All posts by : chebby

• The Institute of Medicine’s report, The Future of Nursing: Leading Change, Advancing Health, addresses the need for nursing leadership; it discusses the potential for nursing to lead improvement and redesign the healthcare delivery system. Take a look at the video Transforming Care at the Bedside: Empowering Better Nursing Care to see what some nurses have done to improve healthcare in their facilities. Based on your nursing experience, what change would you like to implement to improve care? What are the first steps you would take to implement the change?

video link : https://www.youtube.com/watch?v=_CtXFdITU8w

1 page with at least 1 reference

 Respond to  your  colleagues who argued the opposite side as you by countering their  argument with evidence. Identify at least two consequences to support  your position. 

NOTE( my position is against the issue of diagnosing pediatric bipolar depression disorder)

Please cite References

                                                       Main Post

Pediatric Bipolar Depression

The  American Psychiatric Association (2013) requires one manic episode or  one hypomanic episode along with one depressive episode for a diagnosis  of Bipolar Disorder. There has been some controversy over using the  diagnosis of Pediatric Bipolar Disorder (PBD) due to what some believe  was over-diagnosis resulting in a higher prevalence of the disorder in  the United States, showing up to a 40-fold increase in the diagnosis in  the previous decade (Van Meter, Moreria & Younstrom, 2019).  

Arguing FOR the Diagnosis

While  there was some debate for a period of time regarding over-diagnosis of  PBD, Van Meter et al. (2019) suggest that rates of pediatric bipolar  disorder are not increasing and the rate is not higher in the United  States once meta-analysis is utilized to critically evaluate previous  data. Some previous criticism of PBD resulted in the APA (2013)  establishing the newer diagnosis of Disruptive Mood Disregulation  Disorder which addressed the primary issue of children presenting for  treatment with significant and pervasive irritability. An important  distinction that must be made is the difference between PBD and DMDD:  PBD has discrete episodes of irritability (mania) whereas in DMDD the  irritability is chronic and nonepisodic (Findling & Chang, 2018). 

With  no other diagnosis available in the past, it is possible that some of  these kids ended up with a PBD diagnosis for what was likely DMDD;  still, this fact does not negate the necessity for a PBD diagnosis to be  available. In fact, between 50-66% of adults with well-documented  bipolar disorder report having had symptoms prior to age 19 (Findling  & Chang, 2018). As has been well-established, earlier treatment and  intervention result in better outcomes (McGorry & Mei, 2018).

The  International Society for Bipolar Disorders Task Force (Goldstein et  al., 2017) found that the previous studies which resulted in much of the  debate appeared to be more influenced by training, conceptualization,  and insurance as opposed to true differences in prevalence. While the  Task Force acknowledges the need for more studies to more accurately  assess for hypomania and differentiation of PBD from non-mood  psychopathology, a need to recognize and diagnose PBD still remains.  McGorry and Mei (2018) make the case for earlier intervention for PBD  due to the fact that (1) earlier treatment is more effective, and (2)  recurrence is often associated with structural  changes in the brain.  Considering this fact, and the new understanding that previous  “over-diagnosis” was probably not actually over-diagnosis, recognizing  and treating PBD remains a critical piece of pediatric psychiatry. 

My Takeaway

When  I began reading about pediatric bipolar disorder, I was initially  inclined to think that it would be difficult to differentiate PBD from  normal childhood mood swings. However, the more I read, the more clear  it became that by accurately diagnosing PBD, the better the outcomes.  Also, one thing that I noticed in several studies was the necessity for a  “structured interview” in the diagnostic process. I have not seen that  done in real life, but it inspired me enough that I found a handbook and  manual, the Structured Clinical Interview for DSM-V, from the American Psychiatric Association Publishing arm that I purchased for my own resources (https://www.appi.org/Products/Interviewing/SET-of-SCID-5-CV-and-SCID-5-CV-Users-Guide).  The bottom-line, for me, is to make sure that I remain open to what new  research shows and to remember that I will never know everything and  that I can always learn something new.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5th ed.). Washington, DC: Author.

Findling, R.L. & Chang, K.D. (2018). Improving the Diagnosis and Treatment of Pediatric Bipolar

Disorder. Journal of Clinical Psychiatry, 79(2), 62-69. 

