Psychiatric Nursing essay assignment paper
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders. Psychiatric Nursing essay assignment paper

Learning Objectives

ORDER A PLAGIARISM-FREE PAPER HERE

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
• Evaluate efficacy of treatment plans
• Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients. Psychiatric Nursing essay assignment paper

Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

• At each decision point stop to complete the following:
  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources. Psychiatric Nursing essay assignment paper.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

 
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

you can edit my work bellow, add more information  , and use same medication therapy. Plagiarism must be less than 15 %
Introduction
Improving depression care for depressed older men is a public health priority because older men are less likely than older women to receive depression treatment and are also more likely to commit suicide .Depressive disorder causes a continuous feeling of worthlessness , hopelessness and unhappiness to the victim and loss of interest in what they used to enjoy doing, also call major depressive disorder (MDD) or clinical depression (Unützer & Park, 2012). 3 Depression is one of the most common mental health problem leading to disabling in older men (Unützer & Park, 2012). A Late-life depression (LLD), is referring to depression that recurs in old age (having begun earlier in life) and again late in life; this negatively affect patients cognitive impairment, functional impairment, and development of Alzheimer’s disease and vascular dementia (Diniz & Reynolds, 2014).
3 Late-life depression (LLD is associated with burden of medical illnesses (especially cardiovascular and cerebrovascular) and risk of death. Patients assessment for depression should be using a standard rating scale, and initiate effective treatment such as antidepressant medications or evidence-based psychotherapies and psychiatric follow up. Electroconvulsive therapy (ECT) (Unützer & Park, 2012) can be an alternative for patients who are not improving. Antidepressants reduce the consequences of depression. 3 It is important to note that depressed adults may be at increased risk for antidepressant adverse effects. (Diniz & Reynolds, C. F. (2014). 3 This week paper focuses the identifying and trPsychiatric Nursing essay assignment papereatment of late-life depression of an Elderly Hispanic Man with history of Major Depressive Disorder (MDD)
Decision #1
1 Will start with Zoloft 25 mg orally daily
Reason for the Selection:
3 Assessment tool used is Montgomery–Åsberg Depression Rating Scale (MADRS), patient score 52, which is an indication of severe depression. When choosing an antidepressant my treatment option is based on the best side effect profile and lowest risk of drug-drug interactions Wiese, (2011). Wellbutrin is an antidepressant, but can cause seizures and Effexor may increase blood pressure Wiese, (2011). Zoloft is one of the most effective and safest medication for the treatment of severe depression in adults (Flint & Rifat, 2013. My best option is Zoloft 25mg which is best choice because of harmless to the elder (Flint & Rifat, 2013). Antidepressant use in the elderly are thought to be due to changes in hepatic metabolism with aging, concurrent medical conditions, and drug-drug interactions (Wiese, B. 2011). 3 (Flint & Rifat, 2013).
Expected Results
The patient should be able to improve within two weeks. Some signs should might be am improve in his work, exercise, hobbies, intellectual pursuits, as well improve sleep. 3When using Zoloft, the level of awareness should improve. It must be noted that the patient is back on track with motivation to follow his normal activities and relate well with associates (Flint & Rifat, 2013).
1 Differences between Expected Results and Actual Results
3 Expected outcome after the use of Zoloft 25mg is the patient will see improvement in his mental capability and importantly that there was no side effect of the medication.The patient revisited after four weeks on his follow up appointment and reported of a decrease in the symptoms, but with a complain of sexual dysfunction and insomnia. The difference in the expected result and the outcome may be reason out that the body of the patient is trying to adjust to the medication while solving the problem of MDD (National Alliance on Mental Illness, 2017).
1 Decision Point Two
Selected Decision: 1 Augmenting agent such as Wellbutrin XL 100 mg in morning
Reason for Selection
3 The added augmenting agent such as Wellbutrin XL150mg in morning was because the patient has some complain of having decrease sex drive, impotence, or difficulty in having an orgasm and sleep problem (insomnia). Bupropion is an antidepressant with excellent tolerability in elderly person improve depression, insomnia, somatic symptoms, work functioning, and certain quality-of-life measures in elderly depressed subjects with medical disorders (American Psychiatric Association, 2013). Though, patient verbalized decrease in the depression symptoms because of using Zoloft, but because of decrease sex drive and insomnia, Zoloft will be decrease to 12.5mg orally every day and continue to watch for side effects, like suicidal tendency in the elderly, and complain about ejaculatory and sexual dysfunction (American Psychiatric Association, 2013).
Expected Results
3 With the combination of using Wellbutrin and Zoloft, it is still expected to see the patient to continue to experience reduction in depression symptom. The therapeutic effect should be observable which will motivate and encourage the patient.
1 Differences between Expected Results and Actual Results
