ANALYZING GROUP TECHNIQUES

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Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Instructions:

Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.

Compare and contrast your initial posting with those of your peers.  

1. How are they similar or how are they different?

2. What information can you add that would help support the responses of your peers?

3. Ask your peers a question for clarification about their post.

4. What most interests you about their responses? 

5. Summaries at least 1 evidence based article that supports there point.

Please be sure to validate your opinions and ideas with citations and references in APA format.

·
Response 1 400 words IA

·

This case scenario is quite interesting since this is about a young female patient who reports multiple symptoms starting three weeks ago. This is where one researches and I believe this patient may be having an episode of major depressive disorder. I dare to come to come up with this diagnosis since she presents multiple symptoms starting about three weeks ago. Going over the multiple sections to cover this week in the “Diagnostic and Statistical Manual of Mental Disorders” I found that she presents with subjective information such as having insomnia, diminished ability to concentrate, lack of interest, weight loss due to loss of appetite, crying spells with no apparent reason. This young lady also reports feeling “tired & fatigued” and has lost interest in activities she usually enjoys. The key for me here was finding all these symptoms under the diagnostic criteria for major depressive disorder box (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). Although she does not meet all the criteria, she presents more than five symptoms with onset about three weeks ago and according to our manual symptoms must be present at least two weeks (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

Regarding her headache, and according to our book this patient can be reporting somatic complaints such as pain and aches instead of reporting an actual feeling of sadness (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

The classification of medication that I would recommend for this patient would be antidepressants. Our prescriber's book has a long list such as sertraline, paroxetine, trazodone, and escitalopram among many (Stahl, 2021). I would focus on a common drug that I see very often, and that is sertraline. Sertraline would be a good option for her since is an SSRI (selective serotonin reuptake inhibitor) (Stahl, 2021)

and I remember Dr. Kubiak mentioning that serotonin can be the usual one to blame for depression along with norepinephrine. This drug can boost the neurotransmitter serotonin and can also block the serotonin reuptake pump (Stahl, 2021)

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Response 2. 400 words sy

What diagnosis do you believe may apply to this individual?

This patient presented with symptoms of headache, fatigue, sleep disturbance, weight loss, loss of interest in activities, and frequent crying spells, all of which are indicative of major depressive disorder (MDD). Signs that a patient might be suffering from MDD include avoiding certain situations that they enjoy, inability to concentrate, and being unable to go to work due to fatigue. MDD can disrupt the patient's daily life by affecting their home, work, and social life (Salvo et al., 2022). According to the DSM-5, to be diagnosed with MDD, patients must experience 5 or more symptoms in the last week.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

Treatment for this patient will include antidepressants. Antidepressants are classified into different types based on their work and chemical structures. There are four main groups: monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs are a broad category of antidepressant medications. Since this patient has no significant past medical or psychiatric history and takes no regular medications, my recommendation would be fluoxetine 10 mg for 4 weeks, then increasing the dose to 20 mg daily if the drug is well tolerated by the patient (Arcangelo et al., 2021). SSRIs tend to be well-tolerated and are relatively cost-effective. Patients who take SSRIs exhibit fewer side effects in comparison to those who take Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Therefore, SSRIs are often considered the first line and primary choice for the treatment of mood and anxiety disorders. The class of SSRIs includes Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), and Escitalopram (Lexapro). Side effects include weight gain, insomnia, sexual dysfunction, gastrointestinal issues, and agitation (Arcangelo & Peterson, 2021).

References

Arcangelo, V. & Peterson, A. (2021). Pharmacotherapeutics for advanced practice: A practical approach. (5th ed.). Wolters Kluwer

Imiuwa, M. E., Baynes, A., & Routledge, E. J. (2023). Understanding target-specific effects of antidepressant drug pollution on molluscs: A systematic review protocol. PLoS One, 18(6) https://doi.org/10.1371/journal.pone.0287582Links to an external site.

