Delusional Disorders

Examine Case Study: Pakistani Female With Delusional Thought Processes

BACKGROUND:

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so.

She currently weighs 140 lbs, and is 5’ 5”

SUBJECTIVE:

Client reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down.

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM:

The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

The PMHNP administers the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

The Assignment:

With Introduction and a Conclusion.

Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

· Decision #1

o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

· Decision #2

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

· Decision #3

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three to five academic resources no more than five years old.

Course Project: Part 3—Translating Evidence Into Practice

 

In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.

 

(Link for part 1 – https://www.homeworkmarket.com/content/nurs-5052nurs-6052-essentials-evidence-based-practice-course-project-part-1-grading-rubic-an)

 

(Link for part 2 – https://www.homeworkmarket.com/content/nurs-5052nurs-6052-essentials-evidence-based-practice-course-project-part-2-grading-rubic-an)

 

Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.

 

To prepare:

 

Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?

With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.

Explore possible consequences of failing to adopt the evidence-based practice that you identified.

Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?

 

To complete:

 

In a 3- to 4-page paper:

 

Restate your PICOT question and its significance to nursing practice.

Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.

Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.

Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

 

This part of the Course Project is due. It should be combined with the other two components of the Course Project and turned in as your Portfolio Assignment for this course.

Note: In addition, include a 1-page summary of your project.

You will combine Parts 1, 2, and 3 of your Course Project (assigned in Weeks 2, 4, and 8 respectively) into one cohesive and cogent paper.

 

For this final iteration, you will need to:

Submit your paper to Grammarly and SafeAssign through the Walden Writing Center. Based on the Grammarly and SafeAssign reports, revise your paper as necessary.

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The School of Nursing Sample Paper provided at the Walden Writing Center provides an example of those required elements (available from the Walden University website found in this week’s Learning Resources). All papers submitted must use this formatting.

 

 

Please follow the belo link for Templates:

 

http://academicguides.waldenu.edu/writingcenter/templates

 

Required Readings

 

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 12, “Sampling in Quantitative Research”

This chapter introduces key concepts concerning sampling in quantitative research. This includes such concepts as a description of populations, different types of sampling and their uses, and how to determine a manageable, yet sufficient number to be included in a sample. The chapter also includes suggestions for implementing a sampling plan.

 

Chapter 13, “Data Collection in Quantitative Research”

Once a sampling design is complete, the next step is to collect the data, and this is the focus of Chapter 13. The chapter describes how to develop a data collection plan, and provides information about the different types of instruments that can be used, such as structured observation and biophysiologic measures.

 

Chapter 22, “Sampling in Qualitative Research”

The focus of this chapter is on the sampling process in qualitative research. The chapter describes the different types of sampling and when they are commonly used. Sampling techniques in the three main qualitative traditions (ethnography, phenomenological studies and grounded theory studies) are highlighted.

 

Chapter 23, “Data Collection in Qualitative Research”

This chapter examines the process of data collection in qualitative research as well as key issues surrounding data collection. This includes such methods as self-reporting, surveys, interviews, and personal journal keeping. The chapter also highlights important considerations when utilizing unstructured observations to gather data and how to record field notes.

Keough, V. A., & Tanabe, P. (2011). Survey research: An effective design for conducting nursing research. Journal of Nursing Regulation, 1(4), 37–44. Copyright 2011 by Elsevier Science & Technology Journals. Used with permission of Elsevier  Science & Technology Journals via the Copyright Clearance Center.

 

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Walden University. (n.d.a.). Paper templates. Retrieved July 23, 2012, from http://writingcenter.waldenu.edu/57.htm

 

This resource provides you access to the School of Nursing Sample Paper, which will serve as a template for formatting your papers.

Media

Laureate Education (Producer). (2012b). Data collection. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 4 minutes.

 

Dr. Kristen Mauk discusses how she collected data for her DNP project in this video. She describes the details of her pre- and post-tests used to track nurses’ knowledge in a rehabilitation unit.

 

Optional Resources

Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. (2009). Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journal of Nursing Education, 48(4), 186–195.

 

This text emphasizes the advantages of survey research. The authors describe the nuances of survey research projects, including their design, methods, analysis, and limitations.

Horsley, T., Hyde, C., Santesso, N., Parkes, J., Milne, R., & Stewart, R. (2011). Teaching critical appraisal skills in healthcare settings. Cochrane Database of Systematic Reviews (Online), 11, Art. No.: CD001270.

