NU673-7D Full Course Herzing University
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NU673-7D Full Course Herzing University
NU673-7D Full Course Assignments
NU673-7D Unit 2 Assignment – Trauma
Presentation Herzing
Instructions
Choose from one of the three trauma topics
listed below and prepare a presentation related to trauma and clinical
practice. The presentation should be 10-15 slides in length. You
are not required to complete a voice over for this presentation.
- What is the impact of different
restraints in relation to trauma? (physical or pharmacological)
- What is the relationship between trauma
and homelessness (and other social determinants of health)?
- What is the
correlation between trauma and substance abuse?
In your presentation cover the following
information:
- Title Slide
- What is the definition of trauma?
- Who is
vulnerable to trauma?
- How can trauma be experienced on the
intergenerational level and over the individual and family lifespan?
- Pathophysiology of Trauma
- How do social determinants of health
correlate to the effects of trauma?
- S/Sx of Trauma
- What is the difference between trauma
therapy and trauma-informed care?
- What is a trigger and how would you
recognize that someone is experiencing trauma-related distress?
- How might a person with a history of
trauma have behavior that could be interpreted as “noncompliance” or
non-adherence?
- Special trauma topic: one from the 3
choices listed above.
- Conclusion
- References
Your response should include evidence-based
research to support your content using proper citations and APA format.
NU673-7D Unit 3 Assignment – Clinical: SOAP
Note Herzing
Instructions
Each
week students will choose one patient encounter to submit a Follow-up SOAP note
for review.
Follow
the rubric to develop your SOAP notes for this term.
The
focus is on your ability to integrate your subjective and objective information
gathering into formulation of diagnoses and development of patient-centered,
evidence-based plans of care for patients of all ages with multiple, complex
mental health conditions. At the end of this term, your SOAP notes will have
demonstrated your knowledge of evidence-based practice, clinical expertise, and
patient/family preferences as expected for an independent nurse practitioner
incorporating psychotherapy into practice.
NU673-7D Unit 3 Assignment – Clinical: Journal
Reflection Herzing
Reflective Journal Instructions
You will create 5 entries for your Reflective
Journal about a patient encounter. In the 5th entry, you will review the
previous 4 entries and evaluate your progress in reflective practice over the
course of the term. Each journal should be a minimum of 250 words.
The purpose of this reflective journal is
self-reflection regarding the role in the process of self-reflection as a PMHNP
provider. Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as one’s ability to
monitor and manage those feelings. The point of the exercise is to learn
yourself, your triggers, the types of cases you end up getting overly involved
with, and those you’d rather refer to someone else. The idea is to be able to
personally reflect on your behaviors/thoughts/decisions and how those impact
you in the role of PMHNP.
Introduction address
the following items:
- Describe
your past experience in mental health or with someone with mental
illness.
- What are the reasons you have chosen to
work with this population?
- Discuss any concerns you have regarding
this specific clinical course and population Adult/Geriatric.
- Identify
personal and academic/professional goals for the clinical course and
population Adult/Geriatric.
NU673-7D Unit 4 Assignment – Suicide Assessment
Herzing
Complete a SOAP Note as if you were
the psychotherapist in the video. Then write a one-page summary that
highlights the warning signs of suicidality in the patient and why you chose
the treatment plan you choose in your SOAP Note.
NU673-7D Unit 5 Assignment – Clinical: SOAP
Note Herzing
Instructions
Each
week students will choose one patient encounter to submit a Follow-up SOAP note
for review.
Follow
the rubric to develop your SOAP notes for this term.
The
focus is on your ability to integrate your subjective and objective information
gathering into formulation of diagnoses and development of patient-centered,
evidence-based plans of care for patients of all ages with multiple, complex
mental health conditions. At the end of this term, your SOAP notes will have
demonstrated your knowledge of evidence-based practice, clinical expertise, and
patient/family preferences as expected for an independent nurse practitioner
incorporating psychotherapy into practice.
NU673-7D Unit 5 Assignment – Clinical: Journal
Reflection Herzing
Reflective Journal Instructions
You
will create 5 entries for your Reflective Journal about a patient encounter. In
the 5th entry, you will review the previous 4 entries and evaluate your
progress in reflective practice over the course of the term.
Each journal should be a minimum of 250 words.
