Week 1

As a Family Nurse practitioner, Explain what Standardized Procedures are, what their function is, and how they are utilized by Nurse Practitioners in California. Discuss how this practice is different if you live in a state other than California. ( Live in state of Florida)

minimum of 300 words, APA 7th edition, and scholarly references within the last 5 years only.0 % turnitin if possible

Women Health – Week 7 Discussion 2nd REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion:

Discuss the questions that would be important to include when interviewing a patient with this issue

One important question that would be important to ask this patient is the location of the abdominal pain. The location of the abdominal pain is important, as it can help narrow your differential diagnosis. For example, diffuse abdominal pain may represent gastroenteritis, whereas localized right lower quadrant pain is classic for but not limited to appendicitis (Shian & Larson, 2018). Another important question involves asking her to describe more of the pain in terms of things such as the onset, characteristics, severity, aggravating factors, or any other thing that makes the pain better. The purpose of asking these questions is to gather crucial subjective data from the patient that can lead to possible differential diagnosis and help the healthcare team create a plan that will address her concerns and promote health. Also, it is of great importance to ask the patient about her last pelvic exam and Pap test. Knowing this information is important to know if the patient has previously been diagnosed with gynecologic-related complications, and may also help give clues to the cause of the discomfort and pain she is experiencing.

Describe the clinical findings that may be present in a patient with this issue

There are various clinical findings that may present in patients with pelvic pain. Common symptoms include the following (Gopchade, 2018).

i. Lower abdominal pain or crumps before or during periods

ii. Feeling pain during or after sex

iii. Painful ovulation

iv. Constipation or diarrhea

v. Blood seen with bowel movements

vi. Low back pain

vii. Painful urination

viii. Bloating or gas

Are there any diagnostic studies that should be ordered on this patient? Why?

Various diagnostic studies that should be ordered on this patient include the following.

Urine pregnancy test – The patient menstrual period was one month ago and she is currently sexually active with no form of birth control. Besides, she reports symptoms of nausea, vomiting, and pelvic pain, all which suggest pregnancy.

Pap test-thin test with HPV testing – Pap test should be done with HPV testing because her lap pap test, which was done three years ago, showed abnormal cells in the tissue that lines the outer part of the cervix.

Urinary dipstick – This would be important to help rule out a urinary tract infection (UTI).

Pelvic ultrasound – An ultrasound is important to evaluate a possible pelvic mass, the size of the uterus and ovaries, to confirm the location of a pregnancy, or to rule out an inflammatory or infectious process.

HIV and RPR – Both tests should be done as part of the STI screen. RPR is important to rule out syphilis.

List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.

Cervicitis – The condition is mostly caused by chlamydia or gonorrhea, and may present with lower abdominal pain and vaginal discharge.

Urinary tract infection – UTIs usually presents with symptoms such as dysuria and urinary frequency. Besides, UTIs may present with lower abdominal pain.

Vaginitis – Bacterial vaginosis may presents with symptoms such as vaginal discharge, vaginal itching with thick, and white discharge.

Primary diagnosis – Ectopic pregnancy – The patient is sexually active and is not using any form of contraceptive. Ectopic pregnancy is characterized by bright or dark red discharge, as well as pelvic pain and vaginal bleeding. Besides, the patient reports symptoms of missed period, nausea, and breast tenderness.

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

The first management plan for this patient is to prescribe pain relieving medications such as aspirin, Ibuprofen or acetaminophen to provide partial relief from her pelvic pain. The pain relieving medications should be accompanied by antidepressants such as amitriptyline to help improve her pain as well as provide antidepressant effects. Also, it would be important to encourage her to use protections (condom) every time she has sex to help prevent sexually transmitted diseases. Physical therapy such as stretching exercises, massage and other relaxation techniques would also help improve her pain (Mayo Clinic, 2021). The patient needs to be referred to a physical therapists to help her develop coping strategies for the pain and a psychiatrist to help her cope with possible intimate partner violence.

