Discussion Assignment:

Respond to the following Response Post # 1 & 2

Explain how you might apply knowledge gained from the Response case studies to your own practice in clinical settings.

· Share additional interview and communication techniques that could be effective with your colleague’s selected patient.

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· Suggest additional health-related risks that might be considered.

·  

· Validate an idea with your own experience and additional research.

·  

· Explain your reasoning using at least TWO different references from current evidence-based literature in APA Format.

Response Post #: 1

Case 1: Volume 2, Case #16: The woman who liked late-night TV

Case Study

This is a case study of a 70-year-old female who lives at home by herself. The patient struggles with depression. She is sad, has lost interest in things she used to enjoy, and is fatigued with poor focus and concentration. The patient reports trouble sleeping. The patient also likes to watch late-night TV.

Questions

Sleeping disturbances affect 1/3 of Americans.  Sleep can affect an individual’s memory, health, immune system, and pain. Some questions that we may need to ask the client:

How much sleep do you usually get?

Do you feel rested when you wake up?

Do you have trouble falling asleep, or difficulty getting back to sleep when you wake up in the middle of the night?

(Siengsukon, Al-Dughmi, & Stevens, 2017)

Family Questions

When assessing a patient, it is nice to allow the family to be involved, with the patient’s permission, if they are supportive and want to help the patient’s health improve. Some questions that the provider may want to ask the family are: How are the family dynamics, Does the patient’s symptoms nap during the day, and What does the family member suffering from sleep react throughout the day?  These are important questions to help develop a picture of what is going on with the patient (Laff, 2016).

Physical Exam and Diagnostic Testing

When assessing the patient for a sleeping disorder you want to perform a physical examination to see if the patient has difficulty initiating sleep, maintaining sleep, and their routine before going to bed. As practitioners, we want to look to see if the patient is in pain. Does the patient use any substances such as alcohol, caffeine, nicotine, or any illegal drugs? Laboratory diagnostic tools may include blood work such as blood count, thyroid panel, comprehensive metabolic panel, C-Reactive Protein, ferritin, and vitamin B12.  We may need to have the patient have echocardiograms, CT, or EEG performed depending on the lab results. Looking at the patient’s psychiatric history and sleep history. These are just a few tools to help diagnose and help determine the treatment (Riemann et al. 2017).

Differential Diagnoses

Three differential diagnoses that the patient fits the criteria for are Chronic insomnia disorder, sleep apnea syndrome, and Psychological insomnia. Chronic Insomnia disorder is when the individual has trouble sleeping three-four nights per week for three or more months. sleep apnea syndrome criteria include feeling tired throughout the day and snoring while sleeping. Psychological insomnia criteria are hyperarousal and learned sleep- preventing associations (Suzuki, Miyamoto, & Hirata, 2017).

Drug Therapy

Doxepin is a medication recommended to help with sleep at lower dosages. The recommended dosages are 3-6 mg (Sateia, Buysse, Krystal, Neubauer, & Heald, 2017). Doxepin binds with high specificity and affinity to the histamine H1 receptor compared with other receptors. At low doses, doxepin selectively antagonizes H1 receptors, which is believed to promote the initiation and maintenance of sleep (Weber, Siddiqui, Wagstaff, & McCormack, 2010). The next treatment option I would choose is Trazodone. The Therapeutic dose for Trazodone in 50 mg -200 mg. Trazodone can help with sleep and depression (Sateia, Buysse, Krystal, Neubauer, & Heald, 2017). Trazodone is an antagonist/blocker for all the targets except for the serotonin receptor, where it acts as an agonist/agonist (Settimo & Taylor, 2018).

Follow-up

Follow-ups are used to evaluate the progression of the patient’s symptoms. Practitioners evaluate medication side effects, the effectiveness of the medication, and the patient’s symptoms. It can take 4-8 weeks to know the effectiveness of a medication. In the case study, they followed up with the patient every four weeks.

Response Post #: 2

Case Study 3

Case Study 3: Volume 1, Case  5: The sleepy woman with anxiety

Insomnia is a common household occurrence with many people. This disorder can be attributed to medication, trauma, anxiety, and pain.  According to Stahls (2013), sleep is considered to be a vital psychiatric sign during treatment evaluations

Additional Evaluation Questions

The case study included  a lot of information; however, additional information is needed for an accurate diagnosis.

1. How long have you been experiencing a disruption of your sleep?

2. Do you have a problem falling asleep?

3. Do you drink caffeinated beverages before sleep?

4. What is your  sleep routine? Do you have a TV in your room?

5. Have you tried nonpharmacological  inventions such as (relaxation techniques)?

6. Do you have stressors, trauma, flashbacks that  keep you awake?

The following questions are asked to find additional information about the patient’s sleep history. Inquiring about past medications and nonpharmacological intervention is important to know when determining the new treatment options.  Anxiety and the trauma-related event could cause an individual  to lose sleep, especially if the event happens in the night hours. Many victims that experience night time trauma often has flashbacks during that time or increases anxiety. Also, drinking high caffeinated drinks could cause insomnia.  The timing of drinking caffeinated beverages could be adjusted to be more beneficial to the patient.