Melnyk, B., Fineout-Overholt, E., & Mays, M. (2009). The evidence-based practice beliefs and implementation scales: Psychometric properties of two new instruments. Worldviews on Evidence-Based Nursing, 6(1), 49.

Fawcett, J., & Garity, J. (2009). Evaluating research for evidence-based nursing. Philadelphia, PA: F.A. David Company.

Chapter 9, “Evaluation of Research Instruments and Experimental Conditions”

Week 2: Patient Education Technology Guide to a Mobile Health Application PowerPoint

Submit Assignment

Points 175  Submitting a file upload

The purpose of this assignment is to demonstrate the skills of the professional nurse as an educator. You are to prepare a guide that will serve as a handout to assist a specific patient that you identify. Your guide or handout should help this patient find and evaluate a reliable mobile health, or mHealth application (app) that is already developed. This may be related to the patient’s disease process or diagnosis or may be an app that can help a patient maintain or improve good health and prevent illness.

You will develop the guide using Microsoft PowerPoint. PowerPoint is a versatile application that lets you design slideshows and handouts. For this assignment, you will be using PowerPoint to create a guide or handout that you may print and give to patients and families. You will be submitting this PowerPoint file for grading.

Course Outcomes

This assignment enables the student to meet the following Course Outcomes.

CO1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO1)

CO5: Identify patient care technologies, information systems, and communication devices that support safe nursing practice. (PO5)

Points

This assignment is worth a total of 175 points.

Due Date

The Patient Education Technology Guide to a Mobile Health Application PowerPoint assignment is due in Week 2. Submit your completed assignment. You may consult the Policies section in the Introduction & Resources module for details regarding late assignments. Late assignments will result in loss of points. Post questions about this assignment in the Course Q & A Forum.

Directions

You are required to complete this assignment using the productivity tools required by Chamberlain University, which is Microsoft Office 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.pptx” format. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.

You are required to cite your source(s) as it relates to your application slide. Other citations are permitted, but this is not a requirement for the assignment.

Title slide (first slide): Include a title slide with your name and the title of the presentation.

Scenario Slide (one slide): This slide should include a brief scenario, then identify a patient who is experiencing a specific disease process or diagnosis who would benefit from an already developed and reliable mHealth app. Or it could identify a person who is currently healthy and would like to maintain or improve health and prevent illness. Be sure to include the nurse’s assessment of the patient’s learning needs and readiness to learn. Be specific.

Example:

Scenario for Ms. Ellis

Jane Doe (your name here)

Jennifer Ellis, a 62-year-old African American woman, has been recently diagnosed with chronic kidney disease (CKD). She has been prescribed several medications she must take every day.

The nephrologist has stressed the importance of leading a healthy lifestyle to slow or stop the progression of CKD.

She is interested in ways in which she can better track her health and make healthier choices.

She is a high school graduate and iPhone user, mostly to send text messages to family and friends.

She is eager to learn how to use an app that can help her manage her CKD.

Prepare the following slides as if you are presenting them to the patient.

mHealth application slide (one to three slides): Identify a developed and reliable mHealth app that could benefit the patient. Describe the app, including the following.

Name

Purpose

Intended audience

Mobile device(s) upon which it will operate

Where to download or obtain it (include a working link if it is to be downloaded from a website)

Any other information you believe would be pertinent to this situation

Be sure to cite all sources you use.

Teaching slides (one to three slides): Prepare slides that contain important points about the app that you want to teach to the patient, such as how to use the app safely and effectively (including how to interpret and act on the information that is provided).

Evaluation slide (one to three slides): Describe how you would determine the success of the patient’s use of this app. For example, include ways to evaluate the effectiveness of the teaching plan that are a good fit for the type of app or focus on specific ways that this app benefits the patient’s health and wellness.

References (last slide): List any references for sources that were used or cited in the presentation.

Writing and design: There should be no spelling or grammatical errors. Writing is concise and clear. Avoid words that the patient may not understand. Slides are visually appealing, incorporating graphics, photographs, colors, and themes.

Review the section on Academic Integrity Policy found in the RNBSN Policies. All work must be original (in your own words) unless properly cited.

Best Practices in Preparing PowerPoint Slideshows

Be creative but realistic.

Incorporate graphics, color, themes, or photographs to increase interest.

Make it easy to read with short bullet points and large font.

