Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.
For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs.
Case: An elderly widow who just lost her spouse.
Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:
Metformin 500mg BID
Januvia 100mg daily
Losartan 100mg daily
HCTZ 25mg daily
Sertraline 100mg daily
Current weight: 88 kg
Current height: 64 inches
Temp: 98.6 degrees F
Post a response to each of the following:
List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s 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 ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.
The ongoing changes in the health-care landscape are influenced most by globalization, economic and technological factors, and the aging
The ongoing changes in the health-care landscape are influenced most by globalization, economic and technological factors, and the aging of the population. The complexity of the healthcare environment requires us to examine the leadership needs for the APN roles that are applicable for today and the future (Joel, 2018). In chapter 21 (Leadership for APNs: If Not Now, Then When?) the author outlines serval leadership theories or styles including:
Situational or Contingency Leadership;
Transformational or Transactional Leardershp;
Clinical Leadership and Congruent Leadership.
Select one of the above leadership theories or style.
Using your own words define the theory.
Considering the various APN roles (Clinician, Educator, Researcher, Administrator, Entrepreneur, Consultant, and Leader) describe how you might use the leadership theory in your future APN role.
From your experience as a professional nurse, give one example of the selected leadership theory or style as seen in action or provide an exemplary example.
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years
For this assessment you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work
Nursing Assignment Help For this assessment you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.
The health care industry is always striving to improve patient outcomes and attain organizational goals. Nurses can play a critical role in achieving these goals; one way to encourage nurse participation in larger organizational efforts is to create a shared vision and team goals (Mulvale et al., 2016). Participation in interdisciplinary teams can also offer nurses opportunities to share their expertise and leadership skills, fostering a sense of ownership and collegiality.
You are encouraged to complete the Budgeting for Nurses activity before you develop the plan proposal. The activity consists of seven questions that will allow you the opportunity to check your knowledge of budgeting basics and as well as the value of financial resource management. The information gained from completing this formative will promote success with the Interdisciplinary Plan Proposal. Completing this activity also demonstrates your engagement in the course, requires just a few minutes of your time, and is not graded.
Demonstration of Proficiency
Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
Explain organizational resources, including a financial budget, needed for the plan to be a success and the impacts on those resources if nothing is done, related to the improvements sought by the plan.
Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific objective related to improving patient or organizational outcomes.
Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
Explain a change theory and a leadership strategy, supported by relevant evidence, that are most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.
Apply APA formatting to in-text citations and references, exhibiting nearly flawless adherence to APA format.
Mulvale, G., Embrett, M.,
Arnautova (2018) in the article ‘Top Healthcare Industry Trends to Watch in 2018 and Beyond’ outlined five (5) trends
Arnautova (2018) in the article ‘Top Healthcare Industry Trends to Watch in 2018 and Beyond’ outlined five (5) trends that will revolutionize how we provide and consume healthcare services over the next decade. These healthcare trends include:
IoT and wearables
Select 1 of the 5 trends and discuss the potent positive and negative impacts the trend will have on the APN role(s) (Clinician, Educator, Researcher, Administrator, Entrepreneur, Consultant, and Leader).
Reference: Arnautova, Y. (2018). Top healthcare industry trends to watch in 2018 and beyond. Retrieved August 20, 2018 from https://www.globallogic.com/blogs/top-healthcare-industry-trends-to-watch-in-2018-and-beyond/
Please include 2 scholarly references within the last 5 years