Major depression

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2 REFERENCES

Major depression is highly prevalent among childbearing women. And is present in twice the rate of depression among men in the same age group. Unfortunately, major depression is the leading cause of disability among women of childbearing age. (Kalfoglou 2016). Not only does perinatal depression result in being a significant cause of disability during pregnancy, but it also adversely impacts intra-uterine growth. And development. Unfortunately, there are limited evidence-based treatment guidelines or algorithms for treating mental conditions during pregnancy due to the complicated risk-benefit analysis for both mother and unborn child. (Van Ravesteyn et al., 2017).

There are several psychotropic treatment modalities for depression during pregnancy. Selective serotonin reuptake inhibitors are relatively safe during pregnancy. Sertraline is considered a first-line treatment for depression during pregnancy. But not without risk to the fetus. Current research studies pose an increased risk of atrial/ventricular defects and craniosynostosis associated with the use of Sertraline during the first trimester of pregnancy. (Bérard et al., 2015). There are limited off-label treatment options for perinatal depression. Gabapentin is extensively used as an off-label treatment modality for many conditions. It is likely to become increasingly prescribed for off-label use during pregnancy. There is very little information about the safety of Gabapentin during pregnancy. Current studies found that Gabapentin use during pregnancy was associated with a higher rate of preterm births and low birth weight. (Patorno et al. 2020).

analyses for psychotropics medications during pregnancy

Due to all the complex risk-benefit analyses for psychotropics medications during pregnancy, non-pharmacological interventions should be explored before prescribing psychotropic medications during pregnancy. There are several viable non-pharmacological treatment modalities for perinatal depression. Cognitive-behavioral therapy, psycho-educational and interpersonal therapy (IPT) are good non-pharmacological options (Evans et al. 2020).

I was unable to find clinical practice guidelines for treating perinatal depression. However, I was able to find the clinical practice guidelines for postpartum depression. The mood disorder questionnaire or Edinburgh, postnatal depression scale can be utilized to screen for depression. There are many challenges associated with prescribing psychotropic medications during pregnancy. When selecting a psychotropic medication, the provider must consider the health of the mother and unborn child. The provider needs to understand the withdrawal of these medications during pregnancy and the possibility of symptom relapse during pregnancy. The provider should consider that all medications could enter the fetus through the placenta. It is essential to consult the FDA risk category before prescribing the medication. (Lotito & Cook 2015). It is also essential to determine the severity of the depressive symptoms, mild depression symptoms should be treated with psychotherapy only.

References

Bérard, A., Zhao, J.-P., & Sheehy, O. (2015). Sertraline uses during pregnancy and the risk of major malformations. American Journal of Obstetrics and Gynecology, 212(6). https://doi.org/10.1016/j.ajog.2015.01.034

Evans, K., Spiby, H. & Morrell, J.C. (2020) Non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women. A systematic review and narrative synthesis of women’s views on the acceptability of and satisfaction with interventions. Arch Women’s Ment Health 23, 11–28 https://doi.org/10.1007/s00737-018-0936-9

Kalfoglou A. L.(2016) Ethical and Clinical Dilemmas in Using Psychotropic Medications During Pregnancy. AMA J Ethics. 2016;18(6):614-623. DOI: 10.1001/journalofethics.2016.18.6.stas1-1606.

Lotito, M., & Cook, E. (2015). A review of suicide risk assessment instruments and approaches. Mental Health Clinician, 5(5), 216–223. https://doi.org/10.9740/mhc.2015.09.216

Patorno, E., Hernandez-Diaz, S., Huybrechts, K. F., Desai, R. J., Cohen, J. M., Mogun, H., & Bateman, B. T. (2020). Gabapentin in pregnancy and the risk of adverse neonatal and maternal outcomes: A population-based cohort study nested in the US Medicaid Analytic eXtract dataset. PLoS medicine, 17(9), e1003322. https://doi.org/10.1371/journal.pmed.1003322

van Ravesteyn LM, Lambregtse – van den Berg MP, Hoogendijk WJG, Kamperman AM (2017) Interventions to treat mental disorders during pregnancy: A systematic review and multiple treatment meta-analysis. PLoS ONE 12(3): e0173397. https://doi.org/10.1371/journal.pone.0173397

Exercise Recommendations

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Post one response to the original post
• Your response should be 50+ words
• Posting should ask for clarification, challenge respectfully ideas, or describe a situation that illustrates the points being made. Simply agreeing or disagreeing with a post is NOT adequate.