Review directions thoroughly.

Cite all sources within the slides with (author, year), as well as on the reference slide.

Proofread prior to final submission.

Check for spelling and grammar errors prior to final submission.

Abide by the Chamberlain academic integrity policy.

Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful. http://office.microsoft.com/en-us/support/training-FX101782702.aspx (Links to an external site.)Links to an external site. The Chamberlain Student Success Strategies (CCSSS) offers a module on Computer Literacy that contains a section on PowerPoint. The link to SSPRNBSN may be found in your student portal.

**Academic Integrity Reminder**

values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page.

NOTE: Please use your browser’s File setting to save or print this page.

Rubric

NR361 Patient Guide – Sept 18

NR361 Patient Guide – Sept 18

Criteria  RatingsPts

This criterion is linked to a Learning Outcome Scenario Slide

Scenario is clear and concise, including a disease process or diagnosis, or identify a patient with a desire to maintain good health and prevent illness. Include the nurse’s assessment of learning needs and readiness to learn.

40.0 pts

Scenario is a clear and concise description of patient with a specific disease or diagnosis, or someone who is healthy and wants to prevent illness and maintain good health. Makes clear that the person is seeking information, including a detailed assessment of learning needs and readiness to learn.

35.0 pts

Scenario is clear but not concise as it exceeds more than one slide. It includes a description of the patient with specific disease or diagnosis, or desire to maintain good health. Scenario generally describes the nurse’s assessment of learning needs and readiness to learn.

32.0 pts

Scenario includes a description of the patient with specific disease or diagnosis, or desire to maintain good health. Scenario lacks the nurse’s assessment of learning needs OR readiness to learn.

15.0 pts

Scenario is missing the description of disease process OR diagnosis OR desire to maintain good health Scenario lacks both the nurse’s assessment of learning needs AND readiness to learn.

0.0 pts

Scenario fails to describe the patient’s situation The nurse’s assessment of learning needs and readiness to learn are lacking.

40.0 pts

This criterion is linked to a Learning Outcome mHealth Application Slide

Identify a mHealth app that could benefit the patient. Describe the app including its: • Name • Purpose • Intended audience • Mobile device(s) upon which it will operate • Where to download or obtain it. Include a working link if it is to be downloaded from a website. • And any other information you believe would be pertinent to this situation. • Citation

50.0 pts

Describes the mHealth application in detail including its: Name, Purpose, Intended Audience, Mobile device upon which it operates, Download or where to obtain, Other pertinent information, and Sources that are used are cited.

44.0 pts

Describes the mHealth application but is lacking one of the elements in the first column.

40.0 pts

Describes the mHealth application but is lacking two of the elements in column.

19.0 pts

Describes the mHealth application but is lacking three of the elements in the first column.

0.0 pts

Provides a poor or confusing description of the mHealth application that lacks most of the elements in the first column.

50.0 pts

This criterion is linked to a Learning Outcome Teaching Slide

Information on slides to be taught to patient about the mHealth app including any safety guidelines, and how to interpret and act on the information that is provided.

40.0 pts

Prepares slides that teach all pertinent details about how to use the app safely and effectively including how to interpret and act on the information that is provided.

35.0 pts

Prepares slides that teach most information about how to use the app safely and effectively including how to interpret the information that is provided.

32.0 pts

Prepares minimal information that the patient needs to know to use the device, for example, lacking safety guidelines that may need to be followed.

15.0 pts

Prepares slides that are confusing and does not convey useful information that the patient needs to know.

0.0 pts

Teaching slides are not included in the presentation

40.0 pts

This criterion is linked to a Learning Outcome Evaluation Slide

Describe how you would determine the success of the patient’s use of the mHealth app.

20.0 pts

Describes in detail ways to evaluate the effectiveness of the teaching plan that are a good fit for the type of app or focus on specific ways that this app benefits the patient’s health and wellness.

18.0 pts

Describes general or universal ways to evaluate the effectiveness of the teaching plan that considers the nature of the app.

16.0 pts

Describes limited ways to evaluate the effectiveness of the teaching plan, which does not reflect the nature of the app.

8.0 pts

Describes an evaluation plan but it is unlikely to determine if the patient has learned what is necessary.

0.0 pts

Does not include an evaluation plan.

