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• Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.

 Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member. 

My specialty is pschiatry- PMHNP

You have selected one of the designated books to read. You will now write a book review that expresses your motivation for selecting the particular book, the impression the book made on you, information from another external, reliable source that either corroborates or contradicts the book, and how or why this book will or will not impact you. See Content Criteria on page 4 for more details. Note that your additional source should be from a recent (within last 5 years), professional journal or website (NIH, CDC, etc.). Blogs, magazines, and newspapers are not considered professional resources. An external source is one that is not included within the course readings.

Book Review Option #1

Clear, J. (2018). Atomic habits. Avery. ISBN: 9780735211292

Book Review Option #2

Dow, M. (2015). The brain fog fix. Hay House, Inc. ISBN: 9781401946487

Public health laws and regulations are often passed in response to human-caused or natural disasters or the spread of an infectious disease or other health epidemic. Select a law or regulation that was passed after a significant public health event or in response to an epidemic. In a 1,250-1,500 word paper, discuss the public health law or regulation and describe its impact on a community, including its ethical implications. Examples could include laws/regulations targeting smoking, obesity, healthy mothers and babies, vaccinations, etc. Include the following:

Introduction with an overview of the law/regulation, why it was passed, and how it was or is being implemented on the local, state, and/or federal level.

1. A discussion of who the law/regulation targets and how they are being impacted.
2. An evaluation of the efficacy of the law/regulation. Include evidence demonstrating whether it is or is not working.
3. A discussion of the law/regulation’s ethical implications-Do you think this law is fair and ethical in natural? It is being applied ethically/fairly? Were/are there any unforeseen/unintended consequences to be considered?

The client is a 68-year-old female who presents herself at the clinic. Her major symptoms include; disturbed sleep pattern, difficulty concentration, anhedonia, low self-esteem, guilty, decreased appetite, and disordered thought process. After careful assessment of the symptoms, the client is diagnosed with a major depressive disorder. The likely appropriate medication for the client is fluoxetine (Prozac) because research indicates that it is one of the most effective antidepressants for patients aged 65 and above (Kashani et al., 2017). Fluoxetine is a selective serotonin reuptake inhibitor (SSRIs) and doctors prefer to prescribe them to patients with major depressive disorder since it is safe and has fewer side effects compared to other antidepressants.

          When administering fluoxetine to a client, the nurse should inform her about the expected side effects from the use of the medication such as headaches, dizziness, upset stomach, and vomiting. The patient should report back to the clinic if there worsening or new symptoms. Also, the patient needs to comply with the medication directions including dosage and taking the medication at the right time. After using fluoxetine for 2 months, it is expected that the symptoms will improve both in frequency and severity. As the body gets used to fluoxetine, some of the side effects will improve gradually. If the client does not respond to the medication prescribed, a combination of medication and psychotherapy such as cognitive-behavioral therapy (CBT). If the condition persists, brain stimulation therapies such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) can be suggested. ECT and TMS are used if a patient is not responding to medication (Livingston et al., 2016). In ECT, an electrical current is used to impact the functioning of the brain and relieve depression while for TMS treatment coil is placed on the scalp to send magnetic pulses and stimulate nerves in the brain that controls mood and depression.

 1.  Define the following words: 

a.tone 

b.irony 

c.simile 

d. metaphor 

e. personification  

2. How can you use these terms to analyze poetry? 

1. List and discuss at least two of the special nutritional needs of aging women.
2. Describe factors that may disturb sleep in older adults.

Please observe the discussion protocol. Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

All answers or discussions comments submitted must be in APA format according to

Publication Manual American Psychological Association (APA) (6th ed.) 2009

ISBN: 978-1-4338-0561-5

Minimum of two references, not older than 2015.

Need help with essay 

Please go to the following web address:

https://adfs.rasmussen.edu/adfs/ls?wa=wsignin1.0&wtrealm=urn%3aextranet%3aportal&wctx=https%3a%2f%2fportal.rasmussen.edu%2f_layouts%2f15%2fAuthenticate.aspx%3fSource%3d%252F&wreply=https%3a%2f%2fportal.rasmussen.edu%2f_trust%2fdefault.aspx  Please sign in with the following information:

Username: [email protected]

Password: Addie!0823

Click on Courses on the left side, and then click on Technology Today for Medical Administration , click on Module 2, then assignments. Scroll to the bottom (to the fourth assignment) and click on Module 02 Laboratory Assignments.   Listed are the links for each laboratory simulation assignment. By clicking on each link, it will open up the McGraw-Hill Connect platform for you to complete each assignment. Be sure to complete all of the laboratory assignments test exercises. You will have two attempts at each exercise and your highest grade will automatically transfer to the gradebook. Complete the Electronic Health Record (EHR) simulations. 

