To prepare:Reflect on questions or concerns you might have as you begin the MSN program.Consider the individuals, teams, and departments you previously considered in Module 1 as well as how they may provide support with addressing these questions and concerns
please watch the videos that require and write your reflection, one page for each videos. Thank you.
Discuss the possibility of developing Dimentia as age increases
The Assignment:
Read a selection of your colleagues’ responses.
Respond to at least two of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients. In APA Format and proper citation, provide at least two references in each response post.
Colleagues’ Response Post #1
Patient with Post -Trauma Stress Disorder
Post-traumatic stress disorder (PTSD) is common among U.S military war veterans and about 20 of them are affected with estimates ranging from 8.1% to 15.2. Post-Traumatic Stress Disorder (PTSD) is a chronic psychological disorder that can develop from exposure to traumatic events in an individual’s life. It can also be caused by witnessing or perceived traumatic events (as serious injury, violence, or death), but war time veterans are more at risk. Symptoms may include flashbacks, nightmares, severe anxiety hypervigilance, as well as recurrent thoughts about the event (American Psychiatric Association [APA], 2013 (Lancaster et al., 2016).
The Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria of the traumatic event must include an actual exposure or threatened death, serious injury, a violence in at least one criterion (American Psychiatric Association, 2013). In this case, William meet the criterion for PTSD. He is an Iraq war veteran captain which implies he would have directly experienced the traumatic event, witnessing the event occur to others, exposure to adverse details of the traumatic events, and self-destructive behavior (American Psychiatric Association, 2013).
The focus in the case study is William Thompson as a military captain and an Iraq war veteran, Lawyer, husband who is about to lose his job, has lost his home as a result of his inability to pay his mortgage due to alcohol use and PTSD. As a result, he lives with his elder brother and his family
Therapeutic Approaches
In the case of Williams, I will be utilized both the psychotherapy and psychopharmacological treatment to manage his PTSD.
The first psychotherapy treatment I will use for this patient with trauma is the Eye Movement Desensitization and Reprocessing (EMDR). This therapy was developed to resolved symptoms from disturbing and unresolved life experiences like trauma. EMDR is a unique kind of psychotherapy used to eliminate negative emotions linked with traumatic events’ memories by focusing less on the traumatic event but more on the disturbing feelings that derive from the event (Wheeler, 2014). This therapy used approach to address past and present aspect of memories. Francine Shiparo was to first to develop this approach. The Veterans Affairs/Department of Defense clinical practice guideline for PTSD recommends treating PTSD with individual trauma-focused psychotherapy over medications.
Studies have shown that trauma focused therapies can lead to greater outcomes and last longer compared to using just medications (Norman, Hemblen, Schnurr, & Eftekhari, 2018).
Secondly, Cognitive Behavioral Therapy (CBT) will be utilized both PTSD and alcohol abuse. In his case, he has already lost his home and may soon lose his job due to alcohol, CBT will benefit him. CBT focuses on learning to diminish problematic behaviors linked to substance abuse, in this case, alcohol (Wheeler, 2014)
Another therapy for PTSD or trauma survivors is Prolonged Exposure therapy. In this therapy sessions, the client is required to relates the traumatic event or experience for an hour in the treatment session, and then listens to the audiotape of the session for an hour every day. Exposure therapy also requires in vivo exposure homework in which the client engages in an avoided activity related to the trauma. When this therapy is delivered in an intensive format, it has been shown to be highly effective in the treatment of PTSD (Hendriks, Kleine, Broekman, Hendriks, & Minnen, 2018).
Psychopharmacologic therapy can be used if psychotherapy is not effective or in combination. In this case both will be utilized since his PTSD is causing him life. Problems. The Veterans Affairs/Department of Defense clinical practice guideline recommends the use of medication therapy if the client is nonresponsive to psychotherapy or if the client refuses to engage in therapy (Norman, Hemblen, Schnurr, & Eftekhari, 2018). The recommended medications for the treatment of PTSD are sertraline, paroxetine, fluoxetine, or venlafaxine but only sertraline and paroxetine are approved by the FDA for the treatment of PTSD (Norman, Hemblen, Schnurr, & Eftekhari, 2018).
Treatment Outcomes
With the expected results from EMDR, the client will process negative feelings to the scope of traumatic memories and can recalled without producing negative emotions (Khan et al., 2018). William Thompson will recognize his health concern and the need for therapy.