Reference

Gopchade, C. A. (2018). Pelvic Inflammatory Disease in Women of Child Bearing age Group: A Prospective Study.

Mayo Clinic (July 17, 2021). Chronic Pelvic Pain in Women. mayoclinic.org. /orders/www.mayoclinic.org/diseases-conditions/chronic-pelvic-pain/diagnosis-treatment/drc-20354371

Shian, B., & Larson, S. T. (2018). Abdominal wall pain: clinical evaluation, differential diagnosis, and treatment. American family physician, 98(7), 429-436.

CP – Week 6 Discussion 2nd REPLY

CP – Week 6 Discussion 2nd REPLY

Reply to the following discussion by challenging the post. You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language.  

It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. 

JA Discussion:

Week 6 Discussion

PICOT question: Are obese adults in America (P), more successful at losing weight with a medical intervention such as taking phentermine (I), compared to no medical intervention such as diet and exercise alone (C), at achieving and maintaining a healthy weight (O), over 12 months (T).

Synthesis

Hall & Kahan (2018), determined through their research study that weight loss can be achieved through a variety of modalities, but long-term maintenance of lost weight is much more challenging. Obesity interventions typically result in early rapid weight loss followed by a weight plateau and progressive regain. This research showed understanding of the biological, behavioral, and environmental factors driving this weight loss and weight regain trajectory, and the implications for long-term weight management. (Hall & Kahan, 2018). Nicklas et al. (2019), similarly found that weight loss maintenance is difficult to achieve. A substantial proportion of obese U.S. adults who attempt to lose weight reported weight loss, at least in the short term. Obese adults were more likely to report achieving meaningful weight loss if they ate less fat, exercised more, used prescription weight loss medications, or participated in commercial weight loss programs (Nicklas et al., 2019). Both articles found that the treatment for obesity requires ongoing clinical attention and weight maintenance-specific counseling to support sustainable healthful behaviors and positive weight regulation.

References

Hall, K. D., & Kahan, S. (2018). Maintenance of lost weight and long-term management of

obesity. The Medical Clinics of North America, 102(1), 183–197. 10.1016/j.mcna.2017.08.012

Nicklas, J. M., Huskey, K. W., Davis, R. B., & Wee, C. C. (2019). Successful weight loss among

obese U.S. adults. American Journal of Preventive Medicine, 42(5), 481–485. /orders/doi.org/10.1016/j.amepre.2019.01.005

Evidence Base Practice Nursing

As your EBP ( Evidence Base Practice ) skills grow, you may be called upon to share your expertise with others. While EBP practice is often conducted with unique outcomes in mind, EBP practitioners who share their results can both add to the general body of knowledge and serve as an advocate for the application of EBP.

In this Discussion, you will explore strategies for disseminating EBP within your organization, community, or industry.

To Prepare:

· Review the Resources and reflect on the various strategies presented throughout the course that may be helpful in disseminating effective and widely cited EBP.

. This may include: unit-level or organizational-level presentations, poster presentations, and podium presentations at organizational, local, regional, state, and national levels, as well as publication in peer-reviewed journals.

· Reflect on which type of dissemination strategy you might use to communicate EBP.

My organization is Baptist Health in FL and this may be 1 page and 3 citations APA style

Women Health – Week 5 Discussion 2nd REPLY

Women Health – Week 5 Discussion 2nd REPLY

question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion

Discuss the questions that would be important to include when interviewing a patient with this issue.

When interviewing an adolescent, some prevention and counseling may include questions about:

• Home
• Education / Employment
• Eating
• Activities
• Drugs
• Sexuality
• Suicide / Depression
• Safety / Violence

Questions I would ask in regard to her vaginal bleeding would include:

When did your last period begin?

How long do your periods last?

What other symptoms do you have with your period? (abdominal pain, headache, bloating, etc.) Is your bleeding irregular in amount or duration?

Do you have bleeding between your menstrual cycles?

Are your breasts tender?

Are you sexually active?

Is it possible that you are pregnant?

Do you have any pelvic pain?

How severe (1-10 scale) is your pelvic pain?