Salvo, G. D., Bianco, M., Teobaldi, E., Maina, G., & Rosso, G. (2022). A Psychoanalytic-Derived Brief Psychotherapeutic Approach in the Treatment of Major Depression: Monotherapy Studies. Medicina, 58(10), 1335. https://doi.org/10.3390/medicina58101335

Analyis of social determinants of health

What is the best way to analyze social determinants of health on population

Nutrition & Hydration


Nutrition & Hydration/Persistent Vegetative State (PVS)

After studying the course materials located on 

Module 7: Lecture Materials & Resources
 page, answer the following:

1. Cure / care: compare and contrast.

2. Basic care: Nutrition, hydration, shelter, human interaction.

· Are we morally obliged to this? Why? Example

3. Swallow test, describe; when is it indicated?

4. When is medically assisted N/H indicated?

· Briefly describe Enteral Nutrition (EN), including:

· NJ tube

· NG tube

· PEG

· Briefly describe Parenteral Nutrition (PN), including:

· a. Total parenteral nutrition

· b. Partial parenteral nutrition

5. Bioethical analysis of N/H; state the basic principle and briefly describe the two exceptions.

6. Case Study: Terry Schiavo (EXCEL FILE on 

Module 7: Lecture Materials & Resources
 page). Provide a bioethical analysis of her case; should we continue with the PEG or not? Why yes or why not?

7. Read and summarize ERD paragraphs #:  32, 33, 34, 56, 57, 58.

W7

1. When dealing with a patient with both depression and anxiety how should the provider prioritize their care? (focused more on teenagers)

2. What are your thoughts in regard to the standard of care of pediatric patients who are diagnosed with MDD vs. Bipolar Disorder?

3- therapy options available that can assist the patient with
Major Depressive disorder, Recurrent episode, Severe, Generalized Anxiety Disorder and Bipolar II Disorder, current episode depressive, moderate ((no cognitive behavior therapy))

Hello, answer those 3 questions without introduction or conclusions, just the questions. references minimum 1 for each question.. simple but with content

Week 6 – Discussion

HUM 1050 – Introduction to Literature

Week 6 – Discussion

Instructions:

This week, we shift our discussion to poetry, focusing on the work of Martin Espada. You will upload a PowerPoint in the discussion and in the Dropbox for grading that includes a visual that interprets one of his poems. Choose a poem from the link below:

https://www.poetryfoundation.org/poets/martin-espada

Your presentation should be a minimum of six slides and may have more depending on the length of the poem. Here is a suggested layout:

· Slide 1: Include the title of the presentation and your name, college name, course name, instructor name, date

· Slide 2: Include a brief bio of the poet.

· Slide 3: Introduce the poem with a link to the poem.

· Slides 4-5: Present the visual you have selected. Give the background on the visual and explain its relevance to the poem.

· Slide 6: Reference list in APA format. 

 

Criteria

Ratings

The Poem

This criterion is linked to a Learning Outcome

Focus on poem

CSLO 3

threshold: 15.0 pts

15 pts

Mastery

15 pts The poem presented clearly on the slide(s)

The VIsual

This criterion is linked to a Learning Outcome

Visual presented

CSLO 3

threshold: 15.0 pts

15 pts

Mastery

15 pts A vivid image that interprets the poem clearly presented

Theme of poem

This criterion is linked to a Learning Outcome

Theme of poem

CSLO 4

threshold: 20.0 pts

20 pts

Mastery

20 pts The theme of the poem clearly presented

Author's Biography

This criterion is linked to a Learning Outcome

Author’s biography

CSLO 4

threshold: 20.0 pts

10 pts

Mastery

10 pts Poet’s biography clearly presented

Formatting and Readability

This criterion is linked to a Learning Outcome

Formatting and readability

CSLO 6

threshold: 10.0 pts

20 pts

Mastery

20 pts Text and layout are clear and easy to

APA Formatting

This criterion is linked to a Learning Outcome

APA formatting

CSLO 5

threshold: 10.0 pts

10 pts

Mastery

10 pts Citations and References are properly presented

Language

This criterion is linked to a Learning Outcome

Language is appropriate

CSLO 6

threshold: 10.0 pts

10 pts

Mastery

10 pts Fewer than 3 grammatical, punctuation, or mechanical errors

Incivility and Healthful environments

 Reflect on an experience in which you were directly involved or witnessed incivility in the workplace. Provide a brief synopsis of the situation. How did this make you feel? How did you respond? What were the consequences of this situation? Provide an example of how this negatively affected the work environment and outcomes. How could the situation have been prevented? Discuss strategies that would support a healthy work environment. 

informed consent elements

Discuss the elements of informed consent. Provide a clinical example about what can happen when some elements are not adhered to.