The
purpose of this reflective journal is self-reflection regarding the
role in the process of self-reflection as a PMHNP provider.
Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as
one’s ability to monitor and manage those feelings. The point of the exercise
is to learn yourself, your triggers, the types of cases you end up getting
overly involved with, and those you’d rather refer to someone else. The idea is
to be able to personally reflect on your behaviors/thoughts/decisions
and how those impact you in the role of PMHNP.
Discuss a patient interaction in which there
was transference, countertransference, prejudice/biases, or judgments that you
may be making about the patients or that they are verbalizing about you. Have
you encountered this before? From where does this originate? Would it
appropriate for you to continue to provide care to the patient and if so, how
will you prevent these issues from affecting the care you are able to provide
the patient?
NU673-7D Unit 6 Assignment – Diagnostic Tools
Paper Herzing
Instructions
Write
a 4-5 page paper describing the use of a specific screening
tool. Discuss what diagnosis you are using the tool for, how to score the
tool, and support use of the tool with evidence and rationale. Next,
develop a treatment plan for the patient based on your findings in the
diagnostic test and interpretation.
Sections
should include:
- Introduction to the diagnostic
tool
- Discussion of Tool: why it is used, how,
and for what diagnosis
- Discussion of Interpretation of Scoring
for the Tool
- Treatment
Plan for patient with positive results from the tool, include non-pharmacological
and pharmacological approaches, patient education, additional testing
required, and follow-up as needed.
NU673-7D Unit 8 Assignment – Anxiety Case Study
Herzing
Instructions
Read
the case study as listed and complete a SOAP note for an intake. What
additional information do you need for subjective and objective data?
Next, design a treatment plan based on the information you have available;
include pharmacological, non-pharmacological, patient education, referral,
and follow-up.
Milton
is a 68-year-old Asian American male who reports that his biggest problem is
worrying non-stop. He worries all of the time and about
“everything under the sun and beyond.” For example, he reports equal
worry about his wife who is undergoing treatment for breast cancer, and whether
he returned his book to the library yesterday to maintain a good patron
status. He recognizes that his wife is more important than a book and is
bothered that both cause him similar levels of worry even when he tries to rationalize
the differences. Milton is unable to control his worrying with current
mechanisms that he lists as distraction or self-talk. Supplementary, this
excessive and uncontrollable worry is creating difficulty falling asleep and
staying asleep, constant impatience with others, difficulty focusing at work,
and significant back and muscle tension. Milton has had a lifelong
problem with worry, recalling that his mother called him a “worry wart as a
child.” His worrying does “wax and wane”, and worsened when his wife
was recently diagnosed with breast cancer. He feels he is at a loss for
what he can do to control it and relax.
Symptoms:
- Anxiety
- Concentration Difficulties
- Irritability
- Sleep Difficulties
- Worry
Vitals:
132/80
BP
72
HR
20
R
98.8
T
98%
02
Ht.
5’5”
Weight
149
NU673-7D Unit 9 Assignment – Clinical: SOAP
Notes Herzing
Instructions
Each
week students will choose one patient encounter to submit a Follow-up SOAP note
for review.
Follow
the rubric to develop your SOAP notes for this term.
The
focus is on your ability to integrate your subjective and objective information
gathering into formulation of diagnoses and development of patient-centered,
evidence-based plans of care for patients of all ages with multiple, complex
mental health conditions. At the end of this term, your SOAP notes will have
demonstrated your knowledge of evidence-based practice, clinical expertise, and
patient/family preferences as expected for an independent nurse practitioner
incorporating psychotherapy into practice.
NU673-7D Unit 9 Assignment – Clinical: Journal
Reflection Herzing
Reflective Journal Instructions
You
will create 5 entries for your Reflective Journal about a patient encounter. In
the 5th entry, you will review the previous 4 entries and evaluate your
progress in reflective practice over the course of the term.
Each journal should be a minimum of 250 words.
The
purpose of this reflective journal is self-reflection regarding the
role in the process of self-reflection as a PMHNP provider.
Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as
one’s ability to monitor and manage those feelings. The point of the exercise
is to learn yourself, your triggers, the types of cases you end up getting
overly involved with, and those you’d rather refer to someone else. The idea is
to be able to personally reflect on your behaviors/thoughts/decisions
and how those impact you in the role of PMHNP.
