NURS6630 all week discussions latest

Week 1
discussion

Discussion: Foundational Neuroscience
As a psychiatric mental health nurse practitioner, it is
essential for you to have a strong background in foundational neuroscience. In
order to diagnose and treat clients, you must not only understand the
pathophysiology of psychiatric disorders, but also how medications for these
disorders impact the central nervous system. These concepts of foundational
neuroscience can be challenging to understand. Therefore, this Discussion is
designed to encourage you to think through these concepts, develop a rationale
for your thinking, and deepen your understanding by interacting with your
colleagues.
Learning Objectives
Students will:
Analyze the agonist-to-antagonist spectrum of action of
psychopharmacologic agents
Compare the actions of g couple proteins to ion gated
channels
Analyze the role of epigenetics in pharmacologic action
Analyze the impact of foundational neuroscience on the
prescription of medications
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.
Stahl, S. M. (2013).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical
applications (4th ed.). New York, NY: Cambridge University Press *Preface, pp.
ix–x
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 1, “Chemical Neurotransmission”
Chapter 2, “Transporters, Receptors, and Enzymes as Targets
of Psychopharmacologic Drug Action”
Chapter 3, “Ion Channels as Targets of Psychopharmacologic
Drug Action”
Document: Midterm
Exam Study Guide (PDF)
Document: Final Exam
Study Guide (PDF)
Required Media
Laureate Education (Producer). (2016i). Introduction to
psychopharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate
length of this media piece is 3 minutes.
Accessible player
Optional Resources
Laureate Education (Producer). (2009). Pathopharmacology:
Disorders of the nervous system: Exploring the human brain [Video file].
Baltimore, MD: Author.
Note: The approximate
length of this media piece is 15 minutes.
Dr. Myslinski reviews the structure and function of the
human brain. Using human brains, he examines and illustrates the development of
the brain and areas impacted by disorders associated with the brain.
Accessible player
Laureate Education (Producer). (2012). Introduction to
advanced pharmacology [Video file]. Baltimore, MD: Author.
Note: The approximate
length of this media piece is 8 minutes.
In this media presentation, Dr. Terry Buttaro, associate
professor of practice at Simmons School of Nursing and Health Sciences,
discusses the importance of pharmacology for the advanced practice nurse.
Accessible player
To prepare for this Discussion:
Review this week’s Learning Resources.
Reflect on concepts of foundational neuroscience.
Week 3
discussion
Discussion: 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 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.
Stahl, S. M. (2013).
Stahl’s 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 prescriber’s 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
vortioxetine
American 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), 21–24.
doi:10.3928/02793695-20080901-06
Note: 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), 21–24.
doi:10.3928/02793695-20081001-05
Note: 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), 417–423. Retrieved from
/orders/web.archive.org/web/20170809004704//orders/www.fda.gov/downloads/Drugs/ScienceResearch/…/UCM085502.pdf
To 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 working
Case 2: Volume 1, Case #7: The case of physician do not heal
thyself
Case 3: Volume 1, Case #29: The depressed man who thought he
was out of options
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.
Week 7 discussion
Discussion: Sleep/Wake Disorders
It is not uncommon to experience a night or two of disrupted
sleep when there is something major going on in your life. However, sleep/wake
disorders are much more than an occasional night of disrupted sleep. A recent
report from the Centers for Disease Control and Prevention estimated that
between 50 and 70 million American have problems with sleep/wake disorders
(CDC, 2015). Although the vast majority of Americans will visit their primary
care provider for treatment of these disorders, many providers will refer
patients for further evaluation. For this Discussion, you consider how you
might assess and treat the individuals based on the provided client factors.
Learning Objectives
Students will:
Assess client factors and history to develop personalized
therapy plans for clients with sleep/wake disorders
Analyze factors that influence pharmacokinetic and
pharmacodynamic processes in clients requiring therapy for sleep/wake disorders
Evaluate efficacy of treatment plans for clients presenting
for sleep/wake therapy
Apply knowledge of providing care to adult and geriatric
clients presenting for sleep/wake disorders
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.
