NU670 Advanced Psychopharmacology and Health Promotion
Unit 2 Assignment Discussion
Case Study
Prompt
Offering informed consent and accurately educating a patient/ or their caregivers about medication is an essential competency for all prescribers to master. There are many created consent forms available for the prescriber to offer the patient and their family, however, the prescriber should always offer a verbal explanation as well. The forms and pamphlets can be given during the appointment for the patient to review at a later time. It is important to recognize that the majority of patients do not have medical knowledge and have low literacy. For this reason, when they review created consent forms, they may be quickly become overwhelmed, confused, or fearful about treatment. It is the prescriber’s duty to offer full informed consent that encompasses education about the medication, an explanation of the medication’s mechanism of action, the possible side effects, and the goal of the medication in that particular patient.
In this assignment, you will practice giving informed consent for an antipsychotic and obtaining consent for the treatment plan. Even if you have no plans of prescribing these psychotropic medications, you will still complete this assignment.
You will utilize Zoom and/or Youtube to record and then submit the link to your assignment. You may choose any first (1st) or second (2nd) generation antipsychotic to give informed consent about seek consent for treatment.
***However, please see below for specific instructions on whether you will be 1) seeking consent to begin an antipsychotic in an adolescent 2) seeking consent for a LAI (long acting injectable), or? 3) seeking consent to begin an antipsychotic in a geriatric patient. Your audience may be the patient or the patient’s caregiver. Discuss what the medication will be targeting (mechanism of action for specific s/sx), the dose you plan to start, key side effects/consideration for the patient, and monitoring or tests that need to take place, and alternatives. Lastly, let the patient know how soon they will need to have a follow-up appointment and what to expect in terms of how often they will follow-up for an appointment after initiation of treatment. (“Risks, benefits, side effects, monitoring, alternatives and follow-up”).
If your?LAST NAME?starts with?A through I?please use the following circumstance:?Consent for a LAI (any age patient)
If your?LAST NAME?starts with?J through Q?please use the following circumstance: Consent in a geriatric patient?
If your?LAST NAME?starts with?R through Z?please use the following circumstance: Consent in an adolescent patient C
Give one (1) response to a peer for each of the other scenarios, for a total of one (1) initial post and two (2) responses.
Example: Student A: speech is Consent in an adolescent patient; response one (1) to Consent for a LAI (any age patient), response two (2) Consent in a geriatric patient.
Instructions:
If you would like to use Zoom, please see?the Zoom-quick start downloadand Zoom tutorial download?for more detailed instructions. After your recording is complete, follow these instructions to?create a private, unlisted YouTube video (Links to an external site.). You will need the YouTube video website/URL for this discussion. Submit your YouTube video website/URL (link) to this discussion page. The best way to do this is to copy and paste the website/URL for the YouTube video into a Word document and then post the Word document. Your instructor and peers will access your video via the link.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria.
Estimated time to complete: 2 hours
Respond (“comment”) to two (2) peers.?Give one (1) response to a peer for each of the other scenarios, for a total of one (1) initial post and two (2) responses.
Example: Student A: speech is Consent in an adolescent patient; response one (1) to Consent for a LAI (any age patient), response two (2) Consent in a geriatric patient.
Responses are also audio recordings and should be no longer than 2 minutes. At least one scholarly reference should be included with each response.?When citing a reference, simply say it (e.g. “…in the Journal of Psychiatric Nurses, an article titled?Helping Patients Recovery?published in 2019, discussed the importance of…”)
? Discussion Peer/Participation Prompt [Due Sunday]
Please respond to at least 2 of your peer’s posts with substantive comments using the following steps:
Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.
References and citations should conform to APA standards.
Remember: Please respect the opinions of others, even if their views differ. In other words, disagree professionally and respectfully.
Plagiarism is never acceptable – give credit when credit is due - cite your sources.
Responses need to address all components of the question, demonstrate critical thinking and analysis and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
Please review the rubric to ensure that your response meets the criteria. Collaboration points will be forfeited if you fail to meet the response post guidelines.
NU670 Advanced Psychopharmacology and Health Promotion
Unit 7 Assignment Discussion
Instructions
Evaluating and managing the side effects of psychotropics is an important part of prescribing. Some side effects can be safely monitored and managed by a PMHNP. While others may require additional tests, collaboration with primary care providers, or even referrals to specialists. It is key to know which side effects are “ok” to treat and which should really be treated by a different provider. Part of this answer may depend on the state in which you ultimately practice, as what you are allowed to prescribe may vary state by state.
? For this assignment, you will review the PowerPoint?
Evaluating and Managing Side Effects of Psychiatric Medications download[PowerPoint]
Locate your assigned case study and answer the questions which correspond to the FIRST letter of your LAST name. The answers to these questions will be located in the PowerPoint, but you will need to do additional research to support your decisions.
Then you will respond to the main postings of two other learners; at least one response should be to a peer who has answered questions different from yours.
