Please provide a statement of your professional goals and aspirations.It should be typewritten and about one page in length.

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

Vid reflection

Make a PPT with Evidence Base Practice. PICOT Question:  Are educated Medical-Surgical nurses (I) more successful in performing COVID-19 nasopharyngeal swabs (P) compared with non-educated Medical-Surgical nurses (C) for accurate COVID-19 test results (O)? 

I uploaded a PPT that you can use/edit. Check all the articles in the reference list I put in and search 3 more articles that is related to my PICOT question. You have to base all the articles to my PICOT questions. I need it tomorrow in less than 24 hours, if early I appreciate it. Thank you.

*Hope you know how to grade articles using The Johns Hopkins Nursing Evidence-based Practice Rating Scale.

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)

                                                    Main post

Pediatric Bipolar Depression Disorder

Bipolar  disorder is a mood disorder distinguished by profound fluctuations in  emotions, moods, energy, and activity levels in which the individual  experiences episodes of mania, depression, or hypomania (National Institute of Mental Health,  2020). Moreover, bipolar depression disorder is a subdivision of  bipolar disorder characterized by depression extreme enough to impair  day-to-day activities involving school, work, social, and family  interactions (Mayo Clinic, 2018). Symptoms of bipolar depression  include but are not limited to the presence or history of 1 or more  major depressive episodes, presence or history of 1 or more hypomanic  episodes, absence of manic/mixed episodes, significant impairments in  all aspects of life, feeling sad, hopeless, worthless, irritability,  loss of interest in previously enjoyed activities, weight loss/gain,  increased/decreased appetite, sleep disturbance, fatigue, decreased  concentration, decreased ability to make decisions, and suicidal  ideations (American Psychiatric Association, 2013). 

Additionally,  diagnosing bipolar depression disorder in the pediatric population can  be debated both for and against the diagnosis. However, it is a real  mental health condition effecting the pediatric population. Hence, the  diagnosis should be made if criteria is met. Therefore, the remainder of  this discussion will aim to justify the diagnosing of pediatric bipolar  depression disorder. 

To begin, the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-V) is a clinical guideline that uses a common language and standard criteria to diagnosis mental disorders (American Psychiatric Association,  2013). It does not dictate an age requirement when diagnosing bipolar  disorder. Hence, it is suggested that any age group can be diagnosed  with bipolar disorder if criteria is met. Next, a familial history of  bipolar disorder increases the likelihood of the pediatric client having  the disorder with a five-time greater chance if a 1st degree family member has the disorder (Cleveland Clinic,  2019). Also, a research roundtable identified and concluded that  pediatric children can be diagnosed with bipolar disorder using  psychiatric assessment tools (Lynn, 2001). Too, the  Oregon Adolescent Depression Project identified a peak onset of bipolar  disorder at 14 years old with significant progression throughout  developmental stages including adulthood (Lewinsohn et al., 2002). Therefore, there is sufficient support for the diagnosing of pediatric bipolar depression disorder.

Conclusion

While  controversy exist regarding diagnosing pediatric clients with bipolar  depression disorder, the diagnosis should be made if the client meets  criteria. Accurate diagnosing is vital as bipolar depression disorder is  a lifelong mood disorder that will require treatment for effective  management. With accurate diagnosing and treatment management, the  pediatric client can live a productive life. 

References

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

Cleveland Clinic. (2019). Bipolar Disorder in Children. https://my.clevelandclinic.org/health/diseases/14669-bipolar-disorder-in-children 

Lewinsohn, P. M., Seeley, J. R., Buckley, M. E., & Klein, D. N. (2002). Bipolar disorder in adolescence and young adulthood. Child and Adolescent Psychiatric Clinics of North America, 11(3):461-75. DOI: 10.1016/s1056-4993(02)00005-6

Lynn, G. T. (2001). National Institute of Mental Health research roundtable on prepubertal bipolar disorder. Journal of American Academy of Child Adolescent Psychiatry, 40(8):871-8. DOI: 10.1097/00004583-200108000-00007 