1.

Exercise Recommendations

Physical exercise is one of the things that promote a healthy life. It benefits people of all ages, including elderly people with no health complications. As well as those with chronic health conditions. Such as high blood pressure, diabetes, and cardiovascular diseases. Physical exercise promotes both physical and mental health. For older people, being physically active puts them at a lower risk of mortality and developing chronic health conditions. For the older woman in the scenario, it would be advisable for her to engage in exercises that will strengthen her muscles, give her balance, promote flexibility, and generally promote her fitness (Taylor, 2014).

the World Health Organization (WHO)

According to Taylor (2014), the World Health Organization (WHO) recommends that people aged 65 years and older do at least 150-300 minutes of aerobic fitness with breaks in-between and muscle balancing exercises 2-3 days a week. Activities for improving her strength should include, but not be limited to dancing, swimming, brisk walking, light weightlifting, and cycling. Balance can be gained by participating in Tai Chi and Yoga. Flexibility exercises, including stretches and lunges, will help improve her stability and minimize the risk of falls and allow her to move around more comfortably. It is also helpful for older people to participate in daily activities as they will help them move around and can be said to be low-intensity exercises.

Several precautions should be observed when engaging in physical exercises to reduce the risk of injury. First, since she has not been exercising regularly, it would be advisable that she starts exercising lightly, and as time goes by, she can gradually increase the intensity of the exercise. It is good for a person to check with the doctor if they feel dizzy, have shortness of breath, feel pain in the lower legs when walking, or feel pain in the chest (Mayo Clinic, 2021). Stretching before exercising and cooling down afterward helps to prevent muscle strains.

question 2

The Joint Commission (TJC) limits the use restraints to situations when it is clinically necessary to protect the physical safety of the patient, staff, or others (Meiner, 2015).

In this scenario, the patient should not be restrained because, it would be a matter of convenience and not a matter of safety.  The patient is not confused nor a significant threat to self or others.  I would also assess why the patient is agitated instead of making her more anxious with restraints.

Information to consider about the patient includes her poor vision.  I would make sure that the environment is free from clutter to prevent a fall.  The patient has functional urinary incontinence. I can place a bedside commode, so she does not have to walk far when she needs to sit on the commode.  The patient is diabetic.  If her blood glucose is high or low, it can cause behavioral changes, which may explain her agitation.

I would not request body restraints because less preventative measures must be taken to prevent falls.  I would use a bed alarm, tele monitoring service, and place a commode at the bedside.  We can assign the nursing aid as a sitter to monitor the patient if other measures fail. Further more, restraint can cause injury to an agitated patient if they keep struggling to break free.

stress management

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 stress management

In this discussion, we’ll discuss anxiety, effective and ineffective interventions, and stress management. Please include the following in your initial posting:

Describe a client from your clinical setting or work who experienced severe anxiety or panic. Include a brief history and three most pertinent medications.

  • Describe the assessment process for this patient.
  • Identify at least one effective and one non-effective nursing intervention. Why did they work? What didn’t work?
  • Name and describe two stress reduction techniques you have used and whether they were helpful or not in reducing stress.

safety survey

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safety survey

Administer a safety survey (e.g., the Injury Prevention Program [TIPP]. From the American Academy of Pediatrics. Or develop your own) to assess the home environment of a 6-month-old and a 5-year-old.

1.  Develop a plan of education and anticipatory guidance for the family. 2. How would you apply this information to a larger population?

150-word minimum/250-word maximum without the references.

·         Minimum of two references (the course textbook must be one of the references). In APA format, must have been published within last 3-5 years.

Nasal cavity cancer and laryngeal cancer

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Nasal cavity cancer and laryngeal cancer

You are a 2-year graduate of an accredited AGACNP master’s program. You are now a certified AGACNP practicing on a very busy inpatient oncology unit.