Recall that your main posting should be submitted by Friday at 11:59 p.m., Eastern time. All responses to other learners’ discussion questions must be submitted no later than Sunday at 11:59 p.m, Eastern time in order to be considered for grading purposes.
? If your LAST name begins with the letter A through N, please read the following and address the questions:
A 56 yr. old woman signs up with you as his new primary care physician. Her previous diagnosis included hyperlipidemia, hyperglycemia, moderate obesity and hypertension. His medications include: Paroxetine 20 mg for 10 years; Quetiapine 150 mg daily for 2 yrs.; Irbesartan 300 mg daily for 1 yr.; and Atorvastatin 10 mg daily for 1 yr.
Labs: FBS = 126, HgbA1C = 6.2, total cholesterol = 200, LDL = 105, HDL = 35, Tg =286. His present height equal 5’9” and weight = 210 lbs. His BP is 140/84.
She tells you that about 10 yrs. ago she became depressed and was started on Paroxetine and gained 30lbs after 1 yr. Her mood at that time was much improved and remained that way for about 2 yrs. At that time, Quetiapine was added, and she achieved remission of her depression. Six months after this she gained another 20lbs, developed mild hypertension, hyperglycemia and hyperlipidemia. All other lab including thyroid testing was normal. She tells you that she has a craving for carbohydrates and does little exercise since developing depression about 15 yrs. ago.
? Questions:
What advice or modifications to his treatment regimen would you recommend for your new patient? (Discuss a minimum of two). Please support your answer with research-based evidence.
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
? If your LAST name begins with the letters O through Z please address the following:
Patient is a 47-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of duloxetine and quetiapine for a number of years. She smokes, and has diabetes, hypertension, and hyperlipidemia. She is concerned about her weight and asks whether there are medications that she can take to aid in weight loss. She says that she has been told indirectly, by her friends and family, that she is “overweight.” She has tried several “fad” diets without lasting success. She has not been unable to maintain any weight loss for more than a few months.
She tells you that she “watches what she eats” and reads the nutritional labels on food packaging but enjoys eating out and often orders take-out meals. She works full time and spends most of her day sitting in an office. She belongs to a fitness club, but her attendance is inconsistent.
She also confides that she has trouble reaching orgasm regardless of what she tries.
? Questions:
What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach). Please support your answer with research-based evidence.
What would be our approach for the sexual side effects she is experiencing?
If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended?
NU670 Advanced Psychopharmacology and Health Promotion
Unit 3 Assignment
Mood Disorders
Instructions
Patient Intake and History
The patient is a 26-year-old college graduate who is currently euthymic but who has a history of major depressive episodes
He has experienced major depressive episodes, mostly untreated, of varying lengths and severities since he was a teenager
His symptoms have included insomnia, despondent thoughts, depressed mood, low interest in activities, poor energy, and impaired cognition
He says his self-esteem drops and he feels rejection-sensitive and guilt-ridden for no apparent reason
He has never had suicidal thoughts
Some of the depressive episodes have been incapacitating and have interfered with school and work
He appears to have good inter-episode recovery and is able to return to class and work
The patient also has symptoms of social anxiety
He is often nervous around new people and acquaintances
He experiences anticipatory anxiety and will avoid certain social events
These symptoms are present regardless of his affective state
He has asked for a consultation because he has legal issues regarding drinking and driving that he thinks were likely fueled by his psychiatric symptoms
At the time of the infraction (several months ago, just before graduating college), he had been started on a selective serotonin reuptake inhibitor (SSRI) for the depression and SAD symptoms
Within days of starting he experienced elevated mood in a sustained fashion over several days
He lost all anxiety, fear, and avoidance
He was unusually talkative; had racing thoughts; was distractible, hyperactive, and impulsive; and had decreased need for sleep
He exhibited grandiosity, in which he felt invincible and that the law did not apply to him; this led him to purposefully antagonize a man in a bar, drive while drinking, and challenge authority when police were called
The mood elevation is complicated by the fact that the patient admits to heavy alcohol use on weekends throughout college
The mood elevation abated with cessation of the SSRI treatment
He has now completed college; he has few friends in the immediate area but his family is very supportive
He wants to be a news reporter and is planning on applying to graduate school
The patient has no family history of bipolar disorder; his mother has generalized anxiety disorder (GAD)
He is not currently taking any medications
Vitals:
98.8
160/80
76
18
5’10”
190 lbs.
Please use the case study template to complete the case and answer the questions listed below:
Does the patient's history support a diagnosis of bipolar disorder even though his symptoms appear to have been triggered by a selective serotonin reuptake inhibitor?
What would be the expected future course of illness for this patient?
If the patient develops another depressive episode, how would you treat it?
What medication would you choose (there could be many correct answers). What is the MOA of this medication? (Be specific i.3. What receptor does it work on, etc.)
Provide and reference a recent research article (Published over the last 3 years) on the medication treatment of Mood Disorders
There are different ways in which to complete a Psychiatric SOAP (Subjective, Objective, Assessment, and Plan) Note. This is a template that is meant to guide you as you continue to develop your style of SOAP in the psychiatric practice setting.