Have you had pelvic inflammatory disease?

Do you have pain with intercourse?

Have you had sex that was painful or rough, or been forced to have sex?

Are you having, or have you had unprotected sex?

Have you had any sexually transmitted disease?

Describe the clinical findings that may be present in a patient with this issue.

Being that this patient’s vaginal bleeding is due to a spontaneous abortion, some of the clinical findings may include vaginal bleeding, abdominal pain, and passage of tissue (Alves, 2020).

Are there any diagnostic studies that should be ordered on this patient? Why?

Along with beta-hCG measurement and ultrasound, a HGB and HCT should be obtained to rule out acute blood loss anemia.  Since spontaneous abortion can be precipitated by infection, wet mount examination and screening for gonorrhea and chlamydia should be considered (Alves, 2020).

List the primary diagnosis and three differential diagnoses for this patient. Explain your reasoning for each.

Differential Diagnosis

• Ectopic      pregnancy– A      pregnancy in which the fertilized egg implants outside the uterus.  Symptoms include      pelvic pain and vaginal bleeding.
• Molar      pregnancy- A noncancerous tumor that develops in the      uterus as a result of a nonviable pregnancy. The pregnancy may seem      normal at first, but when symptoms develop they include dark brown to      bright red vaginal bleeding during the first trimester, along with severe      nausea and vomiting (Al-Talib, 2016).
• Viable      pregnancy with implantation bleeding- When the fertilized egg attaches to      the uterine wall, it may cause bleeding that can last 2-3 days

Primary Diagnosis

• Spontaneous      Abortion- Spontaneous      abortion is the loss of pregnancy naturally before 20 weeks of gestation      (Alves, 2020).

Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.

The conventionally accepted regimen for medical management consists of misoprostol 800mcg vaginally, with a repeated dose if needed anytime from 3hrs to 7 days after the first dose.  Premedication with mifepristone 200mg PO 24hrs before the first dose of misoprostol may result in a higher success rate.  Surgical management consists of D&C as needed (Alves, 2020).  Follow up as directed my healthcare professional.

Reference

Al-Talib, A. (2016).  Clinical presentation and treatment outcome of molar pregnancy: Ten years experience at a tertiary care hospital in Dammam, Saudi Arabia.  Journal of Family & Community Medicine 23(3), p. 161-165.  doi: 10.4103/2230-8229.189129

Alves, C. (2020).  Spontaneous abortion.  StatPearls.  Retrieved from /orders/www.statpearls.com/articlelibrary/viewarticle/29399

Unit 4 IP Project One TEST

Unit 4 IP Project One TEST

Is this a possibility? This is an online test . it has everything you need to sign up and take , it is over the whole last classes in this management ma, Let me know for sure after you accept the bid Its due Dec 11

it shows about 30 min lengthen you send the results back and I will up load . looks like you follow this ink and its not in the CTU class its self

it states that the link to take the test will be sent to the email you provide so I can give you my email and them send the link or you can use yours , not sure it will make a difference

Assignment Details

You will complete your comprehensive exam. Please review the FAQ here. Directions on how to register for the exam are here. see below

The comprehensive exam is worth 110 points, representing 10% of your grade. You will receive a series of multiple choice questions and you will have 3 minutes to answer each question. You will need to have computer Internet access, but no additional application plug-ins will be required.

The exam works on all Internet browsers. When you receive your results, you will need to upload the copy in your assignment submission file.

Please make sure you upload your results by the due date. Grading for Comprehensive Exam The comprehensive exam is worth 10% of your total grade.

Student Registration Instructions for:

To begin the registration process, please follow the on-screen instructions found at the following URL.

/orders/micro.peregrineacademics.com/site/coloradotech/login.php

Your password is:CTU-MGMT659

The registration process should take no more than 5 minutes to complete.

Upon completion of your

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email address you provide to us.

If you have any problems with the registration process, please visit our technical support page at:

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Discussion 5

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your responses must be substantive and not just agreeing with someone’s work. You need to add by explaining more, refuting a point or correcting a point.  a minimum of 150 words and one reference with in text citation, one reference for each respond.