Your patient is s 45-year-old male with head/neck cancer. This is a new diagnosis, however, the patient has lost over 60 pounds in the past 4 months due to dysphagia, malnutrition, and intractable pain. He is currently NPO due to risk of aspiration.

Explore the 2 types of head and neck carcinomas that you will encounter as an AGACNP on this oncology unit. Describe the following: Nasal cavity cancer and laryngeal cancer

  1. Malignancy, cytology results, and type of cancer markers. if available.
  2. How this is cancer diagnosed.
  3. The key complications for which you must be watchful.
  4. How you will manage this unique and very difficult patient with regard to pain management, airway, cosmetics, psychological concerns, and nutrition.

the aging process

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Remember your first formal writing assignment for this course? It was your “Initial Reflection.” Take a minute to dig that out of your files and read over it. Now, after you finish reading it, take a minute or so and think about just how much you have learned this semester. You have read, talked about, written about, made observations about yourself and others – all with the underlying goal of learning more about the aging process. Wow! I mean it, think for a minute just how much you have accomplished!

Okay, now that you’ve reflected a little bit on this semester’s work, it is time to write your “Final Reflection.” For this formal writing assignment, I’d like you to follow the list below and write about bit about where you are now. Part of the purpose of this assignment is for you to develop a better, clearer understanding of just how much you have learned – BUT – the additional purpose is for you to also see where and how much more there still is to learn. Learning does not end with a class or a degree – The world is a great big place and there is always more to know/learn/explore!

As always, be sure you are using APA style, professional language, and your most polished grammar. One exception to your APA for this assignment – you may use “I.” This is about you after all! So let’s get started on this…

For this assignment, write a minimum of 3 paragraphs (roughly 300-500 words) but you may have more than 3 if you wish. You will be writing in a narrative style which means, don’t just list the following questions with an accompanying answer. Your writing should flow more like a story or a case study. The way that I am writing these instructions is an example of the style/tone I’m describing to you. In your paper incorporate all of the following items:

  • What do you now know about aging and your health that you learned during this class?
  • What do you now know about the older adults in your community that you can relate to what you learned during this class?
  • Describe if you anticipate handling the aging process differently based on what you’ve learned in this class. How?
  • Revisit your biggest questions and/or concerns about aging in yourself and in your community. Were any of these questions answered or concerns addressed?
  • Did you learn what you wanted to from this course? Why or why not?
  • What is the one thing you would change about this course that you believe would make it better?
  • What else did you learn during this course that you think you will keep using over and over?

Leadership And Ethics In Health Care

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 Leadership And Ethics In Health Care

Compare and Contrast Leaders

Assignment Details

Unit Outcomes addressed in this Assignment:

Course Outcomes addressed in this Assignment:

HA405-5: Contrast the leadership styles of healthcare managers.

Instructions:

In this unit, you will explore opposing leadership styles found in managers.

In a 1-page paper, elaborate on two leaders: one which you determine as effective and the other as an ineffective leader. These individuals do not need to be in healthcare. Include two (2) academic references and submit your assignment in APA format.

Requirements:

Submitting your work:

Submit your Assignment to the appropriate Dropbox.

To view your graded work, come back to the Dropbox or go to the Gradebook after your instructor has evaluated it. Make sure that you save a copy of your submitted work.

Policy Brief and Advocacy Letter

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Policy Brief and Advocacy Letter Assignment

Building on the topic the student used for the first assignment. This assignment will require the student to write a one-page policy brief. And advocacy letter to be sent to their legislator. This assignment will be worth 40% of the cumulative grade.

A policy brief is used to convince the target audience of the urgency of the current problem or policy concern. And present the need to adopt the preferred alternative or course of action outlined. It is commonly produced in response to a request directly from a decision-maker (legislator). Or within an organization that intends to advocate for the position detailed in the brief.