NU670 Advanced Psychopharmacology and Health Promotion
Unit 4 Assignment
Depression & Anxiety Case Study
Instructions
Complete a full intake on this patient and then develop a treatment plan using the template offered.
Patient History
The patient is a 59-year-old married woman with 5 grown children
She is moderately overweight (BMI 30) and was diagnosed with non-insulin-dependent diabetes 10 years ago; she is fairly well managed on an oral hypoglycemic medication (glipizide 10 mg twice per day)
Two years ago, the patient experienced 2 tremendous stressors: her oldest child developed leukemia (now in remission), and her mother and father both passed away
She suffered a significant and impairing major depressive episode that went untreated until recently
This was her fifth episode of depression; she experienced 2 major depressive episodes as a teenager, and she developed postpartum depression and anxiety following the births of 2 of her children
Four months ago, after she was too fatigued to get out of bed, she sought treatment for the first time in her life
After receiving education and support from her clinician, she reluctantly agreed to take Paxil 30 mg/day
The patient has experienced a near-complete resolution of her symptoms in the last 6 months; however, she has developed side effects and wants to discontinue the medication
Specifically, she has increased appetite and has correspondingly gained 7 pounds in the last 4 months, with an increase in HgA1c of 1 full percentage point
She also reports excess daytime sedation and anorgasmia (very unusual for her)
What options can you offer to manage these side effects? Be specific
What education should you give the patient about stopping this medication abruptly?
What is your treatment plan?
NU670 Advanced Psychopharmacology and Health Promotion
Unit 4 Assignment
Prescribing Activity
Instructions
Please complete the questions listed below in the assignment.
Provide supporting Documentation and Resource Links.
This must be at least 3-4 paragraphs.
Submit to the dropbox by the due date.
We will review this topic in this week’s Synchronous discussion
Questions
Look up the APRN prescribing regulations in your state.
What are the safe prescribing recommendations for APRN’s in your state? This will vary depending on the level of practice authority.
Does your state have a Prescriptions Drug Monitoring Program? If so, explain. If not, please describe current legislation regarding this topic.
What are the barriers to APRN’s prescribing in your state?
What local or national organizations are available for you to join to support the cause for advancing practice/prescribing for APRN’s?
NU670 Advanced Psychopharmacology and Health Promotion
Unit 5 Assignment
Case Study
Instructions
Review all the learning material for this week; videos, webinars, lectures, articles, and guidelines.?
For this week’s case study assignment, you will create a presentation to educate other providers about caring for the mental health needs of special populations in psychiatric mental health/primary care.? Then record voice over for your presentation using?PowerPoint, zoom,?or Youtube,?etc…?
You will then upload your recorded presentation file to Youtube for easier access and viewing by faculty and peers. Please select the UNLISTED option. This allows your instructor and peers to view and anyone you share the link with but will not publish it to public view.
See instruction here: Creating Private Unlisted Youtube Video Instructions download
You will submit the link to your video in the assignment dropbox as well as to the discussion board this week.
For your assigned special population,?you will provide information for the following listed slides:
Slide 1:? TITLE SLIDE
Slide 2: POPULATION:? Introduction to population
Slide 3:? PREVALENCE of MENTAL ILLNESS: mental health statistics for this population
Slide 4: PSYCHOPHARMACOLOGY TX CONSIDERATIONS: medications to avoid and why, considerations r/t pathophysiology and changes for this population (think genetics, renal clearance, blood volume, development, genetics-CYP450, etc…)
Slide 5: CONTRAINDICATIONS: are there any specific contraindications to prescribing psychotropic to this population
Slide 6: REFERENCES
?See your assigned population listed below:
If your?LAST NAME?starts with?A?through?E?please use the following circumstance:
Elderly/Geriatrics: polypharmacy, physiological consideration of aging
If your?LAST NAME?starts with?F?through?I?please use the following circumstance:
Pediatric/Adolescents: considerations for prescribing, FDA approvals?
If your?LAST NAME?starts with?J through?Q?please use the following circumstance:
Perinatal/Lactation: considerations for prescribing, teratogenicity, physiological considerations of pregnancy
If your?LAST NAME?starts with?R through?Z?please use the following circumstance: Minority?(specific Ethnicities)?Groups: specific genetic considerations for metabolism of medication (think CYP450, etc…)?
To Submit Your Assignment:?
Select the ?Add Submissions?button.?
Submit your video link.
Select ?Save Changes.?
NU670 Advanced Psychopharmacology and Health Promotion
Unit 7 Assignment
PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER CLINICAL PRACTICE PORTFOLIO
Table of Contents
NU670 Psychopharmacology and Health promotion
Neurotransmitter Chart (Unit 1)
Antipsychotics Chart (Unit 2)
Antidepressants, Anxiolytics, & Mood Stabilizers Chart (Unit 3, 4, 5)
Substance Use Resources (Chart links) (Unit 6)
Additional Resources List