Replies week 7 MSN 5550

  Reply to  these posts with a reflection of their response.Minimun 200words each one 

1. In this week’s discussion, I was able to: Integrate nursing and related sciences into the delivery of care to patients. I was also able to analyze quality initiatives to improve patients’ health outcomes.

     Alternative and Complementary medicines are considered health-cultured practices, that are not part of traditional medicine and that have been part of the holistic culture of the populations. They are used as an alternative or in addition to traditional medical treatments with the goal of improving patients’ outcomes (Lee, Richard, et al., 2022). Alternative and Complementary medicines can include therapies such as dietary supplements, herbs, acupuncture, Chinese medicine, yoga, reiki, ayurvedic medicine, complementary supplements, etc (Adeniyi, Washington, et al., 2021). The reasons for using these alternative methods can be many: Cultural, religious, economic, etc. However, as many people use it most of the time, it is important to analyze this point and share our opinion on this matter.

     It is well-known that many people from the general population are used to taking self-prescribed natural treatments. In the first term, we can name herbal medications. In general culture and even in religion, people believe that herbs have a good effect in the treatment of some diseases such as hypertension or Diabetes Mellitus. Many people think that herbs were created by God in order to provide natural treatment for diseases. Actually, many people believe that herbal medicines are better choices as they don’t have undesirable effects at all. Some people prefer to take natural medication rather than medical treatments, as they think that pharmacological preparations are made of chemical and artificial ingredients that can be harmful to the body. Moreover, people trust natural treatments for cancer, as it is thought that they can potentially inhibit oncology cell growth. However, researchers have determined that about 80% of the patients do take their pharmacological treatment in addition to a natural treatment (Adeniyi, Washington et, al. 2021). However, there are some natural treatments that, in addition to pharmacological treatment, can cause adverse effects, for example, ginkgo can increase the anticoagulant effect; ginseng and some teas can decrease the anticoagulant effect (Izzo 2005). Other natural treatments such as exercises, meditation, yoga, and acupuncture, are also used and well-known as coadjuvants to release stress and that way help improve clinical condition.

     In conclusion, the healthcare team needs to accept that alternative and natural treatments are part of the culture and religion of the population. So it is very important to establish a good and trustable relationship with the patient, so he/she can feel confident enough to tell the healthcare provider about the alternative treatments that are been taken, as sometimes they can help, but sometimes they can be harmful. In the end, a closed and trustable relationship with the patient and a good assessment is the basis for the best possible outcomes.

2. The allopathic or conventional medicine is practiced by doctors and health personnel. Complementary medicine refers to the practice of medicine that complements conventional medicine, that is, it is used in conjunction with conventional medicine. An example includes the use of acupuncture in pain management. Alternative medicine, on the other hand, is the use of complementary and alternative medicine as a replacement for traditional medicine

Complementary and alternative medicine are very varied. Within them, we find natural products related to botanical medicine and probiotics. We also find mind and body therapy, such as meditation techniques, yoga, acupuncture, hypnotherapy, and deep relaxation exercises, among others.

In the treatment of cancer, it has been proven that the use of complementary and alternative therapy has been useful in managing the patient’s symptoms. However, it is not considered a miraculous medicine in the cure of cancer; it simply helps, in conjunction with conventional medicine, to manage some symptoms that cancer patients experience. For example, acupuncture treatment can help alleviate symptoms related to pain, therapeutic massages have been shown according to some research studies to reduce depression, pain, and depressive anxiety disorders related to cancer disease (American Cancer Society, 2019). However, some harmful health effects and interactions with medications have been shown, especially in treatment with botanical medicine, so it is recommended that your doctor be notified of its use before starting treatment to avoid drug interactions and potential harm to health (American Cancer Society, 2019).

