1. Because the patient’s reported hallucinations are not persecutory, as a clinician, what medications would you start with?

2. What treatments (pharmacological and non-pharmacological) are most effective for patients with extensive trauma history?

3. What symptoms could be co-occurring in relation to PTSD vs schizophrenia for this patient?  

 

Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

• Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

 Esophageal Reflux Case Studies A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her physical examination were negative. Studies Results Routine laboratory studies Negative Barium swallow (BS), p. 941 Hiatal hernia Esophageal function studies (EFS), p. 624 Lower esophageal sphincter (LES) pressure 4 mm Hg (normal: 10–20 mm Hg) Acid reflux Positive in all positions (normal: negative) Acid clearing Cleared to pH 5 after 20 swallows (normal: <10 swallows) Swallowing waves Normal amplitude and normal progression Bernstein test Positive for pain (normal: negative) Esophagogastroduodenoscopy (EGD), p. 547 Reddened, hyperemic, esophageal mucosa Gastric scan, p. 743 Reflux of gastric contents to the lungs Swallowing function, p. 1014 No aspiration during swallowing Diagnostic Analysis The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and shortness of breath at night were caused by aspiration of gastric contents while sleeping. This was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had only minimal relief of her symptoms after 6 weeks of medical management, she underwent a laparoscopic surgical antireflux procedure. She had no further symptoms. Critical Thinking Questions 1. Why would the patient be instructed to avoid tobacco and caffeine? 2. Why did the physician recommend 6 weeks of medical management? Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 3. How do antacid medication work in patients with gastroesophageal reflux? 4. What would you approach the situation, if your patient decided not to take the medication and asked you for an alternative medicine approach? 

After completing the Foundation of Nursing Leadership self-assessment, I discovered my leadership style aligns with “laissez-faire.” I value the autonomy of my team members and believe that integrating the opinions of other nurses is paramount. This approach significantly influences my decision-making in nursing care, ensuring collaborative and well-rounded decisions. To further hone my leadership skills, I am committed to continuous learning, actively seeking feedback, fostering mentorship relationships with seasoned nursing leaders, and practicing regular self-reflection. Through these strategies, I aim to become an adaptable leader, adept at navigating the intricate realm of healthcare.

Week 2 Ethical Health Promotion Paper

Find a scholarly, peer-reviewed article no more than four years old that discusses an ethical health promotion-related issue.

In your paper:

· Briefly summarize the presented issue.

· Describe your thoughts on the role health care professionals should play in resolving the ethical issue.

· Provide specific theories and refer to specific ethical codes to support your position.

Your paper should be 2–3 pages long. Use APA to cite and reference the article and any other optional sources you use. Adhere to APA formatting throughout your paper.

Rubric

NURS_561_DE – Paper/Essay Rubric

NURS_561_DE – Paper/Essay Rubric
Criteria	Ratings	Pts
This criterion is linked to a Learning OutcomeContent	40 to >31.6 pts Meets Expectations The writer clearly and effectively responds to the assignment. 31.6 to >23.6 pts Approaches Expectations The response to the assignment is generally adequate but may not be thorough. 23.6 to >0 pts Not Meeting Expectations The writer does not respond to the assignment.	40 pts
This criterion is linked to a Learning OutcomeFocus and Detail	30 to >23.7 pts Meets Expectations There is one clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information. 23.7 to >17.7 pts Approaches Expectations There is one clear, well-focused topic. Main ideas are clear but are not well supported by detailed information. 17.7 to >0 pts Not Meeting Expectations The topic and main ideas are not clear.	30 pts
This criterion is linked to a Learning OutcomeOrganization	20 to >15.8 pts Meets Expectations The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong. 15.8 to >11.8 pts Approaches Expectations The introduction states the main topic and provides an overview of the paper. A conclusion is included. 11.8 to >0 pts Not Meeting Expectations There is no clear introduction, structure, or conclusion.	20 pts
This criterion is linked to a Learning OutcomeMechanics and APA	10 to >7.9 pts Meets Expectations The assignment consistently follows current APA format and is free from errors in formatting, citation, and references. No grammatical, spelling, or punctuation errors. All sources are cited and referenced correctly. 7.9 to >5.9 pts Approaches Expectations The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are cited and referenced correctly. 5.9 to >0 pts Not Meeting Expectations The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are cited and referenced incorrectly, or citations and references are missing.	10 pts
Total Points: 100

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