To prepare for this Discussion:

Note: To access the following case studies, click on the Case Studies tab on the Stahl Online website and select the appropriate volume and case number. (Already attached with this posting)

 

Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter

 

Review this week’s Learning Resources and reflect on the insights they provide.

Go to the Stahl Online website and examine the case study you were assigned.

Take the pretest for the case study.

Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

Review the posttest for the case study.

 

By Day 3

Post a response to the following:

Provide the case number in the subject line of the Discussion.

List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

List two pharmacologic agents and their dosing that would be appropriate for the patient’s ADHD therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.

 

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment.  Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

 

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

Chapter 12, “Attention Deficit Hyperactivity Disorder and Its Treatment”

Stahl, S. M., & Mignon, L. (2012). Stahl’s illustrated attention deficit hyperactivity disorder. New York, NY: Cambridge University Press.

 

To access the following chapter, click on the Illustrated Guides tab and then the ADHD tab.

Chapter 4, “ADHD Treatments”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

 

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

 

Review the following medications:

For ADHD

armodafinil

amphetamine (d)

amphetamine (d,l)

atomoxetine

bupropion

chlorpromazine

clonidine

guanfacine

haloperidol

lisdexamfetamine

methylphenidate (d)

methylphenidate (d,l)

modafinil

reboxetine

 

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

 

Optional Resources

Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245–268. doi:10.2165/11599630-000000000-00000

Psychiatric Times. (2016). A 5-question quiz on ADHD. Retrieved from http://www.psychiatrictimes.com/adhd/5-question-quiz-adhd?GUID=AA46068B-C6FF-4020-8933-087041A0B140&rememberme=1&ts=22072016

 

Course Texts

These course texts are available through Stahl Online Resources http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Application Assignment 2: Part 2 – Developing an Advocacy Campaign

To prepare:

Review Chapter 3 of Milstead, J. A. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.

In the first assignment( HEALTH ADVOCACY CAMPAIGN DOCUMENT ATTACHED BELLOW), you reflected on whether the policy you would like to promote could best be achieved through the development of new legislation, or a change in an existing law or regulation. Refine as necessary using any feedback from your first paper.

Contemplate how existing laws or regulations may affect how you proceed in advocating for your proposed policy.

Consider how you could influence legislators or other policymakers to enact the policy you propose.

Think about the obstacles of the legislative process that may prevent your proposed policy from being implemented as intended.

To complete:

Part Two will have approximately 3–4 pages of content plus a title page and references. Part Two will address the following:

Explain whether your proposed policy could be enacted through a modification of existing law or regulation or the creation of new legislation/regulation.

Explain how existing laws or regulations could affect your advocacy efforts. Be sure to cite and reference the laws and regulations using primary sources.

Provide an analysis of the methods you could use to influence legislators or other policymakers to support your policy. In particular, explain how you would use the “three legs” of lobbying in your advocacy efforts.

Summarize obstacles that could arise in the legislative process and how to overcome these hurdles.

Paste the rubric at the end of your paper.

NOTE: CHECK THE DOCUMENT: HEALTH ADVOCACY CAMPAIGN, AND BOOK ATTACHED BELLOW, 

Assignment : Case Study Assignment: Assessing Neurological. 

 

Imagine not being able to form new memories. This is the reality patients with anterograde amnesia face. Although this form of amnesia is rare, it can result from severe brain trauma. Anterograde amnesia demonstrates just how impactful brain disorders can be to a patient’s quality of living. Accurately assessing neurological symptoms is a complex process that involves the analysis of many factors.

In this Case Study Assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

 

To Prepare

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

Also, your Case Study Assignment should be in the Episodic/Focused SOAP Note format rather than the traditional narrative style format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

With regard to the case study you were assigned:

Review this week’s Learning Resources, and consider the insights they provide about the case study.

Consider what history would be necessary to collect from the patient in the case study you were assigned.

Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

 

The Case Study Assignment

Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template.

Provide evidence from the literature to support diagnostic tests that would be appropriate for each case.

List five different possible conditions for the patient’s differential diagnosis, and justify why you selected each. 

 

CASE STUDY

 

Neurological Cases for Week 9

Case 1: Drooping of the face: A 33-year-old female comes to your clinic alarmed about sudden “drooping” on the right side of the face that began this morning. She complains of excessive tearing and drooling on her right side as well.
THIS IS THE LINK TO DOWNLOAD THE BOOK:

 

https://www.sendspace.com/file/wd7quh

NOTE: Check the assignment for plagiarism

 

Evidence-Based Practice

 

Within a busy healthcare environment, it can be difficult to recognize the influence of theory; yet theory plays a critical role in nursing practice as well as nursing research. The ultimate purpose of learning about theory in this course, and throughout the DNP program, is to strengthen your ability to promote evidence-based practice. Consider what you have learned in this course about the relationships among philosophy, science, theory, and practice; how could the insights you have gained help you to facilitate the application of evidence-based practice in a health care setting? How can an EBP model support this application?

