Reflect on the conclusion you are writing for your own essay. Remind us of your topic and give us an idea of what you learned from the experience.
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[order_calculator]Discuss the pathophysiology of the disorder, including the effects on the endocrine feedback system, and the role of the hypothalamic-pituitary axis. Identify the pharmacologic agent(s) used to treat the disorder and how the pharmacologic agent(s) alters the pathophysiology.
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[order_calculator]Human chorionic gonadotropin (HCG) is currently being used as an aid to weight loss in conjunction with an extremely restricted caloric intake of 500 calories per day. Many people are buying the HCG through the Internet with no medical surveillance.
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[order_calculator]Practicum Discussion: Culturally aware nurses recognize that states of health are revealed differently across cultures and ethnicities. Culture and ethnic background will affect the way each individual responds to health, illness, and death (Stanhope & Lancaster, 2016). These nurses are also aware of their own biases, which may affect the care they provide to others (Stanhope & Lancaster, 2016). Because most nurses work in institutions with individual patients, they are accustomed to delivering culturally competent care on a one-on-one basis. When a public health nurse deals with a population, he or she must consider how the population culture affects the ways in which the community nurse may interact. This can be with regard to the provision of education or mass health care needs such as those required in a foodborne illness, if mass vaccinations are needed for a communicable disease outbreak, or if education is required to prevent heart disease. In addition to understanding the nuances of the culture of a population, community health nurses must understand the role genetics play in health. Some disorders, such as glaucoma and diabetes, have a genetic link, as do some cancers, such as breast and ovarian. Please discuss the following questions in your Practicum Discussion: Provide a few examples of community resources that should be put in place to assist your population in resolving their health care needs. What gaps in service do you see that affect your population? Are there any cultural considerations that might inform your approach to caring for this population? Does your population have a genetic predisposition to the health care problem you have identified?
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[order_calculator]Do you have problems with wordiness, slang, cliches, or homonyms? Identify specific strategies for correcting the error or errors you have identified. Your post must be at least 150 words in length. Post your word count at the end of your post.
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[order_calculator]To prepare for this Discussion:Case 1: Volume 1, Case #1: The man whose antidepressants stopped workingReview 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 patients 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.
Review the patients past and current medications. Refer to Stahls Prescribers Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!Provide the case number in the subject line of the Discussion thread.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 patients life you would need to speak to or get feedback from to further assess the patients 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 patients antidepressant 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.
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the clients ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
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 presentationsDiscussion: The Impact of Ethnicity on Antidepressant Therapy
Major depressive disorder is one of the most prevalent disorders you will see in clinical practice. Treatment for this disorder, however, can vary greatly depending on client factors, such as ethnicity and culture. As a psychiatric mental health professional, you must understand the influence of these factors to select appropriate psychopharmacologic interventions. For this Discussion, consider how you might assess and treat the individuals in the case studies based on the provided client factors, including ethnicity and culture.Learning Objectives
Students will:
Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy
Analyze the impact of ethnicity on antidepressant therapy
Evaluate efficacy of treatment plans
Apply knowledge of providing care to adult and geriatric clients presenting for antidepressant therapy
Learning Resources
Note: To access this weeks 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. Stahl, S. M. (2013). Stahls essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. Note: 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 7, Antidepressants
Stahl, S. M. (2014b). The prescribers guide (5th ed.). New York, NY: Cambridge University Press. Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. Review the following medications:amitriptyline
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetineAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Note: Retrieved from Walden Library databases.Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 1: Study design. Journal of Psychosocial Nursing and Mental Health Services, 46(9), 2124. doi:10.3928/02793695-20080901-06Note: Retrieved from Walden Library databases.Howland, R. H. (2008a). Sequenced treatment alternatives to relieve depression (STAR*D). Part 2: Study outcomes. Journal of Psychosocial Nursing and Mental Health Services, 46(19), 2124. doi:10.3928/02793695-20081001-05Note: Retrieved from Walden Library databases. Yasuda, S.U., Zhang, L. & Huang, S.-M. (2008). The role of ethnicity in variability in response to drugs: Focus on clinical pharmacology studies. Clinical Pharmacology & Therapeutics, 84(3), 417423. Retrieved from https://web.archive.org/web/20170809004704/https://www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdfTo prepare for this Discussion:Note: By Day 1 of this week, your Instructor will have assigned you to one of the following case studies to review for this Discussion. 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.Case 1: Volume 1, Case #1: The man whose antidepressants stopped workingCase 2: Volume 1, Case #7: The case of physician do not heal thyselfCase 3: Volume 1, Case #29: The depressed man who thought he was out of optionsReview 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 patients 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 weeks Learning Resources for guidance.