Family Questioning

I would also include questions for other family members. I would ask them about  the patient’s sleep pattern. Also, questions such as “have you witnessed bizarre behaviors from the patient that could affect the lack of sleep.” How much time do you think the patient sleeps daily? Do you think the patient has stressors or anxiety that keep her from sleeping? Many times the family members’ views on the patient’s insomnia can be different from the patient’s account.

Testing and Diagnostic

When patients are prescribed an antipsychotic, it important for the providers to start with a baseline EKG. According to  Brown University Psychopharmacology (2014), Geodon is has known to cause QT prolongation for an individual with a personal or family of cardiac issues.

Possible Diagnosis

The patient presents with several symptoms and has an intensive mental health history.  The three diagnoses that I considered a) post-traumatic syndrome (PTSD), Major Depressive Disorder (MDD), Insomnia Disorder. I think the patient should be treated for insomnia disorder. According to Stahl (2013), insomnia disorders can be linked to other psychiatric disorders and can advance to depressive  occurrences.

Pharmacological Agents

The two-agents that I would consider for this patient are Trazodone and Ambien. Trazodone is a serotonin receptor antagonist, that has an immediate effect on insomnia (Stahl, 2014).  The recommended starting dose is 50mg PO nightly. The dose can tamper to produced the desired effect. Ambien is non-benzodiazepine hypnotic and is used to treat short term insomnia (Stahl. 2014). Ambien recommended starting dose is 5mg PO nightly immediate release. This medication would only be prescribed for 7-10 days due to the risk of dependence and worsening symptoms of depression and suicidal ideations.

Lesson Learned

This case study includes many variables about the patient’s past and present medical history.   Lagerberg et al. (2019) stated that incidents with polypharmacy increase with age and children have the highest incident with 3 or more psychotic drug classes. As an advanced practice nurse, it’s important to assess the medication and the patient history before determining the treatment. The patient indicated that several medications did not work for her but more information was needed to determine if that was an accurate assumption of the medication.

 

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This assignment focuses on the tenet of conscious leadership, the importance of self-assessment, and reflection. Self-awareness is essential for developing management and leadership skills. Recognizing your own strengths, weaknesses, and values, and understanding emotional intelligence and learning styles can help you to be a more effective leader. Becoming self-aware is an ongoing process requiring introspection. The more often people practice self-reflection, the more opportunities they have to understand their own behaviors and adapt their approaches to working with other people, which can improve both your own and other’s abilities to meet their professional goals.

Self-Assessment

For this assignment, you have the opportunity to take a variety of self-assessments to learn more about yourself and identify your assets and weaknesses as a leader. This will assist you in discovering how you can improve your own self-leadership skills. You will be asked to think critically about your results and submit a reflection as directed below. As a starting point, review the resources on conscious capitalism at: http://www.consciouscapitalism.org/. There are several helpful resources, including white papers and speech transcripts, available under the Content tab on the main page of this site. Conduct additional research beyond this website on the principle of conscious leadership.

Refer to the “Self-Assessment Links” resource in Topic Materials and complete each test. Be sure to document the results of each assessment to assist you in completing the reflection portion of the assignment below.

Self-Assessment Reflection

After completing the self-assessments, write a 1,000-1,250 word reflection in which you discuss the following:

1. Explain the characteristics of conscious leadership as defined by Mackey and Sisodia and compare them to the primary characteristics of two or three other leadership theories you have studied.
2. Describe the importance of self-awareness, self-concept, and emotional intelligence and the role they play in enabling effective conscious leadership.
3. Briefly summarize the results of each test you completed. In general, do you believe the results represent who you are as a leader? How will the results inspire you to be a conscious leader? Explain.
4. What insights have you gained about yourself after taking the assessments? How could this knowledge influence your values, attitude towards others, and how you approach new tasks in the workplace?
5. Explain the significance of the self-assessment results in relation to your individual behavior, your behavior within groups, and within organizations. What have you learned about your ability to manage others within the workplace? What have you learned about what it takes to manage yourself or how you respond to the management tactics of others within the workplace?

Include at least four academic references for this assignment to support your analysis and reflection.

This assignment uses a checklist. Please review the checklist prior to beginning the assignment to become familiar with the expectations for successful completion.

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 LopesWrite. Please refer to the directions in the Student Success Center.

 

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Approved Topics:

1. Examine how participative leadership functions in today’s modern health care organization and compare it to other types of leadership styles. Evaluate how each type of leadership style may impact organizational culture, employee performance, and how it may help or hinder the legitimacy of authority.