- Describe a
significant event/patient interaction you have experienced anytime in
your nursing career up to this week. Discuss the impact this had on
you in terms of increasing your understanding of the PMHNP role,
psychopathology, and/or the provider-patient relationship. Explore your
personal strengths and limitations and their effect on the
provider/patient relationship. Include reflection on your therapeutic use
of self. Your discussion should reflect your specific learning/insight.
Identify something specific that you learned from reflecting on this
event/interaction and how will you apply that learning in your future
practice?
NU673-7D Unit 10 Assignment – Substance Use
Presentation Herzing
Instructions
For
this assignment, you will choose one substance or illegal drug that is
prevalently being abused in our society to present to your classmates.
The
presentation should include the following:
- Title page
- Introduction to Substance
- History of Abuse
- Prevalence and Epidemiology in the
US
- Risk Factors/ vulnerable populations
associated with abuse of this substance
- Short–term and Long–term side effects of
the substance use
- Signs and symptoms of abuse upon
assessment
- Potential for overdose or use as suicide
weapon of choice
- Example of a Care Plan for a
patient:
- Pharmacological tx
- Non-pharmacological tx
- Patient Education
- Referral
- Follow-up
- Conclusion
You
will then record a voice-over of the presentation, upload the recorded
presentation to youtube so you receive a simple link to share with
your peers.
Post
your link to this week’s DB posting area as well so peers can view it. No
replies to others’ presentations are required but you are encouraged to view
others’ presentations and comment.
NU673-7D Unit 11 Assignment – Clinical: SOAP
Notes Herzing
Instructions
Each
week students will choose one patient encounter to submit a Follow-up SOAP note
for review.
Follow
the rubric to develop your SOAP notes for this term.
The
focus is on your ability to integrate your subjective and objective information
gathering into formulation of diagnoses and development of patient-centered,
evidence-based plans of care for patients of all ages with multiple, complex
mental health conditions. At the end of this term, your SOAP notes will have
demonstrated your knowledge of evidence-based practice, clinical expertise, and
patient/family preferences as expected for an independent nurse practitioner
incorporating psychotherapy into practice.
NU673-7D Unit 11 Assignment – Clinical: Journal
Reflection Herzing
Reflective Journal Instructions
You
will create 5 entries for your Reflective Journal about a patient encounter. In
the 5th entry, you will review the previous 4 entries and evaluate your
progress in reflective practice over the course of the term.
Each journal should be a minimum of 250 words.
The
purpose of this reflective journal is self-reflection regarding the
role in the process of self-reflection as a PMHNP provider.
Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as
one’s ability to monitor and manage those feelings. The point of the exercise
is to learn yourself, your triggers, the types of cases you end up getting overly
involved with, and those you’d rather refer to someone else. The idea is to be
able to personally reflect on your behaviors/thoughts/decisions and
how those impact you in the role of PMHNP.
- Describe a new experience, significant event/patient
interaction, never seen before diagnosis, etc… you have
experienced in clinical this week. You can choose the same case you
used for your SOAP Note this week if that case had an effect on you.
Discuss the impact this had on you in terms of increasing your understanding
of the PMHNP role, psychopathology, and/or the provider-patient
relationship. Explore your personal strengths and limitations and their
effect on the provider/patient relationship. Include reflection on your
therapeutic use of self. Your discussion should reflect your specific
learning/insight. Identify something specific that you learned from
reflecting on this event/interaction and how will you apply that learning
in your future practice?
NU673-7D Unit 12 Assignment – Mental Health
Policy Paper Herzing
Instructions
For
this assignment, you will write a paper summarizing a current bill either
federal or state that impacts psychiatric mental healthcare and collaborative
care for access to treatment. The paper should contain the following main
points as listed below:
- Select a House of Representatives or
Senate bill (national or state level), either currently in process or one
that has been passed within the last two
years that directly focuses on
or impacts psychiatric mental health care advanced practice
nursing, financing, operations, or collaborative care for access.
(Include the name of the bill: e.g., H.R. 4909 (115th): Stop School
Violence Act of 2018. Be sure to note if the bill is federal or
state-level legislation and indicate the state, if appropriate. Also
note if the bill was passed and the date, if in committee [house or
senate], or if awaiting the president’s signature).
