Please see attachment for instructions.

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.

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Response 1 400 words IA

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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

 

Mixed methods research designs combine quantitative and qualitative research methods to answer research questions requiring both perspectives. Describe the pros and cons of a mixed method research design. Please include 400 words in your initial post with two scholarly references by Wednesday midnight. Please answer two peers by Saturday midnight with 200 words. 

 Consider a population health topic that rises to the presidential agenda level. Which social determinant most affects this health issue? How did two recent presidents handle the problem? What would you do differently? 

NUR640 Week 1 Assignment 1.2 Page 1

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Assignment Title: Population, Intervention, Comparison, Outcome (PICO)

Step 1 for your Evidence-Based Practice Mini-Project (Research Proposal)

Assignment Overview:

For your Evidence-Based Practice Mini-Project Step 1, you will submit your PICO question, identify 5 research articles from Levels of Evidence I-V, and write the following for your Mini-Research Proposal: Your introduction, Problem Statement, Purpose Statement, Significance of your Mini-Research Proposal, your Research Question, and which theory supports your Mini-Research Proposal.

Deliverables:

The final copy of your Step1 Mini-Research Proposal assignment is due on or before Sunday at 11:59pm just before Week 2 begins, at the latest. Be sure to use the file naming protocol: NUR640_EBP Step 1_last name_mmddyyyy.

Assignment Details:

For this assignment, you will write part of Section 1 of your Mini-Research Proposal. Use the discernment gained from your Week 1 Discussion of identifying a problem or area of interest and writing a PICO question as a basis for beginning your Section 1. Review Chapter 2 (Manuscript Structure and Content) and Chapter 3 (Writing Clearly and Concisely) from the Publication Manual of the American Psychological Association (6th ed.).

Note, you will submit a 2-3 page paper plus your Title Page and Reference Page that clearly identifies the following areas:

1) PICO Question;

2) 5 Research articles with Levels of Evidence of I-IV;

3) Your introduction, problem statement, purpose statement, and significance of your Mini-Research Proposal, along with the theory undergirding your PICO and Problem statement.

PICO Question: Describe the Problem/Population (P); Your Intervention (I); your Comparison (C), and Outcomes (O).

Research Articles (5) between I-IV Levels of Evidence with APA reference citation. Identify the level of evidence of each article after the reference citation that goes at the end of this Assignment submission.

Introduction, Problem Statement, Purpose Statement, and Significance of your Mini-Research Proposal. Your
problem statement provides an overview of your Mini-Research Proposal topic and a clear statement of the need for this Mini-Research Proposal topic. The 5 articles that you have selected should provide rationale for the need for this Mini-Research Proposal. Your
purpose statement justifies the need for your Mini-Research Proposal and is supported in the literature. The
significance of your Mini-Research Proposal is clearly stated and supported by the literature. The
research question is clearly presented. Your selected
theory may be based on pathophysiology, a nurse theory, or from any health-related discipline.

Note: Your Step 1 of the Mini-Research Proposal should have an introduction and summary of what you have written.

Grading: Each part of your Mini-Research Proposal has a grading rubric. All submissions should have a title page and reference page. Each Section of the Mini-Research Proposal will then be added together the Week 5 assignment, which will be graded again with a new rubric that includes your best revision based on detailed weekly instructor feedback. Points will be lost if suggestions are not incorporated into the final Week 5 Submission of your Mini-Research Proposal. (See Week 5 Assignment rubric).

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