It is virtually impossible to navigate the current health care system in the United States with a large amount of laws and regulations created by a variety of government agencies, private sector insurers, and institutions. The system is often poorly coordinated, this lack of coordination drives up costs and puts patients at risk. Therefore, it is not surprising that given today’s rising costs, deteriorating access, and variable quality, healthcare professionals, who are directly affected by this situation, try to step up and have a voice in the legislative process.

As healthcare professionals interact with patients and their families, they are often the first providers to see clearly when and how the health care system is not effectively meeting patient needs. Every day healthcare professionals are positioned to see not only the impact of health policy on individual patients but also the need for more comprehensive changes in the policies that address many health-related issues. Healthcare professionals come face to face with issues associated with patient safety and satisfaction, access to services, clinical outcomes, and health disparities. Dealing with these concerns and other workplace issues that having broad implications for whole groups of people, they have the choice to continue on trying to make do while feeling victimized by current changes, or to motivate themselves to act and find opportunities to bring about change in the health care system itself (Jansson et al., 2017).

Jansson et al. (2017) explain that as challenging and time consuming as it may be, accepting the responsibility to advocate offers healthcare professionals the unique opportunity to make a difference and to have the satisfaction of being part of bringing a better health care system into reality for themselves and their patients. Advocacy adds a dimension to their professional practice that offers the reward of having more control over patient care and outcomes. Successful advocacy to bring about changes in the health care system demands access to the resources of power, will, time, and energy, along with necessary political skills. Most often than not issues are too big or complex to be easily resolved by a few phone calls or even the dedicated efforts of one person. In reality, very few policy changes take place without the concerted efforts of many advocates working together to bring about a common goal.

One advocacy action to improve health care through legislation at the state or federal level would be to become part of an advocacy group. Complex health care policies require the knowledge and efforts of organized groups, the help of professional lobbyists, and sustained activity of months or even years. Joining a professional advocacy organization is an important way to enhance individual advocacy efforts. Healthcare workers in an organized professional association have more resources, and are able to strategize more effectively to bring their perspective to health policy decision makers than do individual people (Roman, 2022). Professional advocacy organizations are able to monitor public policy and offer ways for their members to learn about health policy. They also serve as a resource for reliable information related to policy issues and policy makers.

Roman (2022) mentions another way that professional associations work for the benefit of advocates is by providing information and tools to ensure that candidates who are supportive of our ideas are elected to, or remain in office. Registering to vote and voting in all elections is a must for every advocate. Here again, being part of a professional association with an established political action committee (PAC) can be very helpful in discovering where elected officials stand on issues and finding opportunities to work for the candidates who are supportive of nursing and health care issues.

The ability to successfully exert influence in the legislative process where future health care policy decisions are made and to take advantage of opportunities to present our perspective on the health care issues depends on having a power base and knowing where and when to exert that influence. As healthcare professionals get ready to take their issues into the legislative arena and to use their legislative power and political clout, it is also essential to recognize which strategies will be timely and most effective (Roman, 2022).

References:

Jansson, B. S., Nyamathi, A., Heidemann, G., Duan, L., & Kaplan, C. (2017). Validation of the Policy Advocacy Engagement Scale for Frontline Healthcare Professionals.  Nursing ethics,  24(3), 362-375.