- Discuss your encouragement or
opposition of the Bill based on ethical, legal, and
policy considerations, and the nursing view and perspective for
patient care.
- Discuss how the bill impacts or will
impact, the role of the PMHNP. Discuss the impact on health care quality
and outcomes for psychiatric mental healthcare.
- Discuss how
the policy negatively or positively contributes to collaborative care for
psychiatric mental healthcare and increased access to care for psychiatric
mental health diagnoses.
This
paper must be written in current APA format, be 4-6 pages (excluding
the title page and reference page), and have at least 3 scholarly,
peer-reviewed references in addition to the course textbooks.
NU673-7D Unit 13 Assignment – Clinical: SOAP
Notes Herzing
Instructions
Each
week students will choose one patient encounter to submit a Follow-up SOAP note
for review.
Follow
the rubric to develop your SOAP notes for this term.
The
focus is on your ability to integrate your subjective and objective information
gathering into formulation of diagnoses and development of patient-centered,
evidence-based plans of care for patients of all ages with multiple, complex
mental health conditions. At the end of this term, your SOAP notes will have
demonstrated your knowledge of evidence-based practice, clinical expertise, and
patient/family preferences as expected for an independent nurse practitioner
incorporating psychotherapy into practice.
NU673-7D Unit 13 Assignment – Clinical: Journal
Reflection Herzing
Reflective Journal Instructions
You
will create 5 entries for your Reflective Journal about a patient encounter. In
the 5th entry, you will review the previous 4 entries and evaluate your
progress in reflective practice over the course of the term.
Each journal should be a minimum of 250 words.
The
purpose of this reflective journal is self-reflection regarding the
role in the process of self-reflection as a PMHNP provider.
Through reflective practice, the student will evaluate their own
emotional health and recognize one’s own feelings as well as
one’s ability to monitor and manage those feelings. The point of the exercise is
to learn yourself, your triggers, the types of cases you end up getting overly
involved with, and those you’d rather refer to someone else. The idea is to be
able to personally reflect on your behaviors/thoughts/decisions and
how those impact you in the role of PMHNP.
The
ability to analyze one’s self and be aware of how one’s emotions and responses
affect others is a crucial component to developing a therapeutic relationship
with patients. During this clinical/course and particularly through this exercise
it is expected that the student develops recognition of their own feelings,
prejudices, biases, triggers, anxieties, limitations, and of course strengths
while developing the ability to appropriately manage these issues as they arise
and how to best align your strengths to overcome your limitations. In this
final journal entry, review your previous journal entries and reflect upon your
success in achieving this as well as the goals you stated in your first video
journal.
Questions
to address in your final reflective video include:
- What goals did you set for yourself at
the beginning of the semester? Did you meet these?
- What feelings, prejudices, and biases
did you experience during your clinical experience and how did you manage
them?
- How did you manage your anxiety,
self-doubt, and/or uncertainty?
- What
understanding or insights did you develop during your clinical
experience?
- Has
reflective practice impacted you as a person, student, and/or provider? If
so, how? Will you continue to use reflection in your future practice?
If so why and how?
NU673-7D Unit 14 Assignment – Advocacy Against
Violence and Abuse Paper Herzing
Instructions
For
this assignment, you will write a paper discussing the ethical stance and
position of the PMHNP in relation to violence and abuse against,
particularly vulnerable populations. For each section listed below, you
will discuss specific issues, trends, and advocacy for that
specific vulnerable population and then discuss how the PMHNP role can
address this prevalent health crisis in our society and world.
- Introduction and Statistics
- What is abuse and violence against
others?
- Vulnerable Population: Pregnant Women
and Children
- Vulnerable Population: Elder Abuse
- Vulnerable Population: Minorities;
ethnicity, immigrants, and or gender, sexual preference etc…
related
- Screenings
- PMHNP role in advocacy and
prevention
- Conclusion
This
paper must be written in current APA format, be 4-6 pages (excluding the title
page and reference page), and have at least 3 scholarly,
peer-reviewed references in addition to the course textbooks.