In regard to CBT, the expected outcomes are that of learning communication skills to addresses avoidance related to PTSD, relationship problems and challenging trauma-related beliefs. The benefit of CBT will cause the client to be aware of his health-related concerns and the need to receive the intervention (Flanagan, Jones, Jarnecke & Back, 2018). Also, with CBT, another expected outcome is the ability to resist alcohol use as several studies have demonstrated that CBT significantly reduces alcohol use disorder.
In summary, the important thing to remember regardless of the treatment choice, is that therapy should be adjusted to the clients need. Using an individualized therapy, the therapy will be use with clients who get the greatest response. Also, the willingness to engage in therapy will depends on the patient. As PMHNP we have lots of different options to explore to help someone with a trauma in their life. Everybody responds differently so one therapy might not work for one person but will work for the others.
Colleagues’ Response Post #2
Observation of Client
William, the client in question, is a former military Captain and Iraqi war veteran. He is currently homeless and staying with his brother and his brother’s family due to an inability to pay his rent previously. William moved in with his brother because of these issues and is currently dealing with problems with his job being in jeopardy because of his current alcohol troubles. William presents with a flat affect and his family describes him as not “having it together”. According to the American Psychiatric Association (2013), DSM-5 criteria for a Post- Traumatic Stress Disorder diagnosis includes many things that William displays. Some diagnostic criteria includes “exposure to actual or threatened death or serious injury” (APA, 2013). William was exposed to these things and could have possibly experienced fellow platoon members die in war. Along with this, William exhibits signs that his disturbances cause significant distress or impairment “in social, occupational, or other important areas of functioning” by attempting to cope with his problems with alcohol use (APA, 2013). Mahoney et al. (2020) explain that PTSD “is associated with higher levels of alcohol use among returning veterans” as they turn to alcohol when they don’t know how to cope.
Therapeutic Approaches
When considering the treatment approach for clients with PTSD and excessive alcohol use, it is important to think about the specific targeted outcomes as well as the trauma the client has gone through that has caused the issues at hand. Simons et al. (2017) explains that PTSD often debilitates Operation Iraqi Freedom veterans, and the prevalence of these veterans having PTSD has significantly increased since the year 2002, to a “current estimate of 23%”. Goodnight, Ragsdale, Rauch, and Rothbaum (2019) note that clients with PTSD should be approached with trauma-focused therapies as treatment as “trauma-focused treatments are safe and effective for PTSD even when higher-risk comorbidity presents”. If the client struggles with flashbacks and nightmares that interrupt sleep, one could consider prescribing Prazosin. If the client struggles with stopping his alcohol dependence, rehab could be considered, or even prescribing Naltrexone would be acceptable. Taylor, Petrakis, and Ralevski (2016) found that pharmacotherapy, specifically Zoloft, is helpful in reducing PTSD symptoms, and naltrexone combined with psychotherapy is “better for drinking outcomes”.
Expected Outcomes
For this client specifically, it is important for his treatment goals to include becoming free of alcohol addiction and learning ways to effectively cope with his PTSD. Some medications may be needed in reaching these goals, but without a doubt, this client could benefit greatly from psychotherapy. Alcohol use and PTSD both have shown great improvements with effective psychotherapies. This client will likely need trauma-focused therapy and pharmacotherapy both to get himself to a desired level of functionality. Ultimately, with these issues addressed, we would want the client to have no issues with his job and financial situations, able to work without problems, and be able to move out of his brother’s house and support himself in a stable environment, both financially and emotionally.