Discussion 2 Erin

Nurses have the ability to help influence public health policy through advocacy which results in improvements in healthcare and positive patient outcomes. Florence Nightingale was the most well-known pioneer of nursing that taught us about the importance to advocate and raise your voice about what is right when it comes to healthcare and policymaking (Stone, 2020). Florence was also a political activist that advocated for changes of laws and conditions that created social problems (Silva et al., 2022). Politics will always have a driving force in healthcare. Although these two topics seem the farthest, they can be from each other nurses and healthcare providers need to be actively involved in politics to guide necessary changes throughout healthcare. One of the simplest ways that nurses can improve healthcare through legislation is getting nurses to vote in elections which is ultimately the most altruistic acts that a nurse can do to advocate for our patients (Ramsey, 2020). Voting for candidates that are best aligned with a person’s beliefs and understands that changes need to be made can begin the process necessary for changes to happen. If we as healthcare providers continually chose not to vote and elect officials that see the need for change, then that is what we will continue to get, no change, no movement and no improvements. Ramsey (2020), states that there are two major reasons that stand in the way of nursing advocacy in politics. First, there needs to be a push for more political involvement at the baccalaureate level of nursing that helps to discuss and educate on the legalities and implications of nursing. Courses like nursing centric political sciences can be compared to a nurse educating their patients to produce behavioral changes. If professional changes are going to be made, it must be down through the empowerment of political involvement and education on how to make these changes through the political system. The second barrier to nursing advocacy in politics, in this article is referred to as the “forced following” which results in a blind vote following for candidates that the American Nursing Association supports instead of researching for ourselves what a candidate supports (Ramsey, 2020). Blindly voting can result in little to no change or even negative changes that can affect outcomes for our patients. As healthcare professionals we must make sure that we are educating ourselves on the issues at hand as well as what the candidates support. We must advocate for change by educating ourselves on the political issues and becoming active members in the political process for policy change.  We must involve ourselves and allow our voices to be heard as a profession. Changes can be made when we understand how and why things happen. Becoming involved is how the changes will ultimately be made, improving our work environments, healthcare standards and outcomes for our patients. If we are not active in the process of what guides our healthcare standards and practice, then we are not fully advocating for our patients to the best of our ability. We need to take the time to not only recognize where changes can be made but be active in the process of change and how to achieve it.

Women Health – Week 5 Discussion 1st REPLY

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

Discussion

During the interview process, it is important to understand the patient’s history, current use of contraception use, desire to get pregnant, health issues, and relationship status. The history can reveal any chronic illnesses and familial medical issues. Current use of contraception, STI history and sexual activity can guide care of the patient. Knowing her goals in relation to her health are important when guiding her with health education (Hawkins, Roberto-Nicholas & Stanley-Haney, 2020).

This case study went into depth with multiple stages of the patient’s condition. WIth her final diagnosis, the clinical findings that would have been present are vaginal bleeding with clots possibly being seen, pelvic pain and cramping, the os could be opened with pelvic exam. With the use of ultrasound the fetus can be examined. You would find no fetal heart sound and no growth of the fetus (Hawkins, Roberto-Nicholas & Stanley-Haney, 2020).

The primary diagnosis would be inevitable abortion due the presence of dilated os. Secondary diagnosis would include; inclomplete abortion if all the fetal contents have not been expelled, complete abortion if all the contents have been expelled or septic abortion due to an infection in the cervix. With pregnancy the mothers  immune system is lowered making them more susceptible to infection (Hawkins, Roberto-Nicholas & Stanley-Haney, 2020).

The management plan for this patient would include expectant management. This would include symptom management and watchful waiting. Educating the patient on what to look for in regards to excessive bleeding or infection and when to contact the office or emergency personnel (Hawkins, Roberto-Nicholas & Stanley-Haney, 2020).

Hawkins, J., Roberto-Nicholas,D. & Stanley-Haney, J. (2020). Guidelines for nurse practitioners in gynecologic settings (12th ed.). Springer Publishing. ISBN-13: 9780826173263

Discussion 5 Respond

You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your responses must be substantive and not just agreeing with someone’s work. You need to add by explaining more, refuting a point or correcting a point.  a minimum of 150 words and one reference with in text citation, one reference for each respond.

Discussion 1 George

Describe the presenting problems

Vee is a 26-year-old African-American woman presenting with various symptoms of a psychiatric disorder. She has a history of non-suicidal self-injury that include cutting her arms and legs. Her actions indicate she has anger issues and impulsivity observed through buying lavish gifts for her partner. Vee reports issues with concentration whereby she zones out in the middle of conversations and while at work. She has emotional dysregulation characterized by feelings of doing harm and regretting immediately. Other issues observed in the patient include risky behaviors like multiple sexual partners and suicidal thoughts.

Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.

According to the presenting symptoms, Vee has a borderline personality disorder. The DSM-5 describes borderline personality disorder (DSM-5 301.83 (F60.3) as a pattern of instability in interpersonal relationships, self-image, and affect (American Psychiatric Association, 2013). Patients with this disorder present with an intense fear of abandonment even when the patient is expecting separation. Affected individuals often exhibit changes in relationships and they will either strongly love or hate partners. Another common feature is a strong sense of emptiness that translate to self-harm behaviors like cutting, picking, burning, or suicidal ideations. Impulsivity is a feature of borderline personality disorder that sees patients do self-damaging acts like reckless driving, unsafe sex, unwise spending, or substance abuse (American Psychiatric Association, 2013). Vee presents with anger issues, impulsivity, disturbed self-image, intense fear of abandonment, self-harm, and suicidal ideations that are consistent with those with a borderline personality disorder.

Differential diagnosis is important for distinguishing borderline personality disorder from other mental illnesses like bipolar spectrum disorders. The first differential diagnosis is bipolar disorder because it is characterized by changes in mood leading to outcomes like frustration, separation, and anger. However, mood changes in borderline personality are short-lived and the oscillation is frequent (Perrotta, 2020). Post-traumatic stress disorder is another differential whereby the signs of anxiety, fear, and anger are prominent. This diagnosis is different from borderline because events leading to the signs are evident and often recent (Perrotta, 2020). Other differentials may include schizophrenia, somatoform disorder, and narcissistic personality disorder.

Discuss which cluster the primary diagnosis belongs to

Borderline personality disorder belongs to Cluster B of the ten personality disorders. It is often referred to as the dramatic, emotional, and erratic cluster (American Psychiatric Association, 2013). Cluster B also comprises disorders like antisocial personality disorder, narcissistic personality disorder, and histrionic personality disorder. The key features of diseases from this cluster are problems with impulse control and emotional deregulation.

Formulate and prioritize a treatment plan.

Although personality disorders are considered to be the most difficult to manage, the use of psychotropic drugs and psychotherapy can best serve to improve the patient’s condition. The primary goal of treatment is to reduce intense emotional reactions, improve impulse control and minimize or control self-injurious behaviors. Regarding pharmacological treatment, I will prescribe olanzapine 5mg orally once daily and consider increasing the dosage to 10mg after two weeks. Olanzapine is a second-generation antipsychotic drug whose efficacy for managing traits like impulsivity, aggression, anxiety, and psychotic symptoms are well-known (Gartlehner et al., 2021). The second step will involve referral to a psychotherapist for dialectical behavior therapy (DBT). This approach is supported by literature to be the most effective in managing emotional dysregulation and reduced impulse control (Reddy & Vijay, 2017). DBT uses a series of strategies and involves patients in a training aimed at increasing self-awareness and change.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Gartlehner, G., Crotty, K., Kennedy, S., Edlund, M. J., Ali, R., Siddiqui, M., … & Viswanathan, M. (2021). Pharmacological treatments for borderline personality disorder: A systematic review and meta-analysis. CNS Drugs, 35(10), 1053-1067. /orders/doi.org/10.1007/s40263-021-00855-4

Discussion 2 Rafael

The patient (Vee), a 26-year-old African American woman, presents various mental health symptoms. These issues include non-suicidal self-injury attempts, chronic suicidal ideation, reckless sexual activity with strangers, unwarranted spending, extreme mood shifts, inappropriate anger, chronic boredom, and impulsiveness. Her repetitive suicidal behavior ranges from self-mutilation on her legs and arms since her teenage years to an attempted suicide on two occasions, one as a teenager and the most recent being six months ago. Vee describes that she is sometimes impulsive and will occasionally buy her partner lavish gifts and act in a caring manner towards him. However, she sometimes lashes out and will express inappropriate anger towards him. This is followed by regretful feelings and panic at the thought that he could leave her. Vee also reports having extreme mood shifts, which she describes as a pattern of constant changes in her clothing style, hobbies, social group, and jobs. Lastly, she reports feelings of chronic boredom, which are portrayed as the constant zoning out while working or during conversations.