NU673-7D Full Course Discussions
NU673-7D Unit 1 Discussion – Introduction
Herzing
Discussion: Unit 1
Unit 1 Discussion 1 – Introduction
Instructions:
Welcome to NU673! I am looking forward to
learning about each and every one of you, and I know your classmates are as
well. This discussion board is for you to share information with your
classmates and me so we can begin to create relationships within our online
classroom environment. You may begin to find that you are many of the same
courses together as you move through the program. Throw in some fun information
about yourself so we can deepen our knowledge of one another.
Using Zoom, create a 2-3 minute video
introducing yourself to your instructor and peers. In the video, please address
the following: (Please see the Zoom Quick Start PDF for more detailed
instructions).
As a way of introducing yourselves to the
instructor and your peers, please post the following:
- Your name
- Location
- Description of your current position (If
not employed, what are your expectations when you complete your
program?)
- What do you
know about psychotherapy?
Please be sure to validate your opinions and
ideas with citations and references in APA format.
Please
review post and response expectations. Please review the rubric to ensure that
your response meets criteria.
Peer Response: Unit 1
Unit 1 Discussion 1 – Introduction
Instructions:
- Always construct your response in a word
processing program like Word. Check for grammar, spelling, and mechanical
errors. Make the corrections and save the file to your computer.
- Find the post that you are going to
reply to.
- Submit your
peer responses to at least two peers.
Please be sure to validate your opinions and
ideas with citations and references in APA format.
NU673-7D Unit 3 Discussion – Psychiatric
Interview Herzing
Discussion Prompt
- Using the readings, lecture, and
references, write a complete SOAP note for this patient in the proper
format as if this were a referral for you from the school counselor.
- Post the SOAP note to this discussion
board for your peer review.
- Your post
should include a comprehensive treatment plan which incorporates both
psychosocial interventions as well as a medication plan, if indicated,
with collateral information.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions of
others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
NU673-7D Unit 5 Discussion – Diagnostic
Assessments Herzing
Discussion Prompt
For
this discussion, you will answer the question which corresponds to the FIRST
letter of your FIRST name:
Then
you will respond to the main postings of at least two of the other learners who
have answered questions different from yours.
If your FIRST name begins with the letter A through I,
please address this question:
- Compare and
contrast major depressive disorder and bipolar II disorder with particular
emphasis on how comprehensive assessment could help us to arrive at the
correct diagnosis.
If your FIRST name begins with the letter J through P,
please address this question:
- Compare and
contrast bipolar I and bipolar II disorder with particular emphasis on how
comprehensive assessment could help us to arrive at the correct
diagnosis.
If your FIRST name begins with the letters Q through Z,
please address this question:
- Compare and
contrast bipolar II from cyclothymic disorder with particular emphasis on
how comprehensive assessment could help us to arrive at the correct
diagnosis.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
- Substantive comments add to the
discussion and provide your fellow students with information that will enhance
the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions of
others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
NU673-7D Unit 7 Discussion – CPT E&M Code
and ICD-10 Diagnosis Code Herzing
Discussion Prompt
Use
your lecture materials to determine what CPT E&M Code and ICD-10 diagnosis
code to utilize for this ‘new patient’ encounter using the medical decision-making
(complexity) approach.
Provide
justification for the code you assigned by including the following information
in your discussion:
Case:
This
patient presents to a local health center. As the provider, you must
conduct a full physical on the patient as well as a psychiatric intake.
Liam is
a 22-year-old who reports to you that he feels depressed and is
experiencing a significant amount of stress about school, noting that he’ll
“probably flunk out.” He spends much of his day in his dorm room playing video
games and has a hard time identifying what, if anything, is enjoyable in a
typical day. He states once he leaves the room he begins sweating and
feels as if he has heart palpations. He rarely attends class and has
avoided reaching out to his professors to try to salvage his grades this
semester. Liam has always been a self-described shy person and has
had a very small and cohesive group of friends from elementary through high
school. Notably, his level of stress significantly amplified when he began college.
You learn that when meeting new people, he has a hard time concentrating on the
interaction because he is busy worrying about what they will think of him – he
assumes they will find him “dumb,” “boring,” or a “loser.” When he loses his
concentration, he stutters, is at a loss for words, and starts to sweat, which
only serves to make him feel more uneasy. After the interaction, he replays the
conversation over and over again, focusing on the “stupid” things he said.