 

For this Discussion, you will consider the various EBP models as well as the difference between EBP and clinical research.

 

To prepare:

 

• Reflect on the EBP models presented in the Learning Resources and their application in clinical practice.
• Recall the clinical practice problem you identified for Application #5, and consider which EBP model would best support investigating that problem.
• Also, contemplate the difference between the application of research in evidence-based practice and clinical research and the role of the DNP-prepared nurse in both.

 

By tomorrow Wednesday 8/9/17, write a minimum of 550 words essay with a minimum of 3 references that include the level one headers as numbered below:

post a cohesive response that addresses the following:

 

• Which EBP model would best support the exploration of the practice problem you utilized for Application #5? Include a brief summary of your practice problem and the rationale for your EBP model selection.
• Provide a summary of how evidence-based practice differs from clinical research, and include your perception of the role of DNP-prepared nurses in both.

 

Required Readings

 

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

• Chapter 19, “Application of Theory in Nursing Research”
• Chapter 19 delves into the application of theory to nursing research and provides examples of its importance and use.

 

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

• Review Chapter 1, “Discovering the World of Nursing Research”
• Review Chapter 1 focusing on how theory is applied to nursing through evidence-based practice.
• Chapter 19, “Evidence Synthesis and Strategies for Evidence-Based Practice”
• This section of Chapter 19 presents strategies for transitioning the nursing profession toward EBP.

 

Fitzpatrick, J. (2010). Connecting or disconnecting the dots between research and evidence-based practice. Applied Nursing Research, 23(1), 1. doi:10.1016/j.apnr.2009.10.001

This brief editorial calls for practitioners to be aware of the difference between research and evidence-based practice.

 

Ganz, F., Fink, N., Raanan, O., Asher, M., Bruttin, M., Nun, M., & Benbinishty, J. (2009). ICU nurses’ oral-care practices and the current best evidence. Journal of Nursing Scholarship, 41(2), 132–138. doi:10.1111/j.1547-5069.2009.01264.x

This article explores the use of evidence-based practices in the ICU.

 

Kenny, D. J., Richard, M. L., Ceniceros, X., & Blaize, K. (2010). Collaborating across services to advance evidence-based nursing practice. Nursing Research, 59. S11–S21.

This article discusses the implementation of EBP through the collaborative efforts of nurses at two medical facilities.

 

Krom, Z., Batten, J., & Bautista, C. (2010). A unique collaborative nursing evidence-based practice initiative using the Iowa model: A clinical nurse specialist, a health science librarian, and a staff nurse’s success story. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 24(2), 54–59. doi: 10.1097/NUR.0b013e3181cf5537

This article discusses the efforts of a clinical nurse specialist, a health science librarian, and a staff nurse to heighten staff nurse awareness of the evidence-based practice process.

 

University of Iowa Hospitals and Clinics (2010). The Iowa model of evidence-based practice. Retrieved from http://www.uihealthcare.org/otherservices.aspx?id=1617

This website provides numerous resources that explain and support the Iowa Model of EBP.

 

Required Media

 

Laureate Education (Producer). (2011). Theoretical and scientific foundations for nursing practice: An evidence-based practice model [Video]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 10 minutes.

In this media presentation, Dr. Kathleen White discusses the Johns Hopkins model for evidence-based practice. Dr. White presents how the model was developed and provides examples of how each stage of the model is applied in nursing practice.

 

Optional Resources

 

Dufault, M. (2004). Testing a collaborative research utilization model to translate best practices in pain management. Worldviews on Evidence-Based Nursing, 1. S26–S32. doi:10.1111/j.1524-475X.2004.04049.x

 

 

Fineout-Overholt, E., & Johnston, L. (2005). Teaching EBP: Asking searchable, answerable clinical questions. Worldviews on Evidence-Based Nursing, 2(3), 157–160.

 

 

Maramba, P., Richards, S., Myers, A., & Larrabee, J. (2004). Discharge planning process: applying a model for evidence-based practice. Journal Of Nursing Care Quality, 19(2), 123–129.

 

Newhouse, R.P. (2007). Diffusing confusion among evidence-based practice, quality improvement, and research. JONA: The Journal of Nursing Administration, 37(10), 432–435. doi:10.1097/01.NNA.0000285156.58903.d3

 

Newhouse, R., Dearholt, S., Poe, S. Pugh, L., & White, K. (2005). Evidence-based practice: Practical approach to implementation. Journal of Nursing Administration, 35(1), 35–40.