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 11, “Disorders of Sleep and Wakefulness and Their
Treatment”
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 insomnia
alprazolam
amitriptyline
amoxapine
clomipramine
clonazepam
desipramine
diazepam
doxepin
flunitrazepam
flurazepam
hydroxyzine
imipramine
lorazepam
nortriptyline
ramelteon
temazepam
trazodone
triazolam
trimipramine
zaleplon
zolpidem
American Psychiatric Association. (2013). Diagnostic and
statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Davidson, J. (2016).
Pharmacotherapy of post-traumatic stress disorder: Going beyond the guidelines.
British Journal of Psychiatry, 2(6), e16-e18. doi:10.1192/bjpo.bp.116.003707.
Retrieved from http://bjpo.rcpsych.org/content/2/6/e16
To 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 2, Case #16: The woman who liked late-night
TV
Case 2: Volume 2, Case #11: The figment of a man who looked
upon the lady
Case 3: Volume 1, Case #5: The sleepy woman with anxiety
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.
Week 9
discussion
Discussion: Presentations of ADHD
Although ADHD is often associated with children, this
disorder is diagnosed in clients across the lifespan. While many individuals
are properly diagnosed and treated during childhood, some individuals who have
ADHD only present with subsyndromal evidence of the disorder. These individuals
are often undiagnosed until they reach adulthood and struggle to cope with
competing demands of running a household, caring for children, and maintaining
employment. For this Discussion, you consider how you might assess and treat
individuals presenting with ADHD.
Learning Objectives
Students will:
Assess client factors and history to develop personalized
therapy plans for clients with ADHD
Analyze factors that influence pharmacokinetic and
pharmacodynamic processes in clients requiring therapy for ADHD
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 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.
Note: Retrieved from Walden Library databases.
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
To 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 #13: The 8-year-old girl who was
naughty
Case 2: Volume 1, Case #14: The scatter-brained mother whose
daughter has ADHD, like mother, like daughter
Case 3: Volume 2, Case #21: Hindsight is always 20/20, or
attention deficit hyperactivity disorder
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.
Week 10
discussion
Discussion: Influencing Social Change
Individuals with psychiatric mental health disorders are
frequently stigmatized not only by society as a whole, but also by their
friends, family, and sometimes healthcare providers. In your role, however, you
have the opportunity to become a social change agent for these individuals. For
this Discussion, consider how you might make a positive impact for your clients
and advocate for social change within your own community.
Learning Objectives
Students will:
Apply strategies to become a social change agent for
psychiatric mental health
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
Angermeyer, M. C.,
Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric
treatment and people with mental illness: Changes over two decades. The British
Journal of Psychiatry, 203(2), 146–151. Retrieved from
http://bjp.rcpsych.org/content/203/2/146.full
Bui, Q. (2012).
Antidepressants for agitation and psychosis in patients with dementia. American
Family Physician, 85(1), 20–22. Retrieved from
http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Dingfelder, S. F.
(2009). Stigma: Alive and well. American Psychological Association, 40(6), 56.
Retrieved from http://www.apa.org/monitor/2009/06/stigma.aspx
Jenkins, J. H.
(2012). The anthropology of psychopharmacology: Commentary on contributions to
the analysis of pharmaceutical self and imaginary. Culture, Medicine and
Psychiatry, 36(1), 78–79. doi:10.1007/s11013-012-9248-0
Note: Retrieved from from the Walden Library databases.
Price, L. H. (2010). Violence in America: Is
psychopharmacology the answer? Brown University Psychopharmacology Update,
21(5), 5. Retrieved from
http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1556-7532
Note: Retrieved from from the Walden Library databases.
Optional Resources
Bennett, T. (2015).
Changing the way society understands mental health. National Alliance on Mental
Illness. Retrieved from
http://www.nami.org/Blogs/NAMI-Blog/April-2015/Changing-The-Way-Society-Understands-Mental-Health
Mechanic, D. (2007).
Mental health services then and now. Health Affairs, 26(6), 1548–1550.
Retrieved from
/orders/web.archive.org/web/20170605094514/http://content.healthaffairs.org/content/26/6/1548.full
Rothman, D. J.
(1994). Shiny, happy people: The problem with “cosmetic
psychopharmacology.” New Republic, 210(7), 34–38.
To prepare for this Discussion:
Reflect on how you might influence social change for
psychiatric mental health.