Goldstein, B.I., Birmaher, B., Carlson, G.A., DelBello, M.P., Findling, R.L., Fristad, M., 

Kowatch, R.A., Miklowitz, D.J., Nery, F.G., Perez-Algorta, G., Van Meter, A., Zeni, C.P.,

Correll, C.U., Kim, H.W., Wozniak, J., Chang, K.D., Hillegers, M. & Youngstrom, E.A. 

(2017). The International Society for Bipolar Disorders Task Force report on pediatric

bipolar disorder: Knowledge to date and directions for future research. Bipolar Disorders,

19, 524-543. Doi: 10.111/bdi.12556.

Van Meter, A., Moreira, A.L., & Youngstrom, E. (2019). Updated Meta-Analysis of 

Epidemiologic Studies of Pediatric Bipolar Disorder. Journal of Clinical Psychiatry, 80(3),

e1-e11. doi: 10.4088/JCP.18r12180.

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Select two clients you observed or counseled this week during a group therapy session for CHILDREN AND ADOLESCENT Note: The two clients you select must have attended the same group session. 

Then, address in your Practicum Journal the following:

• Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.
• 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 any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

Read chapters 18 and 19 of the class textbooks and review the PowerPoint presentations located in the PowerPoint folder. Once done answer the following questions.

1. Identified and explain situations that make populations underserved and apply the recommendations from Healthy People 2020 initiatives to meet individual, family, and population health needs.

2. Are there legal obligations that you can identify in relation to rural, correctional, LGBTQ, or homeless health? Give specific examples and what your resource would be to address these issues.

3.  Explain the different types of disasters and how they may vary, the primary goal of simulation in disaster preparedness and the phases involved in disaster planning

A minimum of 3 evidence-based references no older than 5 years must be used 

APA format (intext citations and references)

800 words

Plagiarism FREE

Review the feedback on the change proposal professional presentation and make required adjustments to the presentation. Present your evidence-based intervention and change proposal to an interprofessional audience of leaders and stakeholders. Be prepared to answer questions and accept feedback.

After presenting your capstone project change proposal, write a 250-350 word summary of the presentation. Include a description of the changes that were suggested by your preceptor before your presentation and how you incorporated that feedback. Describe how this interprofessional collaboration improved the effectiveness of your presentation. Include a description of the feedback and questions from your audience after your presentation, and how this experience will affect your professional practice in the future.

Provide examples of experimental and nonexperimental research design. Contrast the levels of control applied to each.

Attention Wizard Kim. 

Week 6 Discussion: Practicum professional Development Objectives/ Progress Appraisal  3 pages. 

Rubrics 

The U.S. Department of Health & Human Services released a comprehensive Clinical Practice Guideline for Treating Tobacco Use and Dependence–2008 Update 

https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/clinicians/update/index.html 

The goal of these recommendations is that clinicians strongly recommend the use of effective tobacco dependence counseling and medication treatments to their patients who use tobacco, and that health systems, insurers, and purchasers assist clinicians in making such effective treatments available. 

After reading these recommendations answer the following questions.

1. what are the clinical interventions for patients unwilling to quit cigarette smoking?

2. According to the best practices what are the best strategies to help your clients quit smoking?

3. are there any specific smoking cessation recommendations for especial populations such as teenagers or the elderly?

Every student must post just once during the time frame Discussion Forum is Open.

  Watch the film “A Road to Home”  and complete a movie review. 

Respond to each question below in 100 words. 

1. State the title of the film and the year it was released. Then briefly describe what the film is about.

2.  Identify the people, places, events, that are the focus of this film. Describe and clarify the significance of each

3. List six facts described in the film that impressed you and explain how each fact relates to the film’s premise or theme.

4. Stay or Go? What are the pros and cons of an LGBTQ individual leaving home?

5. Describe an aspect of the film that showed you something you had not seen before, caused you to think in a new way, or helped you understand something more thoroughly than before. In addition, describe how it changed your thinking as a nurse.

6. Identify at least two community resources in you’re the state of Illinois to provide homeless health care. Describe them briefly.

7. Would you recommend this film to other nursing students about the plight of the LGBTQ community and homelessness? Explain.

8. Discuss 3 health educational needs for a member of the homeless LGBTQ community. Chose one of the educational needs and write a paragraph explaining how you could implement the health education as a community nurse.

9. View the following website about the AliForneyCenter.org. What services do they provide and benefits?

Read the following article and write a 200 words summary. “Legal Issues with Sexual and Gender Minority Patients in the Emergency Department” Edie Brous RN, BSN, MS, MPH, JD (2019)