Write a brief Conclusion why you made these decisions and what will be the objective of obtaining an improvement in the condition of this patient .

  

Decision 1

The PMHNP will administer 10 mg of zyprexa orally at bed time and initiate 230mg of invega sustenna through intramuscular, in addition to 156 mg via the same route on day four. A similar dose will be administered within one months’ time. In addition the PMHNP will administer 10mg of Abfility orally at bed time. Expected outcome for this decision is a 25% decrease in the PANSS score (Stahl, 2013). This decision is also expected to alleviate the patient’s psychotic symptoms and achieve normalcy within one month. A slight weight gain is also expected as the drugs are known to increase weight in patients. Because I don’t select the other decisions, the patient is expected to have faster and noticeable changes in psychotic behavior within two weeks of treatment commencement. 

Decision 2

At this point the PMHNP will decide to continue with use of medications selected in decision 1 (Stahl, 2013). However the PMHNP will instruct the administering nurse to begin intramuscular injections of 300mg of Abfility and continue with 10 mg of the same drug in the morning. At this point, PANSS is expected to decrease by 50 % although the patient will also have noticeable weight gain due to use of invega sustenna (Stahl 2014). Because I don’t select other decisions, the patient is expected to have less cardiovascular drug toxicities and experience reduced risks for adverse drug reactions between Invega sustenna and Haldol Deaconoate. 

Decision 3

The decision at this point is to have the patient continue with Invega Sustenna and provide psychological counseling on the effects of the drugs associated with weight gain. It will be essential to explain to the patient that the weight gain from this drug is minimal in comparison with other drugs (Stahl, 2013). The PMHNP will set an appointment follow up date with the patient after one month duration and refer to the nutritionist and physical activity instructor. The difference between expected outcome in decision 3 and results of the decision is Abfility may not be efficacious for more than a period of 6 months given that it does not bind to D 2 receptors in a similar manner as Invega Sustenna. This will necessitate the PMHNP to change to Abfility Maintena because it is easily tolerated by patients on Abfility. 

Because I don’t select the other decisions, the patent will be able to utilize the same drug for the longest possible duration and optimize on their efficacy prior to switching to other types of medication (Stahl, 2013). Since the patient may not have the mental capacity to participate in the decision making process or make autonomous mental health decisions, it is essential to discuss treatment options with the spouse and explain the importance of adherence to treatment (Stein & Giordano, 2015). In addition, the mental health nurse is required to make those decisions which will benefit the patient and also outweigh the risk for adverse health outcomes. 

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stein, D. J., & Giordano, J. (2015). Global mental health and neuroethics. BMC Medicine, 13(1), 44.  

Schizophrenia Treatment

Decision 1

The PMHNP will administer 10 mg of zyprexa orally at bed time and initiate 230mg of invega sustenna through intramuscular, in addition to 156 mg via the same route on day four. A similar dose will be administered within one months’ time. In addition the PMHNP will administer 10mg of Abfility orally at bed time. Expected outcome for this decision is a 25% decrease in the PANSS score (Stahl, 2013). This decision is also expected to alleviate the patient’s psychotic symptoms and achieve normalcy within one month. A slight weight gain is also expected as the drugs are known to increase weight in patients. Because I don’t select the other decisions, the patient is expected to have faster and noticeable changes in psychotic behavior within two weeks of treatment commencement. 

Decision 2

At this point the PMHNP will decide to continue with use of medications selected in decision 1 (Stahl, 2013). However the PMHNP will instruct the administering nurse to begin intramuscular injections of 300mg of Abfility and continue with 10 mg of the same drug in the morning. At this point, PANSS is expected to decrease by 50 % although the patient will also have noticeable weight gain due to use of invega sustenna (Stahl 2014). Because I don’t select other decisions, the patient is expected to have less cardiovascular drug toxicities and experience reduced risks for adverse drug reactions between Invega sustenna and Haldol Deaconoate. 

Decision 3

The decision at this point is to have the patient continue with Invega Sustenna and provide psychological counseling on the effects of the drugs associated with weight gain. It will be essential to explain to the patient that the weight gain from this drug is minimal in comparison with other drugs (Stahl, 2013). The PMHNP will set an appointment follow up date with the patient after one month duration and refer to the nutritionist and physical activity instructor. The difference between expected outcome in decision 3 and results of the decision is Abfility may not be efficacious for more than a period of 6 months given that it does not bind to D 2 receptors in a similar manner as Invega Sustenna. This will necessitate the PMHNP to change to Abfility Maintena because it is easily tolerated by patients on Abfility. 

