Chapter 7 Application Exercises 1 and 2

1. Visit the ICD-11 website (http://www.who.int/classifications/icd/revision/en/ (Links to an external site.)Links to an external site.) and locate the information on Topic Advisory Groups. What is the role of the clinical topic advisory groups? Which diseases or domain areas are represented? What is the relationship of the Topic Advisory groups to the Revision Steering Group?
2. Visit the ICD-11 website (http://apps.who.int/classifications/icd11/browse/f/en (Links to an external site.)Links to an external site.) and locate the information on the ICD-11 beta draft. Then answer the following questions:
   • What are the caveats listed for the ICD-11 beta draft?
   • What is the date ICD-11 will be presented to the World Health Assembly?
   • What is a known issue for which a planned solution is in the works?

Chapter 8 Application Exercises 1, 2, and 3

1. Go to http://www.nlm.nih.gov/research/umls/  (Links to an external site.)Links to an external site.and locate the release notes for the last monthly update.
   • Write a report summarizing the contents of the update
2. Go to the daily med website (http://dailymed.nlm.nih.gov (Links to an external site.)Links to an external site.). Search on Lasix
   • What are the RxNorm normal forms for Lasix? How many RxCUIs are there for Lasix?
3. Use your search engine to locate information about the RxNorm Current Prescribable Content (CPC).
   • What is the CPC? What is its purpose? What does it include? What does it not include?

Assignment Guidelines

• You have the choice to write a two-page paper, double spaced, or create a multimedia presentation to respond to the exercises

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion. Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To prepare:

• Review the Bazzano et al. and Mayhew articles in the Learning Resources. Reflect on situations in which children should be prescribed drugs for off-label use.
• Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

With these thoughts in mind:

By Day 3

Post an explanation of circumstances under which children should be prescribed drugs for off-label use. Then, describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

CLASS RESOURCES

Arcangelo,  V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.).  (2017). Pharmacotherapeutics for advanced  practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams  & Wilkins.
Review Chapter 4, “Principles of Pharmacotherapy in Pediatrics” (pp. 53-63)
This chapter explores concepts relating to drug selection, administration, and interaction for pediatric patients. It also compares age-related pharmacokinetic differences in children and adults.

Chapter 17, “Ophthalmic Disorders” (pp. 221-243)
This chapter examines the causes, pathophysiology, diagnostic criteria, and drug treatment for four ophthalmic disorders: blepharitis, conjunctivitis, keratoconjunctivitis sicca, and glaucoma. It also explores methods of monitoring patient response to treatment.

Chapter 43, “Attention-Deficit/Hyperactivity Disorder” (pp. 743-756)
This chapter explains the process of diagnosing Attention-Deficit/Hyperactivity Disorder (ADHD). It also identifies drugs for treating patients with ADHD, including proper dosages, selected adverse events, and special considerations for each drug.

Chapter 51, “Immunizations” (pp. 906-926)
This chapter explores vaccines that are licensed for use in the United States and provides a recommended vaccination schedule for pediatric patients and adults.

Chapter 52, “Smoking Cessation” (pp. 927-943)
This chapter examines clinical implications of smoking. It also covers various approaches for aiding patients who are dependent on nicotine but want to stop smoking.

Chapter 54, “Weight Loss” (pp. 945-956)
This chapter begins by reviewing patient factors that contribute to obesity. It also examines drug therapy for initiating weight loss in patients, as well as alternative non-drug treatments.

Bazzano, A. T, Mangione-Smith, R., Schonlau, M., Suttorp, M. J., & Brook, R. H. (2009). Off-label prescribing to children in the United States outpatient setting. Academic Pediatrics, 9(2), 81–88.
Note: Retrieved from the Walden Library databases.

This study examines the frequency of off-label prescribing to children and explores factors that impact off-label prescribing.

Mayhew, M. (2009). Off-label prescribing. The Journal for Nurse Practitioners, 5(2), 122–123.
Note: Retrieved from the Walden Library databases.

This article reviews the prevalence of off-label prescribing, including its benefits and risks. It also explores issues regarding the safety of off-label prescribing and when it is unavoidable.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

       Group Therapy for Addiction

Consider the following scenario:

The psychiatric mental health nurse practitioner is working for a community health clinic that offers state mandated “intensive outpatient rehabilitation” services for individuals who face incarceration for driving while under the influence. Mr. Smith, a 24-year-old male patient, shows up for his initial intake appointment and says, “Look, this sounds like it’s going to be an AA meeting. Can’t I just go there? I only had a couple of drinks. I don’t know why the judge was such a jerk.”

Clients with addictive disorders may present for therapy for various reasons. Some, like Mr. Smith, attend because it is court mandated. Some attend because family or friends have pushed them to do so, while others may attend because life has become unmanageable. Regardless of clients’ reasons for presenting for therapy, to reach these clients and effectively treat them, you must be able to break down barriers, establish relationships, and help them see the benefits of this therapeutic approach.

