case study 6

/in /by

2

Generalized Anxiety Disorder
Middle-Aged White Male With Anxiety

Middle aged male

 

BACKGROUND INFORMATION

The client is a 46-year-old white male who works as a welder at a local steel fabrication factory. He presents today after being referred by his PCP after a trip to the emergency room in which he felt he was having a heart attack. He stated that he felt chest tightness, shortness of breath, and feeling of impending doom. He does have some mild hypertension (which is treated with low sodium diet) and is about 15 lbs. overweight. He had his tonsils removed when he was 8 years old, but his medical history since that time has been unremarkable. Myocardial infarction was ruled out in the ER and his EKG was normal. Remainder of physical exam was WNL.

He admits that he still has problems with tightness in the chest and episodes of shortness of breath- he now terms these “anxiety attacks.” He will also report occasional feelings of impending doom, and the need to “run” or “escape” from wherever he is at.

In your office, he confesses to occasional use of ETOH to combat worries about work. He admits to consuming about 3-4 beers/night. Although he is single, he is attempting to care for aging parents in his home. He reports that the management at his place of employment is harsh, and he fears for his job. You administer the HAM-A, which yields a score of 26.

Client has never been on any type of psychotropic medication.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. He is appropriately dressed. Speech is clear, coherent, and goal-directed. Client’s self-reported mood is “bleh” and he does endorse feeling “nervous”. Affect is somewhat blunted, but does brighten several times throughout the clinical interview. Affect broad. Client denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, as is insight. He denies suicidal or homicidal ideation.

You administer the Hamilton Anxiety Rating Scale (HAM-A) which yields a score of 26.

Diagnosis: Generalized anxiety disorder

RESOURCES

§ Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0

Decision Point One

Select what you should do:

Begin Paxil 10 mg po daily

Begin Imipramine 25 mg po BID

Begin Buspirone 10 mg po BID

image4.png

image5.png

image2.jpeg

image3.png

Writing

/in /by

 

Provide an overview of each nurse theorist/and or nursing theory that you have chosen.

Be sure to discuss the basic philosophical and structural components of the theory, the classification of the theory, the purpose and intention of the theory, and whether the theory is based upon other theories or approaches (from other nursing scholars or from other disciplines). Identify what areas of nursing the theory has the most impact, nursing practice, nursing research, nursing education, or nursing administration. Also discuss the development of the theory/theoretical approach based upon the sociopolitical and cultural influences of the time and environment of its development, upon the roles in nursing that the theorist held, and the values and beliefs of the theorist.
Be sure to use appropriate APA citation and when responding to your peers, begin with addressing them personally and end your response posting with your name.

Guidelines for Weekly Discussion Postings/ Discussion Participation: The online discussions will provide opportunities to explore different topics, share what you are learning with your classmates, and gain clarity about the course content. Your discussion responses should demonstrate critical thinking skills and your responses should be thoughtful and promote respectful discourse with the other students in the class. The rules of common courtesy are to be followed (e.g., one voice speaks at a time, polite debate occurs, and all opinions are honored). In order for an online discussion assignment to be considered complete, the student must effectively and adequately cover the assigned topic, reference the course text and other sources with appropriate APA citations, meet the 400 word minimum, the responses to classmates must be developed in a manner that furthers the conversation and learning, the spelling, grammar, and writing must be appropriate, and the online discussion assignment must be submitted on time. Interactions should be thorough, thoughtful and facilitate the learning community’s growth. Discussions will be reviewed on a weekly basis. Contribution toward the course grade total will be based on the pattern of demonstrating these characteristics. Please remember, initial posts should be submitted by deadline. 

journal week 9

/in /by

Journal/Overview -The journal document should be 3-4 pages in length. No citations are required, and no specific formatting is needed. Utilize appropriate grammar and mechanics of writing.

Refer to the journal submission you completed in Unit 1 and reflect on the following:

Topic: The use of pharmacology in advanced practice.

1. How has your knowledge of pharmacology changed?

2. Do you find yourself thinking about medication use in your current employment differently? Why or why not?

3. Explain how your appreciation of the advanced practice role changed or did not change?

How do you envision using the knowledge from this course in your future advanced practice role?