Because I don’t select the other decisions, the patent will be able to utilize the same drug for the longest possible duration and optimize on their efficacy prior to switching to other types of medication (Stahl, 2013). Since the patient may not have the mental capacity to participate in the decision making process or make autonomous mental health decisions, it is essential to discuss treatment options with the spouse and explain the importance of adherence to treatment (Stein & Giordano, 2015). In addition, the mental health nurse is required to make those decisions which will benefit the patient and also outweigh the risk for adverse health outcomes. 

References

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

Stein, D. J., & Giordano, J. (2015). Global mental health and neuroethics. BMC Medicine, 13(1), 44.

 

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Part 3:Strategies to promote Academic Integrity and  Professional Ethics

Nurse-scholars have a significant obligation to their community as well. Their work must have academic and professional integrity. Their efforts are designed to add to the body of knowledge, advance the profession, and ultimately help in the care of patients. Work that lacks integrity is subject to erode quickly or worse.

Fortunately, there are strategies and tools that can help ensure integrity in academic and professional work. This Assignment asks you to consider these tools and how you might apply them to your own work.

In this Assignment you will continue developing your Academic Success and Professional Development Plan by appending the original document you began in the previous assignment.

To Prepare:

• Reflect on the strategies presented in the Resources for this Module in support of academic style, integrity, and scholarly ethics.
• Reflect on the connection between academic and professional integrity.

The Assignment:

Part 3, Section 1: Writing Sample: The Connection Between Academic and Professional Integrity

Using the Academic and Professional Success Development Template you began in Module 1 and expanded in Module 2, write a 2- to 3-paragraph analysis that includes the following:

• Explanation for the relationship between academic integrity and writing
• Explanation for the relationship between professional practices and scholarly ethics
• Cite at least two resources that support your arguments, being sure to use proper APA formatting.
• Use Grammarly and SafeAssign to improve the product.
• Explain how Grammarly, Safe Assign, and paraphrasing contributes to academic integrity.

Part 3, Section 2: Strategies for Maintaining Integrity of Work

Expand on your thoughts from Section 1 by:

• identifying and describing strategies you intend to pursue to maintain integrity and ethics of your: (1) academic work as a student of the MSN program and (2) professional work as a nurse throughout your career. Include a review of resources and approaches you propose to use as a student and a professional.

Note: Add your work for this Assignment to the original document you began in the Module 1 Assignment, which was built from the Academic Success and Professional Development Plan Template.

 

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1.- Clinical Case Presentation

Students must post one interesting case that he/she has seen in the clinical setting via Discussion Board in the online part of this course. The case should be an unusual diagnosis, or a complex case that required in-depth evaluation on the student’s part. The case should be posted in the SOAP format, with references for the patient diagnosis, differential diagnoses (there should be at least 3), and the treatment plan. Notes will be graded as “pass/fail”. In order to receive grade points for SOAP notes, the notes must be approved by the deadlines specified on the course assignments page. The student will lose the opportunity for points on any SOAP notes not approved by the specified deadlines. The posting does not have to be written in APA format, but should be written with correct spelling and grammar. References should be in APA format. The selected references should reflect current evidence – dated within the past 5 years. See rubric in the syllabus section 

2.- Resume/Cover letter

A resume is a personal document whose purpose is to promote one in a positive manner. This resume will be a current true representation of you as a professional Nurse practitioner. You can focus it as if you were applying for your current position. Each section in the resume should have a heading. Design should be uniform throughout the document and power words should be included. All sections must be flawless for spelling, punctuation, grammar, truth, etc. This resume should be accompanying by a cover letter. The cover letter formally introduces you and creates a critical first impression Should be specifically tailored to a specific position and company. Use professional vocabulary and style. Highlight relevant experiences / qualities as they relate to the position. 

You will find a job announcement of interest to you and write a letter of application to the job. Be sure to address the qualifications and job requirements that the employer is seeking in your letter. Market yourself to the employer by highlighting your experiences that will make you a good candidate for this job. 

 

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    THE TOPIC TO WORK WILL BE “SAFETY AND QUALITY OF CARE IN PEDIATRIC PATIENT”

Details:

 

In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the Healthy People 2020 website.

Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

1. The      problem, issue, suggestion, initiative, or educational need that will be      the focus of the project
2. The      setting or context in which the problem, issue, suggestion, initiative, or      educational need can be observed.
3. A      description providing a high level of detail regarding the problem, issue,      suggestion, initiative, or educational need.
4. Impact      of the problem, issue, suggestion, initiative, or educational need on the      work environment, the quality of care provided by staff, and patient      outcomes.
5. Significance      of the problem, issue, suggestion, initiative, or educational need and its      implications to nursing.
6. A      proposed solution to the identified project topic

You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 

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500 words

APA 

Addition two sources 

 

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