Similarly, he has a long-standing history of being uncomfortable
with authority figures and has had a hard time raising his hand in class
and approaching teachers. Since starting college, he has been isolating more,
turning down invitations from his roommate to go eat or hang out, ignoring his
cell phone when it rings, and habitually skipping class. His concerns about how
others view him are what drive him to engage in these avoidance behaviors.
After conducting your assessment, you give the patient feedback that you
believe he has social anxiety disorder, which should be the primary treatment
target. You explain that you see his fear of negative evaluation, and his
thoughts and behaviors surrounding social situations, as driving his increasing
sense of hopelessness, isolation, and worthlessness.
Significant Symptoms:
- Anxiety
- Depression
- Ruminations
- Social Anxiety
- Physical
symptoms; sweating, heart palpations
Vitals:
127/80
98
18
60
90%
BMI
30
225 lbs
72”
Physical exam:
General: Well appearing,
well-nourished, in no distress. Oriented x 3, normal mood
and affect. Ambulating without difficulty.
Skin:
Good turgor, no rash, unusual bruising, or prominent lesions
Hair:
Normal texture and distribution.
Nails:
Normal color, no deformities
HEENT:
Head: Normocephalic, atraumatic, no visible or palpable masses, depressions, or
scaring. Eyes: Visual acuity intact, conjunctiva clear, sclera non-icteric, EOM
intact, PERRL, fundi have normal optic discs and vessels, no exudates or
hemorrhages
Ears:
EACs clear, TMs translucent & mobile, ossicles nl appearance,
hearing intact.
Nose:
No external lesions, mucosa non-inflamed, septum,
and turbinates normal
Mouth:
Mucous membranes moist, no mucosal lesions.
Teeth/Gums:
No obvious caries or periodontal disease. No gingival inflammation or
significant resorption. Pharynx: Mucosa non-inflamed, no tonsillar hypertrophy
or exudate
Neck:
Supple, without lesions, bruits, or adenopathy, thyroid non-enlarged and
non-tender
Heart:
No cardiomegaly or thrills; regular rate and rhythm, no murmur or
gallop
Lungs:
Clear to auscultation and percussion
Abdomen:
Bowel sounds normal, no tenderness, organomegaly, masses, or hernia
Back:
Spine normal without deformity or tenderness, no CVA tenderness
Rectal:
Normal sphincter tone, no hemorrhoids or masses palpable
Extremities:
No amputations or deformities, cyanosis, edema or varicosities, peripheral
pulses intact
Musculoskeletal:
Normal gait and station. No misalignment, asymmetry, crepitation, defects,
tenderness, masses, effusions, decreased range of motion, instability, atrophy
or abnormal strength or tone in the head, neck, spine, ribs, pelvis or
extremities.
Neurologic:
CN 2-12 normal. Sensation to pain, touch, and proprioception normal. DTRs
normal in upper and lower extremities. No pathologic reflexes.
Psychiatric:
Oriented X3, intact recent and remote memory, judgment and insight, anxious
mood and affect.
Breast:
No nipple abnormality, dominant masses, tenderness to palpation, axillary or
supraclavicular adenopathy.
G/U:
Penis circumcised without lesions, urethral meatus normal location without
discharge, testes and epididymides normal size without masses,
scrotum without lesions.
- The level of medical complexity
encompassed by including the number of points for the diagnoses/management
options and the amount/complexity of data reviewed; then identify the
level of risk for complications, morbidity, mortality
- In the
discussion explore how the ICD-10 Codes that you assigned impact
third-party payor reimbursement for this visit.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions of
others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
NU673-7D Unit 9 Discussion – Depression
Treatment Planning for Effectiveness Herzing
Discussion Prompt
- Compare and contrast delirium with brief psychotic
disorder. For this discussion, you will need to place particular emphasis
on how comprehensive assessment could help us to arrive at the correct
diagnosis for the adult/geriatric patient
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
·
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions
of others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
NU673-7D Unit 11 Discussion – Managing Mood
Disorders and Adjunctive
Discussion Prompt
Rebecca
Cole is a 39 years old, single, African
American female. She has never been married or had children. She has
been institutionalized at a state mental health hospital
for more than 7 years since she was diagnosed with unspecified
schizophrenia. She was diagnosed at age 21 and has undergone more than 8
psychiatric hospital admissions over her lifespan.