Review the patients past and current medications. Refer to Stahls Prescribers Guide and consider medications you might select for this patient.
Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!Provide the case number in the subject line of the Discussion thread.
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 patients life you would need to speak to or get feedback from to further assess the patients 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 patients antidepressant 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.
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the clients ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
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
Read a selection of your colleagues’ responses.
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[order_calculator]Create a resume detailing your license(s), earned degree(s), certification(s), professional experiences, previous positions held, membership in professional organizations, publications, and skills.Both the cover letter and resume should be formally written using a professionally accepted format. Review “Resume Resources,” located at for http://www.resume-resource.com/examples-medical.html for examples of approved formats; however, other professional templates may be used.Share your resume with a colleague and elicit their feedback. Revise your resume if needed and submit the resume in the assignment section of the course.
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[order_calculator]How do you measure prices? What is the price index for consumers? Explain minimum wages and issues. What is the natural rate of unemployment? What are shoe leather costs? Are there too many people unemployed and why?
What is GDP measures and business cycles. Inflation, deflation. Investment, Savings, debt, and the financial system. What is your financial plan: how to turn money into wealth. Stocks, houses, annuities, inheritance, diversification, interest rates, mutual funds, and insurance. Do you need health insurance, life insurance? What is unemployment? How do we measure it?
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[order_calculator]Our healthcare system is often constrained by the resources that we have available. When resources are scarce, our allocations must be well justified. Perhaps the toughest example of resource allocation comes during times of emergency. Not enough medication, medical supplies, physicians, or hospital beds, coupled with uncertainty and urgency means that some people die, while others will receive the care that they need to live. For this assignment, please first listen to Radiolabs Podcast – Playing God, which can be found at http://www.radiolab.org/story/playing-god/ (Links to an external site.)Links to an external site. (Link on Blackboard). Then, please read Sheri Finks AUG. 21, 2016 NYT article, Whose Lives Should Be Saved? Researchers Ask the Public, available at:http://www.nytimes.com/2016/08/22/us/whose-lives-should-be-saved-to-help-shape-policy-researchers-in-maryland-ask-the-public.html?_r=0 (Links to an external site.)Links to an external site. Please reflect on above resources, and then consider the following questions, and write a clear, concise, and reasoned essay expressing your answers. As you find them applicable, you should incorporate the principles, theories, and strategies that we have been discussing in class and reading about in our homework assignments. Which bioethical principles are implicated in the case of Memorial Hospital during Hurricane Katrina? How do they arise?
How do we decide what the greatest good looks like?
Which moral theory or theories that we have discussed/read about do you believe is/are most helpful in emergency situations like the one described?
Do you think that the clinicians profiled in the Memorial Hospital case achieved an ethical outcome? Why or why not.
Grading: This first essay is a reflection paper worth 100 points. Each of the above questions is worth approximately 20 points, and the overall articulation of your response is likewise worth approximately 20 points. This essay should be no more than 1000 words. This assignment is due onSeptember 25, 2018.You must bring a hard copy to class.
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[order_calculator]Write a 3- to 4-page paper that addresses the following:Summarize the question you developed, and then relate how you would work through the four steps of the data, information, knowledge, wisdom continuum. Be specific.
Identify the databases and search words you would use.
Relate how you would take the information gleaned and turn it into useable knowledge.
Can informatics be used to gain wisdom?
Your paper must also include a title page, an introduction, a summary, and a reference page.
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