Mayo Clinic. (2018). Bipolar disorder. https://www.mayoclinic.org/diseases-conditions/bipolar-disorder/symptoms-causes/syc-20355955

National Institute of Mental Health. (2020). Bipolar Disorder. https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml 

This is a Collaborative Learning Community (CLC) assignment.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 3 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

PLEASE REFER TO: 

 Theory; Nightingales Environmental Theory-grand theoryNightingales Environmental Theory-grand theory 

PowerPoint of at least 18 slides about the different gastrointestinal disorders in pediatric. Must include definition, risk factors, signs and symptoms, Diagnosis tests, management and education of the most important gastrointestinal diseases in children. 

Due 10/11/20 Sunday @ 7pm EST

2 – 3 pages

Must be submitted through TurnItIn with the submission report.

All other instructions attached. 

1 journal

1 discussion 

From my experience and observation as a mental health nurse, I remember a 20-year-old male patient who was admitted to my facility with a diagnosis of schizophrenia, self-harming behaviors, and substance abuse. This patient had a long history of using fentanyl, methamphetamine, and street drugs like Mexican Percocet’s. He has been admitted numerous times to our facility for substance abuse detox. This patient had been on several dosages of Clozapine which was prescribed by the provider to help with his acute case of mental illness. A week after starting his initial Clozapine medication, this patient was complaining of discomfort, chest pain and will explain to the staff that his pain was getting worse daily. The physician ordered EKG to check the activity of his heart.

Pharmacodynamics

Clozapine is a serotonin antagonist, with strong binding to 5-HT 2A/2C receptor subtype. It also displays strong affinity to several dopaminergic receptors but shows only weak antagonism at the dopamine D2 receptor, a receptor commonly thought to modulate neuroleptic activity. Clozapine also binds to D1, D3, and D5 receptors, and has a high affinity for the D4 receptor (McEvoy, 2018). Researchers shows that it includes the limbic system.

Pharmacokinetics

              Clozapine is absorbed quickly, first-pass metabolism reduces its bioavailability to 60 to 70 percent of the administered dose; food has little effect on the bioavailability of clozapine (Patuszynski & Applegate, 2017). The eliminated half-life of clozapine averages a period of 14 hours under certain conditions, but there is considerable variability across individuals. For example, it depends on each individual own metabolism and its underlying factors (McEvoy, 2018).

Care plan

Because clozapine has an increased incidence of clozapine-induced myocarditis as well as cardiomyopathy. Patients who are currently taking clozapine will need to be monitored closely by a cardiologist. Staff must educate the patient regarding the risk that are involved with this medication. “We need to understand that there should be standardized and mandatory plans of care which should include troponin levels as well as EKGs and echocardiograms at various times during inpatient stays” (Kir et al., 2020).  “Other factors to consider would be airway clearance due to excessive salvation and neutropenia” (Okada et al., 2020). Careful patient monitoring is essential when taking clozapine therapy. It is important to educate patient to keep to their lab appointments where they could monitor blood levels.

References

 Kır, Y., Baskak, B., Kuşman, A., Sayar-Akaslan, D., Özdemir, F., Sedes-Baskak, N., Süzen, H.

S., & Baran, Z. (2020). The relationship between plasma levels of clozapine and N-desmethyclozapine as well as M1 receptor polymorphism with cognitive functioning and associated cortical activity in schizophrenia. Psychiatry Research: Neuroimaging, 303. 

Okada, T., Kumakura, J., Yasuda, M., & Suda, S. (2020). Treatment-resistant schizophrenia

successfully maintained with brexpiprazole following abrupt withdrawal of clozapine due to neutropenia. Asian Journal of Psychiatry, 47. 

Patuszynski, D., & Applegate, P. M. (2017). Suspected Clozapine-Induced Cardiomyopathy and

Heart Failure With Reduced Ejection Fraction. Federal practitioner: for the health care professionals of the VA, DoD, and PHS, 34(4), 20–22.