PLEASE REMEMBER TO REVIEW THE ATTACHED 7 VIDEO TRANSCRIPTS BEFORE DOING THE ASSIGNMENT, and to include a title page, introduction, summary, and references

                                                              The Assignment

In a 2- to 3-page paper, address the following:

· Identify the psychotherapeutic approach that the group facilitator is using and

explain why she might be using this approach.

· Determine whether or not you would use the same psychotherapeutic approach

if you were the counselor facilitating this group and justify your decision.

· Identify an alternative approach to group therapy for addiction and explain why

it is an appropriate option.

· Support your position with evidence-based literature.

                                                                    Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

• Chapter      16, “Psychotherapeutic Approaches for Addictions and Related Disorders”      (pp. 565–596)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

• Chapter 13, “Problem Group Members” (pp. 391–427)

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

Gamble, J., & O’ Lawrence, H. (2016). An overview of the efficacy of the 12-step group therapy for substance abuse treatment. Journal of Health & Human Services Administration, 39(1), 142–160. Retrieved from http://jhhsa.spaef.org/

Kim, J. W., Choi, Y. S., Shin, K. C., Kim, O. H., Lee, D. Y., Jung, M. H., … Choi, I. (2012). The effectiveness of continuing group psychotherapy for outpatients with alcohol dependence: 77-month outcomes. Alcoholism: Clinical & Experimental Research, 36(4), 686–692. doi:10.1111/j.1530-0277.2011. 01643.x

Required Media

Allyn & Bacon (Producer). (2000). Motivational interviewing [Video file]. Mill Valley, CA: Psychotherapy.net.

Note: You will access this media from the ATTACHED TRANSCRIPT. The approximate length of this media piece is 102 minutes.

Laureate Education (Producer). (2013d). Levy family: Sessions 1-7 [Video file]. Baltimore, MD; Author.

Primary health Plan focused on preventive services.

Title: Diabetes prevention in elderly population of my community.

APA style, 10 pages long, not including references and presentation page.

Identify a health problem in your community, in which you can develop a preventive program. (I choose Obesity prevention in adolescents of my community).

Create a clinical question using the PICOT (problem/patient/or population, intervention/indicator, comparison, outcome, and time element or type of study).

Objectives of the presentation

· Define preventive services commonly offered to different types of communities, using Healthy People 2020.

· Explain how to develop and write a practical policy for preventive services

· Define the steps to develop Primary Health Plan.

· Explain the evaluation criteria of a primary health plan.

· Explain the commonly used methods for evaluating a preventive health program.

· Identify a health problem in which it is important to develop a preventive health program.

Introduction.

Abstract

Literature that support the project

Description of the proposed solution.

Theory of change.

Problem identification, intended participant, Setting selection.

Objective and goals.

Intervention

Community involvement.

Develop materials and activities

Implementation and monitoring the intervention.

Choose one of the four overarching goals to work on the project:

· Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.

· Achieve health equity, eliminate disparities, and improve the health of all groups.

· Create social and physical environments that promote good health for all.

· Promote quality of life, healthy development, and healthy behaviors across all life stages.

Evaluation.

Practice.

Conclusion.

References.

You have been named the Administrative Director at Trident International Hospital (TIH) and will be presenting your PPT to the Board of Directors at TIH for approval. TIH is restructuring to meet the current needs of their consumers.

For this assignment, you are responsible for creating a department organizational chart for both the inpatient and outpatient departments at TIH. Using the research and information presented in your Case 1 assignment, you should:

1. Design a department organization chart for TIH’s inpatient and outpatient department.
   1. You may create your own or use the one of the templates at the following link: http://templatelab.com/organizational-chart-templates/#.
   2. Include in the charts at least 2 units in each department, e.g., acute inpatient units, inpatient rehabilitation, skilled nursing, etc. (An example of a department organization chart can be access here: http://annals.org/data/Journals/AIM/20209/10FF4.jpeg)
2. In the slides following each chart you are to:
   1. Describe the personnel that will staff these units.
   2. Explain the importance of having your chosen units.
   3. Explain how the chosen units meet the needs of health care consumers.

Your PPT should be professional and provide substantial information about the two departments at TIH.

Your presentation should be at least 5-6 slides (not including the title and reference slide).  Speaker notes are required.

Assignment Expectations

1. Conduct additional research to gather sufficient information to support your design of your department organization chart.
2. Limit your PPT to a maximum of 6 slides.
3. Support your powerpoint with peer-reviewed articles, with at least 3-4 references. Use the following source for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php.
4. You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.
5. For additional information on reliability of sources review the following source: https://www.edb.utexas.edu/petrosino/Legacy_Cycle/mf_jm/Challenge%201/website%20reliable.pdf.