Efficient policy briefs include several common features. Those features include:

  • The brief is focused. All aspects discussed are focused on achieving the intended audience to take the requested action.
  • The brief is professional and not academic. The usual audience is not interested in research or analysis conducted to produce the evidence. Rather they are interested in knowing the writer’s perspective on the problem and potential solutions, based on NEW and convincing evidence.
  • The brief should be evidence-based. The policy brief serves as a communication tool produced by someone with a vested interest in the policy (stakeholder), therefore the target audience will only be convinced by arguments that are supported by evidence.
  • The brief should also be concise. One page documents are the ones most likely to be read by busy lawmakers and their legislative teams.
    The format of the brief should be written as a one-page single spaced document. It does not need to include a title page, running header, or abstract. However, all references in-text and the reference list MUST be in APA format.
    The policy brief should include the following components:
  • An interesting title to attract the attention of the reader.
  • A clear and concise statement of the problem or issue.
  • A short overview of the root causes of the problem or issue.
  • One to two recommendations with a least two rationales with
    supporting evidence to validate the recommendations made. Evidence should come from scholarly journals, not textbooks or

NSG505AdvLetter.PolicyBrief

1

organization web sites. Three scholarly journal articles are required

to be used.
• Finally, the conclusion with a summary of the action the brief is

requesting.

An advocacy letter is a way to influence the ideas and views of legislators or decision makers within an organization. It allows the writer to maintain contact with the legislator or decision maker, to keep the issue high on the priority list when the writer cannot meet with them personally.

The format of the advocacy letter should be written in a standard letter format. Proper title and language should be used. It should not be more than two pages long, as to increase the chances that the letter will be read by the legislator, his or her staff or decision maker. Letters maybe mailed or sent electronically.

The advocacy letter should contain the following components:

  • Addressing the Letter – If the letter is concerning a Federal or State Bill or issue, it should be addressed to the Member of Congress or State Legislator who represents the student or if the issue is more local, it should be addressed to the decision makers who would be most concerned with the issue. Use the correct salutation.
  • Introduction – Introduce yourself and offer a concise statement about the reason for the advocacy letter. If discussing a specific legislative bill, include the bill number.
  • Health Policy Issue – In one to two paragraphs, accurately describe the issues raised, provide a clear position in favor of or opposed to, and offer specific examples of your concerns. Personal stories work well here.
  • Legislative or Advocacy Recommendations – Directly ask for the action you are requesting. State why your position is important to that person and the constituents he or she is associated with.
  • Closing – Develop a closing statement and provide your contact information for any follow-up questions or to act as a resource for further information.
    You can find examples of each of these in your book. Once your advocacy letter and policy brief has been reviewed by the faculty member, we encourage you to send it to the person whom your letter is addressed.

NSG505AdvLetter.PolicyBrief

Recommending An Evidence-Based Practice Change

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The collection of evidence is an activity that occurs with an endgame in mind. For example, law enforcement professionals collect evidence to support a decision to charge those accused of criminal activity. Similarly, evidence-based healthcare practitioners collect evidence to support decisions in pursuit of specific healthcare outcomes.

In this Assignment, you will identify an issue or opportunity for change within your healthcare organization and propose an idea for a change in practice supported by an EBP approach.

To Prepare:

  • Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
  • Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
  • Consider the best method of disseminating the results of your presentation to an audience.

The Assignment: (Evidence-Based Project)

Part 4: Recommending an Evidence-Based Practice Change

Create an 8- to 9-slide narrated PowerPoint presentation in which you do the following:

  • Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
  • Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
  • Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
  • Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
  • Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
  • Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
  • Be sure to provide APA citations of the supporting evidence-based peer-reviewed articles you selected to support your thinking.
  • Add a lessons learned section that includes the following:
    • A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    • An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

Patient Safety and a Culture of Safety

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Patient Safety and a Culture of Safety

A shift in paradigm is occurring across the United States from volume- to value-based care. Reflect upon your organizational culture to address the following.

  • Describe the culture of your organization (hospital) as it relates to patient safety.
  • Identify one opportunity to improve patient safety outcomes. Propose a strategy for the implementation of this improvement initiative.
  • Describe the current technology used to support patient safety. Identify the potential unintended consequences of this technology. Propose solutions to address these potential consequences.
  • Describe an incident in which patient safety was. Or had the potential to be compromised due to an emphasis on volume-based care.

 

Instructions:

Use an APA 7 style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3) Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations and references are included when information is summarized/synthesized and/or direct quotes are used, in which APA style standards apply.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.