 I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

A comprehensive psychiatric assessment is a necessary element for the Psychiatric Mental Health Nurse Practitioner (PMHNP) to provide the necessary treatment for a client with mental illness while establishing a  criteria-based diagnosis (Sadock, Sadock & Ruiz, 2014).  A comprehensive psychiatric assessment depends on the skills and training of the PHMNP to interact well with their client and gather the information that will guide them to an accurate diagnosis and course of treatment.

 Classification of mental health diagnosis in a clinical setting for diagnosis, treatment, and evaluation for the child or adolescent depends on the availability of reliable and valid instruments such as standardized diagnostic interviews (SDIs).  These SDIs include the Diagnostic Interview Schedule for Children, 4th ed. That takes 90-120 minutes to administer,  and the Mini International Neuropsychiatric Interview for Children and Adolescents and takes about thirty-five minutes to administer, enabling the PMHNP to document the presence and severity of symptoms and diagnose a specific psychiatric disorder (Duncan et al., 2018).

These assessments will include background information regarding family, whom the client lives with if the parents are separated, and their relationship with family members—information of past mental health issues, inpatient or outpatient treatment, and current medication.  The PMHNP will also need to know about any medical conditions the client may have, and there is a need for medication.  The client will also give information about his or her social life, friends, school activities, how well they are doing in school, and favorite subject. All of this information helps to discuss goals and develop a treatment plan.

This discussion is based on the video by YMH Boston, 2013 where I am observing an initial interview between and the provider and a male adolescent give additional suggestions of improvement and concerns that may or may not have been addressed during the initial interview and any additional questions that may need to be asked.

Observation of what the Practitioner Did Well and Areas of Improvement

The practitioner addressed confidentiality issues and when confidentiality will be broken, and Shawn was receptive and understood. The practitioner was able to establish a rapport with Shawn and obtain some basic information. The practitioner was able to talk about school sports, favorite subjects, and identify two people who can relate.

When talking about Shawn’s relationship with his mother, the practitioner’s comment makes Shawn uncomfortable and defensive when Shawn does not understand why his mom sent him for therapy. Shawn also becomes defensive when the practitioner probes why Shawn’s mom wants him to come to this appointment.  The practitioner could have asked more questions regarding the school and the reasons for Shawn not liking school, and how Shawn’s dad fit into the picture.

Compelling Concerns and Additional Questions

The concerns would be at the root of the anger and how Shawn’s father fits into the picture. Does he take an active role in Shawn’s life, and I would ask Shawn about his dad, especially when Shawn states that he can confide in his coach and sees him as a father figure. I would want to know more about the difficulties he has at school, and his mom is aware of these difficulties.  How do these issues need to be addressed? How are his grades? Does he need a tutor or peer support for subjects such as English to keep his grades up so that he can continue to play basketball?

I would also want to know what makes him angry, are there any identifiable triggers? Does he threaten his mom physically or verbally? Does he need group therapy whose focus is on anger management?  Once again, are his school issues overflowing into his relationship with his mom, causing these angry outbursts?

Conclusion

One possible diagnosis for Shawn based on the interview would be Disruptive Mood Dysregulation Disorder 296.99 (F34.81). Shawn states that he loses his temper nearly every day and that his angry mood and yelling cause problems at home and could be a possible cause at school. He clearly stated that he gets upset when his mom asks him questions, mostly about school that triggers him, and he starts yelling. He stated that his mom set up the appointment because she believes he needs help managing his anger.

I would want to know about anxiety or depression, but there was not enough information or screening questions to come to any other diagnoses.

Anger is a secondary emotion that the root cause can be due to various internal and external factors. These factors can be biological, psychological, and social, a particular personality trait, anxiety and depression, and the ability to problem-solve, leading to verbal and physical aggression. By helping Shawn to acknowledge his anger and learns more about his anger and ways to manage the triggers that cause his anger, he will see a decrease in aggressive behavior and an increase in communication skills (Farisandy & Hartini, 2020)

References

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

Duncan, L., Comeau, J., Wang, L., Vitoroulis, I., Boyle, M. H., & Bennett, K. (2018). Research         review: Test-retest reliability of standardized diagnostic interviews to assess child and                      adolescent psychiatric disorders: A systematic review and meta-analysis. Journal of             Child Psychology and Psychiatry, 60(1), 16–29. https://doi.org/10.1111/jcpp.12876

Farisandy,E., & Hartini, N. (2020). The effect of anger manatment training toward aggressive

            Behavior in adolescents. Jurnal Psikologi, 19(1),95-107.             https://doi.org/10.14710/jp.19.1.95-107

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

YMH Boston. (2013, May 22). Vignette 4 – Introductions to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

Electronic health records – Make a 12 slide power point presentation.  including Title Page, Introduction, Conclusion, and References following APA format.