment specifications, outline, and grading rubric.
Case Study 1 Scenario:
Client, Sarah Collins, has chronic kidney disease. She receives dialysis twice a week. Today when Mrs. Collins arrives at the dialysis clinic, the nurse assesses Mrs. Collins and notes her blood pressure is 145/90 mm Hg and she has gained three pounds since her last visit. Mrs. Collins tells the nurse she was trying earlier to walk to her mailbox at the end of the driveway and couldn’t because she was out of breath. Mrs. Collins' husband and 16-year-old grandson are at the clinic with her.
Case Study Analysis Assignment Outline:
The case study analysis paper should include the following sections with responses and rationales for all the prompts.
Introduction (3-5 paragraphs)
Provide an overview of the pathophysiology of the disease exhibited by the client. Include:
· What additional assessment findings would you look for?
· What lab abnormalities would you expect to see?
· What diagnostics would you anticipate the healthcare team ordering?
· Provide a rationale for your answers.
Implications for Self-Care (2 paragraphs)
· Consider Maslow’s hierarchy of needs and describe where the client falls in that hierarchy and how this will impact care and healing.
· How does this disease process impact the client’s and/or their care provider’s ability to care for themselves?
Patient Education Strategy (2-3 paragraphs)
· Identify 3-5 appropriate nursing interventions and teaching points for your client based on the pathophysiology and assessment findings.
· Describe the educational strategies that should be incorporated when building a plan of care for your client.
· Support with rationale.
Interdisciplinary Collaboration (2-3 paragraphs)
· Identify 2-4 interdisciplinary team members who need to be included in the care of the client. Include rationale.
· Consider the care the client will need while inpatient and upon discharge.
· Consider nutrition, community services, and financial implications.
Conclusion
· Summarize the key concepts of this disease process and client case study scenario.
References
· A minimum of three references should be used in this paper.
· References should be no more than five years old.
Exceptions include seminal works, such as original publications by nurse theorists.
· One reference must be your textbook,
· One reference must be from a peer-reviewed journal,
· One reference must be from an authoritative website such as the CDC, NIH or Healthy People 2030.
Assignment Specifications:
· Name the paper with a File Naming Protocol: When you save the paper, name it: LastName_NSG 3300_CaseStudyAnalysis_1.docx
· Paper reflects clinical and professional client/cases, and no references to personal or family issues.
APA Formatting
· All papers should be written in APA formatting. This paper should include:
· Formal components, such as a title page, and APA formatting with an introductory and conclusion paragraph that summarizes the key concepts
· APA-formatted
level headings
· APA margin, font, and paragraph spacing
· Include page numbers
· Appropriate in-text reference citations
· A reference page, in correct APA format