Nicole Hoffman 5 posts Re: Topic 2 DQ 1 Healthcare workers and the public are aware that nurses did not directly impact the opioid crisis, however, studies show that nurses will have a direct impact on reversing the impact America is currently facing with opioid abuse and death. As many major medical companies and pharmacies face lawsuits and even bankruptcy in light of recent lawsuits, it is likely that nursing practice and evidence-based practices will change in an attempt to save lives and reduce opioid-related deaths. Working in a surgical center provides a unique nursing opportunity to address and change the opioid crisis, as many patients that begin abusing opioids begin their prescriptions either for chronic pain, or after injury or surgery (Demsey, Carr, Clarke, & Vipler, 2017). Two ways that we can expect nursing practice to be impacted by the change in addressing our nation’s opioid crisis include patient teaching, and tracking medication use and pain levels (American Journal of Nursing [AJN], 2015). Patient education regarding opioid medications include educating the patient on the risks of opioid diversion, and the proper storage and disposal of opioid medication prescriptions (AJN, 2015). Studies show that approximately one-quarter of medications are diverted from legal prescriptions, while 71% of those diverted opioids were obtained either from friends or family, either for free or by theft (AJN, 2015). Educating patients about these facts as well as the importance of proper safe-keeping of medications and how or where to safely dispose of opioid medications is an important first step in correcting the opioid crisis. Monitoring patient and tracking usage of opioids include patient teachings that focus on the correct usage, as well as appropriate indication and expectations (AJN, 2015). For example, patients after surgery should be educated that they will not be pain-free immediately following their procedure and that opioid prescription medications should not be used for any other indication other than pain, which includes induction of relaxation or sleep (AJN, 2015). It is also important to teach the patient about keeping a pain medication journal which includes the type of pain the patient is experiencing, the pain scale rating associated with the pain, as well as time and dosage of the medications taken, reviewing these journals with the patient can help the healthcare providers notice usage or patterns that could indicate a current or potential problem (AJN, 2015). Helping to identify issues before they become an actual problem are other interventions that the nurse provides to the patient that will aid in addressing and correcting the opioid crisis in the United States. References American Journal of Nursing. (2015, August). Nurses’ role in preventing prescription opioid diversion. Lippincott Nursing Center, 115(8), 34-40. Retrieved from https://www.nursingcenter.com/cearticle?an=00000446-201508000-00021&Journal_ID=54030&Issue_ID=3152763 Demsey, D., Carr, N. J., Clarke, H., & Vipler, S. (2017, October 1). Managing Opioid Addiction Risk in Plastic Surgery During the Perioperative Period. Plastic and Reconstructive Surgery. https://doi.org/10.1097/PRS.0000000000003742
Provide an answer that is at least 150 words in apa format with in-text citations and references to the below question:
Choose one provision from the ANA Code of Ethics. How is ethical behavior an integral part of being a nurse leader? How does one display the characteristics of a role model with this provision? Does a nurse leader have an ethical foundation to inject into business practice?
What events led you to choose nursing as a career at this stage in your life? Why are you choosing to pursue this degree at NYU? 500 words
Which of the characteristics or components (define at least two) health care delivery system have the most significant impact on the health care delivery system in the United States? What makes these more impactful than the other 8 characteristics?
See additional attached information
You began your literature review matrix in Week 4 Assignment 1: Start Your Literature Review Matrix, where you completed two articles for the matrix. Using the same document you submitted for the Week 4 Assignment, complete the matrix by adding six more articles and filling in each of the rows for each article that are directly related to your study that you are writing about in your Review of the Literature Section of your EBP Project Proposal.
You will be starting your own literature review matrix (Word) this week. Based on your investigation of the literature from the library and online resources.
Family Health Assessment Part I
Understanding family structure and style is essential to patient and family care. Conducting a family interview and needs assessment gathers information to identify strengths, as well as potential barriers to health. This information ultimately helps develop family-centered strategies for support and guidance.
This family health assessment is a two-part assignment. The information you gather in this initial assignment will be utilized for the second assignment in Topic 3.
Develop an interview questionnaire to be used in a family-focused functional assessment. The questionnaire must include three open-ended, family-focused questions to assess functional health patterns for each of the following: Values/Health Perception Nutrition Sleep/Rest Elimination Activity/Exercise Cognitive Sensory-Perception Self-Perception Role Relationship Sexuality Coping
Select a family, other than your own, and seek permission from the family to conduct an interview. Utilize the interview questions complied in your interview questionnaire to conduct a family-focused functional assessment. Document the responses as you conduct the interview.
Upon completion of the interview, write a 750-1,000-word paper. Analyze your assessment findings. Submit your questionnaire as an appendix with your assignment.
Include the following in your paper: Describe the family structure. Include individuals and any relevant attributes defining the family composition, race/ethnicity, social class, spirituality, and environment. Summarize the overall health behaviors of the family. Describe the current health of the family. Based on your findings, describe at least two of the functional health pattern strengths noted in the findings. Discuss three areas in which health problems or barriers to health were identified. Describe how family systems theory can be applied to solicit changes in family members that, in turn, initiate positive changes to the overall family functions over time.
Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria.
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.
Academicpapers.net is a pioneering academic writing service with a customer base comprising of thousands of students. We have hundreds of expert writers aboard working in collaboration with a diligent quality assurance team.
Phone: +1 (940) 905 5542