You must complete this Journal submission before the Unit 10 Quiz will open.

question

/in /by

Original Work, No Plagiarism, Cite and Reference

In a brief response (no more than 1-2 paragraphs), describe why research collaborations are important and provide an example of how collaborative research impacts responsible conduct of research.  You may include an example from something you have experienced in an academic, professional or organizational setting, or an example from the readings.

QUESTION

/in /by

Please see attached

Laboratory for Diagnosis, Symptom and Illness Management

/in /by

 

Soap Note 1 “ADULT”  Wellness check up (10 points)

Follow the MRU Soap Note Rubric as a guide:

Use APA format and must include mia minimum of 2 Scholarly Citations.

Soap notes will be uploaded to Moodle and put through TURN-It-In (anti-Plagiarism program)

Turn it in’ s Score must be less than 25% or will not be accepted for credit; it must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 25%. Copy-paste from websites or textbooks will not be accepted or tolerated and will receive a grade of 0 (zero) with no resubmissions allowed.

reply

/in /by

Professor and class,

 

Collecting, analyzing, interpretating, and presenting data is statistics (Zach, 2022). Understanding your data is key to statistics, not over computing calculations (Holmes et al., 2017). Working on a medical/surgical unit, two different forms of data that I work with are daily blood pressure and temperature checks on my patients to assess their condition and overall health. Temperature checks can alert staff of an indication of infection, and or hypothermia. Blood pressure checks will provide knowledge of hypertension, hypotension, hypervolemia, hypovolemia, and sepsis. The average patient to nurse workload is eight to ten patients per shift. These are both classified as quantitative data related to numerical measurements and values. Blood pressure is usually classified as continuous due to having an infinite number of values within a range with a normal blood pressure of 120/80. Whereas temperatures are discrete due to being measured in finite increments such as tenths of a degree. Temperatures level of measurement is Interval due to being quantitative, can be ordered, meaningful differences between data can be collected and does not have an inherent zero, it is just a position on the scale. Blood pressure is measured on a ratio scale related to the numbers are equal in magnitude and rank on a numerical scale that has an absolute 0. The type of sampling used is cluster due to dividing the population into groups and selecting all the patients in one cluster but not the whole population.

Holmes, A., Illowsky, B., & Dean, S. (2017). 
Introductory Business Statistics. Houston, TX: OpenStax CNX. Retrieved from https://openstax.org/details/books/introductory-business-statistics

Zach. (2022, August 29).
The importance of statistics in Healthcare (with examples). Statology. https://www.statology.org/importance-of-statistics-in-healthcare/

Contraception / IVF

/in /by

 

  1. Name and explain the levels of human sexual intercourse.
  2. Difference between reproduction and procreation.
  3. What are the two dimensions of intimacy?
  4. Contraception:
    • What is it?
    • What is the intention of contraception?
    • Describe the three types of artificial contraception.
    • Risks / Side effects
    • Bioethical analysis and unfair dynamics of artificial contraception.
  5. Non-Therapeutic sterilization; bioethical analysis
  6. Principle of double effect; explain
  7. Bioethical analysis of:
    • Ectopic pregnancy
    • Cancerous reproductive system with pregnancy
  8. In Vitro Fertilization(IVF):
    • Process
    • Bioethical analysis of IVF
  9. Bioethical analysis of “to have a child”
  10. Read and summarize ERD paragraphs #: 40, 41, 42, 48, 52, 53.

  is to be clear and concise and students will lose points for improper grammar, punctuation, and misspelling.

  • If references are used, please cite properly according to the current APA style.

Nursing theory and one counseling/psychotherapy

/in /by

Please see attachment for instructions.

Self Assessment

/in /by

Use the PMHNP Clinical Skills Self-Assessment Form to complete the following:   

  • Rate yourself according to your confidence level performing the skills identified on the Clinical Skills Self-Assessment Form.  
  • Based on your ratings, summarize your strengths and opportunities for improvement.   
  • Based on your self-assessment and theory of nursing practice, develop 4 measurable goals and objectives for this practicum experience. Include them on the designated area of the form.