Holistic medicine, unlike conventional medicine, is not focused on treating diseases as allopathic medicine does. Rather, it is preventative medicine, although it can be integrated with allopathic medicine in some instances. Holistic medicine is based on the fact that illnesses appear as a consequence or result of environmental, physical, social and/or emotional imbalances (Cannon, 2023). Therefore, its essence is to heal the body and mind with alternative therapies to maintain their balance and prevent the onset of illness. Holistic medicine dates back to ancient times, and after the appearance of conventional medicine, it was somewhat abandoned. However, in around the 1960s in Europe and America, the properties of holistic medicine regained popularity. An example of this is homeopathy, which can be used to recover body vitality as holistic medicine, but it can also be used as an adjunct treatment to allopathic medicine. The use of phytotherapy has had great success in the management of certain diseases, such as those of the immune system, favoring healing.

In the management of high blood pressure and diabetes, the practice of natural medicine plays a fundamental role as an adjunct to integrated medicine; even natural medicine can be used as a technique for the prevention of these diseases. The practice of a balanced and healthy diet, daily physical exercise, relaxation techniques and stress management are determining factors in the prevention of arterial hypertension, cancer, and diabetes. Other natural medicine can be used, for example omega 3 is an essential oil that can be used to prevent special hyperlipidemia in patients with chronic disease.

Both allopathic and holistic medicine have an important role on patient care, and together, they can give the best result in the management of the disease. As a provider, we need to offer the patient different option to treat their condition, but we need to be respectful of patients’ autonomy in their decision.

DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE

DEVELOPING A CULTURE OF EVIDENCE-BASED PRACTICE

As your EBP skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry. 

To Prepare:

· Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

· This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.

· Reflect on which type of dissemination strategy you might use to communicate EBP.

Post at least two dissemination strategies you would be most inclined to use and explain why. Explain which dissemination strategies you would be least inclined to use and explain why. Identify at least two barriers you might encounter when using the dissemination strategies you are most inclined to use. Be specific and provide examples. Explain how you might overcome the barriers you identified.

LEARNING RESOURCES

Required Readings

· Melnyk, B. M., & Fineout-Overholt, E. (2023). 
Evidence-based practice in nursing & healthcare: A guide to best practice (5th ed.). Wolters Kluwer.

· Chapter 10, “The Role of Quality Improvement and Evidence-Based Quality Improvement in Practice Change” (pp. 365–393)

· Chapter 12, “Leadership Strategies for Creating and Sustaining Evidence-based Practice Organizations” (pp. 410–427)

· Chapter 14, “Models to Guide Implementation and Sustainability of Evidence-based Practice” (pp. 466–518)

· Gallagher-Ford, L., Fineout-Overhold, E., Melnyk, B.M. &  Stillwell, S.B. (2011). 
Evidence-based practice step-by-step:  Implementing an evidence-based practice changeLinks to an external site.
American Journal of Nursing, 111(3), 54-60.

· Newhouse, R. P., Dearholt, S., Poe, S., Pugh, L. C., & White, K. M. (2007). 
Organizational change strategies for evidence-based practiceLinks to an external site. 
Journal of Nursing Administration, 37(12), 552–557. doi:0.1097/01.NNA.0000302384.91366.8f

· Melnyk, B. M. (2012). 
Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice.Links to an external site. 
Nursing Administration Quarterly, 36(2), 127–135. doi:10.1097/NAQ.0b013e318249fb6a

· Melnyk, B. M., Fineout-Overholt, E., Gallagher-Ford, L., & Stillwell, S. B. (2011). 
Evidence-based practice, step by step: Sustaining evidence-based practice through organizational policies and an innovative model.Links to an external site. 
American Journal of Nursing, 111(9), 57–60. doi:10.1097/01.NAJ.0000405063.97774.0e

· Melnyk, B. M., Fineout-Overholt, E., Giggleman, M., & Choy, K. (2017). 
A test of the ARCC© model improves implementation of evidence-based practice, healthcare culture, and patient outcomesLinks to an external site.
Worldviews on Evidence-Based Nursing, 14(1), 5–9. doi:10.1111/wvn.12188