Ms. Cole has been transferred to a local acute
care hospital due to uncontrolled diabetes and hypertension. She has been
refusing blood glucose monitoring daily, so the charge nurse on
the women’s floor has not been able to check her blood sugar for
2 days. She has also been refusing her antihypertensive and antipsychotic
medication for 3 days. This has now led to more
uncontrolled hypertension and an increase in psychosis and behavioral
issues today. The nursing staff has become very frustrated and voiced
their issues with hospital administration because they don’t feel the
administration is listening to their concerns about
the challenges faced on the psychiatric units, and particularly
the challenges they are facing in caring for Rebecca.
You
are the PMHNP who is assigned and is managing her psychiatric care
while in the acute care hospital.
- At this point,
can Rebecca make her own healthcare decisions? Why or why
not? What legal risk for the PMHNP could be associated with caring
for Rebecca in the acute care hospital setting?
- How can integrative care be an approach
that is utilized with this patient?
- What other specialties should be
involved and when she they be involved?
- Discuss the potential ethical issues
facing the staff nurses caring for Rebecca in both the acute care
hospital setting currently and the state psychiatric hospital
setting?
- Why is
continued integrative care a better option for patient outcomes and a better
option from an ethical and legal perspective?
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
·
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions
of others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
NU673-7D Unit 13 Discussion – Telehealth
Herzing
Discussion Prompt
Telehealth
is an integral part of our healthcare system and becoming more prominent.
Being comfortable with multiple platforms is a must for the PMHNP.
Discuss the specific questions in your initial post:
Part
1: Nurses, in general, are seeing telehealth increase. When might
telehealth be preferred over an in-person medical visit and why?
Part
2: As healthcare incorporates various mobile health applications, describe how
mHealth (mobile health) is different from telehealth? How should we adjust
healthcare due to mobile access by patients?
Part
3: As a PMHNP, what clients would best be suited for telehealth visits, and
which would you rule out from seeing in telehealth and require in-person and
why?
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
·
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions
of others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis, and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
NU673-7D Unit 15 Discussion – Suicide Risk
Herzing
Discussion Prompt
Ms.
Smith is a Psychiatric-Mental Health Nurse Practitioner working in an outpatient
psychiatric clinic. She is seeing Dale Knox, a 32-years old man for
a psychiatric evaluation for the first time. Dale is currently
separated from his wife, Sofie. Dale and Sodie have been
married for 9 years. Dale has fully completed all of his
pre-evaluation paperwork and he has signed the consent for
treatment. During the psychiatric evaluation,
Ms. Smith observes that Dale is distraught, tearful and
verbalizing feelings of worthlessness and no motivation for life in
general. He states directly that he is going to kill his wife and
then kill himself tonight when she returns home from work
because he can’t stand the thought of being divorced and he
knows she is preparing to leave him. Mr. Knox states he has a handgun
in his car and has bought additional ammunition.
Answer
the following questions based on the case presentation:
- Discuss the importance of informed
consent in psychiatric-mental health treatment.
- Would Mr. Knox meet the
criteria for involuntary commitment, explain why or why not, and then
discuss the involuntary commitment process for your state and if PMHNP is
able to involuntarily commit a patient the state where you practice?
- Should the PMHNP notify
Mrs. Knox about her husband’s threat to kill her, or should the
PMHNP protect the confidentiality of Mr. Knox treatment?
- What additional resources should you
consider in this case for help for the patient and his family?
- What is the
prevalence of suicide-related to someone who has a plan and the
means? Are there any other criteria that this patient meets that
places him in a higher risk category for carrying out suicide?
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria.
Estimated time to complete: 2 hours
Discussion Peer/Participation Prompt
Please respond to at least 2 of your peer’s
posts with substantive comments using the following steps:
- Substantive comments add to the
discussion and provide your fellow students with information that will
enhance the learning environment.
- References and citations should conform
to APA standards.
- Remember: Please respect the opinions of
others, even if their views differ. In other words, disagree
professionally and respectfully.
- Plagiarism
is never acceptable – give credit when credit is due – cite your sources.
Responses need to address all components of
the question, demonstrate critical thinking and analysis and include
peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and
ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your
response meets the criteria. Collaboration points will be forfeited if you fail
to meet the response post guidelines.
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