Read the following case study and answer the reflective questions.  Please provide evidence-based rationales for your answers.  APA, 7th ed. must be followed. 

 Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

J.T.  is a 20 year-old who reports to you that he feels depressed and is experiencing a significant amount of stress about school, noting that he’ll “probably flunk out.” He spends much of his day in his dorm room playing video games and has a hard time identifying what, if anything, is enjoyable in a typical day. He rarely attends class and has avoided reaching out to his professors to try to salvage his grades this semester. J.T. has always been a self-described shy person and has had a very small and cohesive group of friends from elementary through high school. Notably, his level of stress significantly amplified when he began college.

You learn that when meeting new people, he has a hard time concentrating on the interaction because he is busy worrying about what they will think of him – he assumes they will find him “dumb,” “boring,” or a “loser.” When he loses his concentration, he stutters, is at a loss for words, and starts to sweat, which only serves to make him feel more uneasy. After the interaction, he replays the conversation over and over again, focusing on the “stupid” things he said. Similarly, he has a long-standing history of being uncomfortable with authority figures and has had a hard time raising his hand in class and approaching teachers. Since starting college, he has been isolating more, turning down invitations from his roommate to go eat or hang out, ignoring his cell phone when it rings, and habitually skipping class. His concerns about how others view him are what drive him to engage in these avoidance behaviors.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers. 

1. Generate a primary and differential diagnosis using the DSM-5 criteria.
2. Develop a biopsychosocial plan of care for this client.
3. Compare and contrast fear, worry, anxiety, and panic.

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.) 
• All replies must be constructive and use literature where possible.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

 Week Four APA Assignment: Evaluating the socioeconomic impact of healthcare across our diverse communities: Educating our clients regarding accessibility and affordability.

• Sections of the assignment must include:
  Introduction
  Focus points covered in the discussion posts
  Any arguments and rationales for your stance
  Conclusion or Summary
• The components of your APA Assignment includes the following:
  The assignment must be completed on a word document.
  Your APA  Assignment must include a title page (Refer to Purdue OWL).
  All in-text citations must be used when paraphrasing or quoting a previous author.
  All references must reflect the in-text citations used.
  All reference sources must be within the past 5 years unless it is the works of a nurse theorist or a significant reference material.
  The length of the assignment must be 750-1000 words. Please pay attention to spelling and grammar. Points are deducted for repeat offenders.
  Upon completion of the assignment, you must submit it via Turnitin.com and please note that your plagiarism score should be no more than 20%. If you score higher, please make adjustments

Chamberlain

NR599-11532

Week 5

Clinical Decision Support Systems

Preparing the Assignment

Post a written response in the discussion forum to EACH threaded discussion topic:

1. This week we learned about the potential benefits and drawbacks to clinical decision support systems (CDSSs). Create a “Pros” versus “Cons” table with a column for “Pro” and a separate column for “Con”. Include at least 3 items for each column. Next to each item, provide a brief rationale as to why you included it on the respective list.

2. The primary goal of a CDSS is to leverage data and the scientific evidence to help guide appropriate decision making. CDSSs directly assist the clinician in making decisions about specific patients. For this discussion thread post, you are to assume your future role as an APN and create a clinical patient and scenario to illustrate an exemplary depiction of how a CDSS might influence your decision. This post is an opportunity for you to be innovative, so have fun! 

Adhere to the following 
guidelines regarding quality for the threaded discussions in Canvas:

· Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.

· Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread. 

· Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.

· Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category. 

For each threaded discussion per week, the student will select no less than 
TWO scholarly sources to support the initial discussion post.

Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are 
NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal.  You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article.  The following sources should not be used: Wikipedia, Wikis, or blogs.  These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality.  For example, the American Heart Association is a .com site with scholarship and quality.  It is the responsibility of the student to determine the scholarship and quality of any .com site.  Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years.  Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.

Purpose

The purpose of this interactive discussion is to allow for a discovery of the clinical decision-making process that guides the appropriate clinical use of pharmacologic agents used in the treatment of acute disorders across the adult lifespan. The development of evidence-based prescribing practice supports the professional formation of the AGACNP practice role.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Summarize the clinical utilization of pharmaceutical agents for specific diseases with rationale. (COs 1, 2, 3, 5, 6)
2. Evaluate alternative perspectives on clinical management of selected diseases with pharmaceutical agents and articulate a substantial rationale that supports further discussion and healthy debate. (COs 1, 2, 3, 5, 6)

Due Date

The initial response to the chosen discussion question is due by Wednesday 11:59 pm MT. Subsequent posts, including substantive responses to peer(s) and faculty questions, must occur by Sunday 11:59 pm MT. A total of 3 substantive posts are required on 3 different days.

A 10% late penalty will be imposed for initial discussions posted after the deadline on Wednesday at 11:59 pm MT, regardless of the number of days late. NOTHING will be accepted after 11:59 pm MT on Sunday (0 points are earned).

A 10% penalty will be imposed for not entering the minimum number of interactive dialogue posts (3) OR not posting on the minimum required number of days (3). NOTHING will be accepted after 11:59 pm MT on Sunday (0 points are earned).

Total Points Possible

This assignment is worth 100 points.

Preparing the Assignment

Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

1. Answer the question that corresponds with the 1st letter of your last name only, do not respond to any other questions in your initial post (see table below).
2. Post your initial response to the discussion question by the due date.
3. Post substantial replies to peer and faculty by the due date.
4. Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion.

If your name begins with the letters…

Answer this question…

A-G

You are working in the Emergency Department and a 20-year-old female with history of intravenous drug abuse presents with concern of septic shock. What are the considerations in choosing the appropriate antibiotic for this patient? Explain your thought process, questions you would need to ask, and what antibiotic you would order, and when.

H-M

How does the empiric pharmacological therapy differ in a patient with healthcare-associated meningitis (such as a neurosurgical patient with an external ventricular drain) as compared to a healthy adult with community-acquired bacterial meningitis? Explain your rationale.

N-S

You are admitting a 78-year-old male smoker with hx of asthma into the intensive care unit for a diagnosis of hospital acquired pneumonia. He was admitted three weeks ago with pneumonia and discharged to home on azithromycin after a 2-day hospitalization. What antimicrobial treatment will you order on his ICU admission now? Explain your rationale.

T-Z

What would be the alternative empiric pharmacological therapy for a 50-year-old male with a history of anaphylaxis to cephalosporins? Explain your rationale.

**To see view the grading criteria/rubric, please click on the 3 dots in the box at the end of the solid gray bar above the discussion board title and then Show Rubric. 

Last name initial is P.

References can’t be no more than 5 years old, unless it’s a recent CPG.