Based on the presenting problems, the primary diagnosis is that Vee suffers from Borderline Personality Disorder. The DSM5 describes this disorder as a complicated pattern of unstable interpersonal relationships, moods, and a sense of self marked with a heightened sense of impulsiveness. To diagnose this disorder, the patient should manifest at least two personality impairments in self-directionality, intimacy, empathy, and identity (Perrotta, 2020). Similarly, they should exhibit at least four pathological personality traits. These may include hostility, impulsiveness, reckless behavior, disinhibition, depressive behavior, separation anxiety, intense panic and nervousness, and emotional liability. Based on ICD 10, an individual exhibiting this disorder usually portrays impulsiveness, an unpredictable mood, frequent mood shifts, and constant conflict with others when criticized or repressed (Perrotta, 2020).

The differential diagnosis for the presenting issues is that Vee could have bipolar disorder. First and foremost, bipolar disorder is often characterized by constant mood shifts ranging from mania to depression which is also a characteristic of borderline personality disorder. Secondly, bipolar disorder patients exhibit intense feelings of guilt and worthlessness, and one will often zone out or get distracted easily. Thirdly, bipolar patients suffer from recurrent suicidal thoughts and suicide attempts (Bayes et al., 2019). Lastly, bipolar patients exhibit impulsivity, resulting in reckless sexual activity and unwarranted spending.

The presenting symptoms in this case study reveal that the patient likely has a borderline personality disorder, our primary disorder. Based on the DSM5, this disorder is classified as a cluster B personality disorder (Perrotta, 2020). Typically, patients exhibit impulsivity, emotional dramatization, and unpredictable behavior in this cluster. Usually, this cluster includes disorders that portray erratic and dramatic behaviors (Stern, 2016). With borderline personality disorder, patients exhibit a recurring fear of abandonment which could be imagined or real. Secondly, patients often display self-mutilating behavior and repetitive suicidal behavior. Thirdly, patients exhibit self-damaging behavior portrayed by a heightened sense of impulsiveness in the form of unnecessary spending, reckless sexual activity, binge eating, and substance abuse. Fourthly, patients display inappropriate anger and recurring outbursts (Perrotta, 2020). At times patients may suffer from chronic boredom and intense feelings of emptiness. Further, they may experience identity problems and dramatic changes in personal values, goals, and interests.

As described in the case study, the patient exhibits cluster B symptoms of borderline personality disorder. To treat this disorder, Vee should undergo Dialectical behavioral therapy, which is one of the most effective treatment methods for this disorder. Usually, this treatment undertakes a collaborative systems approach by incorporating all aspects of the patient’s behaviors (Perrotta, 2020). The therapy teaches the patient coping skills since it recognizes that the negative behaviors associated with this order are learned. Further, this therapy helps the patient to learn how to recognize negative behaviors and feelings beforehand so that one can deal with them outright. In essence, this treatment approach applies empathy and understanding to teach its patients coping skills (Perrotta, 2020). Over time, with this therapy, Vee can learn to cope with situations better and reduce her reliance on unsafe and self-injury behavior.

References

1- Bayes, A., Parker, G., & Paris, J. (2019). Differential Diagnosis of Bipolar II Disorder and Borderline Personality Disorder. Current Psychiatry Reports, 1-11. /orders/doi.org/10.1007/s11920-019-1120-2

Case Study: Jax

Purpose:Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.

1. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
3. What physiological and psychological processes lead to substance dependence?

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 3 academic sources.
  

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  We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

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  Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

  Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

  SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – 

  We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

  • Discussion Questions (DQ)

  Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.

  • Weekly Participation

  Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

  • APA Format and Writing Quality

  Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.

  • Use of Direct Quotes

  I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

  • LopesWrite Policy

  For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.

  • Late Policy

  The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

  • Communication

  Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

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  SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

  We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.

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