Assignment: Practicum – Week 2 Journal Entry

· Develop diagnoses for clients receiving psychotherapy*

· Analyze legal and ethical implications of counseling clients with psychiatric disorders*

Select a client whom you observed or counseled this week. Then, address the following in your Practicum Journal:

· Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

· Using the Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (DSM-5), explain and justify your diagnosis for this client.

· Explain any legal and/or ethical implications related to counseling this client.

· Support your approach with evidence-based literature.

NOTE: PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION

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Describe each client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.

Using the DSM-5, explain and justify your diagnosis for each client.

Explain whether solution-focused or cognitive behavioral therapy would be more effective with this family. Include expected outcomes based on these therapeutic approaches.

Explain any legal and/or ethical implications related to counseling each client.

Support your approach with evidence-based literature.

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Psychotherapy for Addictive Disorders

“A long-standing debate has roiled over whether addicts have a choice over their behaviors. The disease creates distortions in thinking, feelings, and perceptions, which drive people to behave in ways that are not understandable to others around them. Simply put, addiction is not a choice. Addictive behaviors are a manifestation of the disease, not a cause.”

–Dr. Raju Hajela, former president of the Canadian Society of Addiction Medicine

A common misconception is that addiction is a choice, and addicts are often labeled as individuals who lack morals, willpower, or responsibility. However, addiction is a clinical disorder that must be treated with the support of a health care professional. Although many people who are exposed to potentially addictive substances and behaviors continue life unaltered by their experiences, some people are fueled by these experiences and spiral out of control. In your role as the psychiatric mental health nurse practitioner, you must be prepared to not only work with these individuals who struggle with addiction, but also help them and their families overcome the social stigmas associated with addictive behavior.

This week, as you explore psychotherapy for addiction, you assess clients presenting with addictive disorders. You also examine therapies for treating these clients and consider potential outcomes. Finally, you develop diagnoses for clients receiving psychotherapy and consider legal and ethical implications of counseling these clients.

Learning Objectives

Students will:

· Develop diagnoses for clients receiving psychotherapy*

· Evaluate the efficacy of motivational interviewing techniques for clients*

· Analyze legal and ethical implications of counseling clients with psychiatric 

  disorders*

   Select a client whom you observed or counseled this week. Then, address the  

   following in your Practicum Journal:

·  Describe the client (without violating HIPAA regulations) and identify any  

   pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for this client.

·  Explain whether motivational interviewing would be effective with this client.   

   Include expected outcomes based on this therapeutic approach. Support your  

   approach with evidence-based literature.

·  Explain any legal and/or ethical implications related to counseling this client.

·  Support your approach with evidence-based literature.

· NOTE: PLEASE SEE THE ATTACHED Practicum Journal Template AND JOURNAL SAMPLE (TIME LOG & JOURNAL ENTRIES) FOR WRITING THIS ASSIGNMENT…..ALSO FOR THE TIME LOG AND JOURNAL ENTRIES, JUST MAKE UP A REASONABLE INFORMATION AND CLIENT INFORMATION IN MENTAL HEALTH NURSING.

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

• Chapter 7, “Motivational Interviewing” (pp. 299–312)
• Chapter      16, “Psychotherapeutic Approaches for Addictions and Related Disorders”      (pp. 565–596)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Albrecht, U., Kirschner, N. E., & Grusser, S. M. (2007). Diagnostic instruments for behavioral addiction: An overview. German Medical Science Psycho-Social-Medicine, 4, 1–11. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736529/

Fisher, M. A. (2016). The ethical ABCs of conditional confidentiality. In Confidentiality limits in psychotherapy: Ethics checklists for mental health professionals (pp. 13–25). Washington, DC: American Psychological Association. doi:10.1037/14860-002

PLEASE, PAY ATTENTION TO THE QUESTIONS AND INCLUDE OTHER NEEDED INFORMATION THAT WERE NOT ADDED IN THE  EXAMPLE

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                    Pre-Briefing Simulation And Drug Cards 

                            PATIENT: Keola Akana 

THIS ASSIGNMENT HAS TWO PART QUESTIONS

                                                INSTRUCTION

Please keep in mind you will also be required to recognize a variety of signs and symptoms linked to abnormalities in these skills. 

Therefore, in order to prepare for the simulation, you are required to complete the Pre-Briefing questions & Drug Cards below and submit to the faculty facilitating the simulation prior to the start of pre-briefing. If you do not complete the pre-briefing questions below and submit to faculty facilitating the simulation prior to the start of pre-briefing, you will not be permitted to participate in the simulation. 

                                  PART 1  QUESTIONS   

SCENARIO OVERVIEW: 

Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring, and cardiac rehabilitation. The scenario takes place on Monday at 0900, at which time morning medications are due. 

1. What are the nutritional implications, key assessment findings, and nursing interventions for a patient with hypokalemia? 

2. What are the signs and symptoms of digoxin toxicity and how would the nurse assess for these symptoms? In your response, be sure to include specific body systems. 

3. How would the nurse provide family-centered care? 

PLEASE USE REFERENCE LESS THAN 5 YEARS OLD AND APA FORMAT NEEDED.

                          PART 11 QUESTIONS   

SCENARIO OVERVIEW: 

Keola Akana is a 70-year-old male with a history of heart failure. He was admitted to the medical-surgical unit early on Monday morning for medication adjustment, monitoring and cardiac rehabilitation.  During this scenario, students will have the opportunity to assess and manage medication administration for a patient experiencing digoxin toxicity.

FOR EACH OF THE FOLLOWING DRUGS BELOW THAT WAS PRESCRIBED FOR THE ABOVE PATIENT WITH HEART FAILURE, WRITE OUT IN DRUG CARD FORMAT FOLLOWING THE HEADING BELOW

1) THE INDICATION, (2) DOSAGE, (3) CONTRAINDICATION, (4) SIDE EFFECTS, (5) ADVERSE EFFECTS AND (6) NURSING CONSIDERATION

⦁ Patient: Keola Akana Drug Lists

Lasix 40 mg po now and daily 

Potassium Chloride CR 10 mEq po daily

Digoxin 0.25 mg po now and daily 

Atenolol 50mg po now and daily 

Acetaminophen 650 mg po Q 4 hrs PRN mild pain or temp greater than 101.3 

IV saline flush Q 8hrs and PRN 

N:B: SEE THE ATTACHED SAMPLE OF THE DRUG CARD LIST

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