After identifying your topic, choose a health care organization in your area. This organization may be small or large and may provide single inpatient health service or multiple outpatient services; it is your choice. Consider your topic in light of the leadership of this organization and research the challenges and successes it has faced in managing operational effectiveness.  You are welcome to use as many research methods as possible to obtain information for your organization and its managers (e.g., web-based resources, electronic articles, or personal interviews). The more informed you are, the better prepared you will be to complete your project.  

Finally, develop a management training program that includes relevant guidelines and information to combat the issues identified in the selected topic, as well as recommendations for managers to more effectively lead health care organizations. Your training program should be in the form of a 20 to 25 slide PowerPoint presentation (excluding title and reference slides) that includes comprehensive speaker’s notes (i.e., at least 150 words) for each slide. Utilize at least three to five scholarly sources from the Ashford University Library and two to three current, scholarly web sources (total of five to eight references required). All sources must be cited according to APA style.Your presentation must be engaging and relevant to your audience. Lines of text on a slide will not be sufficient for this project. It should contain at least five images, graphics, and/or multimedia that communicate your training clearly to your audience. For tips on creating an excellent presentation, read this overview

The Senior Project:

1. Must be 20 to 25 PowerPoint slides (excluding title and reference slides) in length. There are 20 content criteria worth a total of 10 points.  
2. Must include a title slide that contains the following: 
   1. Title of project
   2. Your name
   3. Course name and number
   4. Instructor’s name
   5. Date submitted
3. Must include an introduction with a succinct thesis statement.
4. Must address the topic of the project with critical thought in the areas of: 
   1. Organization details
   2. Challenges and opportunities
   3. Training program outcomes
   4. Impact on at least three stakeholder groups involved delineated by cost, quality, and access to service
   5. Suggested actions
5. Must include a conclusion that reaffirms your thesis.
6. Must use at least five supporting graphics (images, graphics, and/ or multimedia) are included and relevant communicating the training content (two points).
7. Must include speaker’s notes that have evidence of critical thinking and application (content analysis, synthesis, evaluation) related to the research methodology used to develop (six points): 
   1. Project content
   2. Practical and relevant solutions to the organizational challenges/opportunities
   3. Appropriate evaluation of individual stakeholder groups involved
8. Must use at least three to five scholarly sources from the Ashford University Library and two to three current, scholarly web sources.
9. Must document all sources in APA style, as outlined in the Ashford Writing Center.
10. Must include a separate reference slide, formatted according to APA style as outlined in the Ashford Writing Center.

 

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Write a Senior Project Summary paper on the selected topic from Week One. In your paper include the following:(2-3 PAGES ONLY)

1. Title Page 
   1. Anticipated title (this may change for the completed project)
   2. Your name
   3. Course name and number
   4. Instructor’s name
   5. Date submitted
2. Introduction: Provide a description of your selected topic (i.e., health care trend) and a thesis statement. Identify the organization that you have chosen to address, including why the issue of your selected topic is important to the health care administrators in your organization, and to the health care industry in general. This should be about one-third of a page.
3. Scope of the Senior Project: This section should summarize the content topics and sub-topics related to the health care trend that will be addressed in the Senior Project.
4. Discussion: This section should be a constructive and analytical overview of what was found in the scholarly and professional literature. Make sure to discuss the pros/cons or strengths/weaknesses of the stakeholder group impacted (e.g., patient, provider, third-party payer, administrator, legislator, etc.) as applicable. In developing this section, it is important to demonstrate your understanding of the topic and the interventions and influences. This should be about one page.
5. Conclusion:  Provide a summary of the main effects of the contemporary health care trend on costs, quality, and access to services as it impacts various stakeholder groups.
6. Reference Page
7. The Senior Project Summary should be two- to- three pages (excluding title and reference pages) in APA format as outlined in the Ashford Writing Center

 

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Sentence outline for informative speech

The outline is a crucial component of the speech planning process. Write a full sentence outline for your career path or professional goals informative speech and submit it to the Submissions Area. Use this outline templatefor creating your outline. Give the file the following name: SU_SPC1026_W3_Project_LastName_FirstInitial.

You will not be graded on the visual aid component of the outline; however, you will receive feedback and this can be valuable in maintaining points, as you will be required to use visual aids in your informative and persuasive speeches in Weeks 4 and 5 that relate to your career path or professional goals.

The template contains areas where you must list your speech title, its general purpose, and its specific purpose as it pertains to communication and your career path or professional field. In addition, outline your introduction. Let us know what your attention-getting statement is, why you have credibility to speak on your subject, what the relevancy for your target audience is, and what the central idea of the speech is. The template also contains the area that links to the body of the speech. This will break the speech up into three main points with supporting information and details. In the conclusion of the speech you will summarize your main points for us and close with a memorable statement.

In addition to these outline areas, complete the References section. Your Informative Speech Outline should reference at least three sources that relate to your career field or professional goals, two of which should come from the South University Online Library.

Your assigned readings for this week include more information about good outlining technique.

Name your document SU_SPC1026_W3_Project_LastName_FirstInitial.doc and submit your document to the Submissions Area by the due date assigned.

 

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