20.0 pts

This criterion is linked to a Learning Outcome Writing and Design

Writing contains no spelling or grammatical errors. Bullets should be used instead of long sentences or paragraphs. Reading level is appropriate for patient described. Slides are visually appealing incorporating graphics, photographs, colors and themes. Sources that are used are cited.

25.0 pts

Slides have the following elements: Name of student appears on the Title Slide; Themes of slides are clearly identified; Bullets are used instead of long sentences or paragraphs; Reading level appropriate for patient; Slides are visually appealing incorporating graphics, photographs, colors and themes; Grammar, punctuation, and spelling are correct; Citation present for application.

22.0 pts

Good mechanics considering the elements listed in the first column.

20.0 pts

Fair mechanics considering the elements listed in the first column.

10.0 pts

Poor mechanics considering the elements listed in the first column.

0.0 pts

Very poor mechanics such that assignment is difficult to read.

25.0 pts

This criterion is linked to a Learning Outcome Topic Use/Use of Power Point

0.0 pts

0 points deducted

Correct Topic/Power Point used for the assignment results in 0 points lost.

0.0 pts

17.5 (10%) points deducted

Incorrect topic used or NO power point used results in a deduction of 17.5 (10%) points. 17.5 point deduction

0.0 pts

Total Points: 175.0

The purpose of this assignment is to complete a direct observational assessment of a community in your area. This windshield survey will help you to identify a vulnerable population, an important community health problem, and a related Healthy People 2020objective for a community in your area.

 

1. Introduction to the Community: Identify the community you will be using for this assignment with the city and state, and provide a brief, one-paragraph description of the community. Your community should be the area where you live or the area surrounding your work setting. The community must include a residential area and be a large enough area to answer the survey questions. Do not include epidemiological or demographic data as this is based on what you observe.
2. Windshield Survey: Assess your community by doing a windshield survey. Information about the components of a windshield survey is located in your textbook, Nies and McEwen (2019). Drive through the area and report your observations by answering the questions on the form. Be sure to include what you observed related to each of these categories, and also include any significant items that are missing in your community because this may be equally important in identifying a community health problem.
   1. Community vitality
   2. Indicators of social and economic conditions
   3. Health resources
   4. Environmental conditions related to health
   5. Social functioning
   6. Attitude toward healthcare
   7. Note: It is helpful to conduct this assessment at least two different times: during the day or evening, on a weekday, and/or on the weekend. If possible, plan on asking someone to drive during your survey so that you can take notes.
3. Vulnerable population: Identify the aggregate or vulnerable populations that you observed in your community during your drive through. What did you observe about this population?
4. Community problem: Based on your assessment in the survey above, identify and discuss one priority community health problem that a community health nurse could positively impact.Example: If you observed teens who were pregnant or had young children during your survey and felt this was a priority problem in your community, the diagnosis could be
   Risk of unintended pregnancy among adolescent girls in XXXX community as evidence by observation of pregnant teens and teens caring for young children during windshield survey.
5. Healthy People 2020 Objective: Go to the Healthy People topic areas at https://www.healthypeople.gov/2020/topics-objectives. Find a topic area that relates to one of the vulnerable populations you observed. Click on the topic area, and then click on the green Objectives tab. Review the objectives within that topic area to complete the relevant sections of the form. State the Healthy People 2020 objective number (not just a goal) that describes your problem.Example: The topic area Family Planning would be relevant. You would click on Family Planning, and then click the green Objectives tab, and you might choose
   FP-8.1 “Reduce pregnancies among adolescent females aged 15 to 17 years” (U.S. Department of Health and Human Services: Healthy People 2020, 2018, Objectives: Family Planning, para 8).
6. Summary: Complete the summary of learning section.
7. References: The purpose of this assignment is to document your observations of your community. Outside sources other than Healthy People 2020 should not be used. We have included this reference on the Windshield Survey form for you.

Best Practices in Completing the Form

The following are best practices in preparing this project.

• Make sure all elements of the form are included.
• Review directions and grading rubric thoroughly.
• Use a professional writing style with complete sentences in the fill-in sections.
• Check for spelling and grammar errors prior to final submission.
• Abide by the Chamberlain academic integrity policy.

**Academic Integrity Reminder**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

Formulate a PICOT statement for your capstone project. (Childhood Obesity)

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process.

Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 750 -1000 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

1. Evidence-Based Solution
2. Nursing Intervention
3. Patient Care
4. Health Care Agency
5. Nursing Practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.