3 The expected outcome after four weeks visitation is that the therapeutic effect of the medication will be clear and no more report of adverse reaction, that shows patient is tolerating the medications as agree. The actual result was that the patient report that there was more reduction in the MDD symptom and improved in the side effect which is insomnia and sexual dysfunction.
Decision Selected. Psychiatric Nursing essay assignment paper
1 Decision Point Three
3 Selected Decision I will discontinue Zoloft 12.5mg orally daily and increase the dosage of Wellbutrin to 150mg XL every morning.
1 Reason for Selection
3 The desire result was not obtained in the second stage though the patient observe reduction in the symptom of MDD, but the resulting side effect is not reducing or eliminated. Wellbutrin XL can help to reduce depression and remove most of the side effect of Zoloft (Mangoni, & Jackson, 2004), also this will help attain therapeutic effect with his symptoms until his next appointment to evaluate response to therapy (Mangoni, & Jackson, 2004). The patient will have to be monitor closely because of the medication adjustment side effect, the suicidal tendency (Mangoni, & Jackson, 2004).
Expected Results
3 At this point the patient is anticipated to experience close to zero symptom of major depressive disorder without any side effect, the sleeping problem or insomnia, sexual dysfunction. He is also expected to have good interaction with neighbor and friends.  Psychiatric Nursing essay assignment paper
1 Differences between Expected Results and Actual Results
Wellbutrin 150mg XL, there is a solution in the treatment of the patient with MDD, (Laureate Education, 2016). 3 When the medication is working well with no side effect, patient will continue with Wellbutrin XL 150mg orally daily dose and will be re-evaluated during the next appointment, medication can be increase if there is a reduction in symptoms to achieved desired maximum therapeutic effect. The actual result from the patient is that the medication is achieving the therapeutic effect that is nePsychiatric Nursing essay assignment papereded by the patient (Mangoni, & Jackson, 2004).
1 Impact of Ethical Considerations on Treatment Plan
3 Ethical Considerations on treatment plan of a psychiatry patients can be complicated which can arise from plan therapy. Addressing the side effects of medications should be the most important in the plan of this therapy which include suicidal tendencies, dosage adjustment and close monitoring for effects (Flint & Rifat, 2013. Some drugs can cause patients to have suicidal tendencies (Flint & Rifat, 2013. Ethically there are sometimes practitioner are being influence by the health insurance of the patient, that is it easier to have a claim for drug treatment than physical therapy, therefore the health professional will choose to go the route of drug treatment. In all consideration the beneficence and no maleficence principles must be observe, the best treatment and best drug that sooth the patient must be administered.
Conclusion
When treating patients, we must understand that some drugs are good for a patient but the side effect on the patient might be grave. A careful treatment and monitoring of patients is important for total healing (NAMI National Alliance on Mental Illness, 2017). Psychiatric Nursing essay assignment paper
References
4 American Psychiatric Association. (2013). 3 Diagnostic and statistical manual of mental
disorders (5th ed.). Washington, DC: Author. Note: 3 Retrieved from Walden Library databases.
Diniz, B. 3 S., & Reynolds, C. F. (2014). 3 Major Depressive Disorder in Older Adults:
Benefits and Hazards of Prolonged Treatment. Drugs & Aging, 31(9), 661–669.http://doi.org/10.1007/s40266-014-0196-y
Flint, A. 3 J., & Rifat, S. L. (2013). 5 The effect of sequential antidepressant treatment on
geriatric depression. 3 Journal of affective disorders, 36(3), 95-105.
Laureate Education. (2016g). Case study: 1 An elderly Hispanic man with major depressive
disorder [Interactive media file]. Baltimore, MD: Author.Psychiatric Nursing essay assignment paper
Mangoni, A. 3 A., & Jackson, S. H. D. (2004). 3 Age-related changes in pharmacokinetics and
pharmacodynamics: 3 basic principles and practical applications. British Journal of Clinical Pharmacology, 57(1), 6–14. Retrieved from: 3https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884408/
6 National Alliance on Mental Illness. (2017). 3 What Is Sertraline and What Does It
Treat? Retrieved from: 7 https://www.nami.org/learn-more/treatment/mental-health-medications/sertraline-(Zoloft)
Unützer, J., & Park, M. (2012). 3 Older Adults with Severe, Treatment-Resistant
Psychiatric Nursing essay assignment paper

Goal Attainment Nursing Theory Essay
The Theory of Goal Attainment was developed by Imogene King in the early 1960s. It describes a dynamic, interpersonal relationship in which a patient grows and develops to attain certain life goals. The theory explains that factors which can affect the attainment of goals are roles, stress, space, and time. Goal Attainment Nursing Theory Essay.
The model has three interacting systems: personal, interpersonal, and social. Each of these systems has its own set of concepts. The concepts for the personal system are perception, self, growth and development, body image, space, and time. The concepts for the interpersonal system are interaction, communication, transaction, role, and stress. The concepts for the social system are organization, authority, power, status, and decision-making.
ORDER A CUSTOM-WRITTEN PAPER NOW
The following propositions are made in the Theory of Goal Attainment:

• If perceptual interaction accuracy is present in nurse-patient interactions, transaction will occur.
• If the nurse and patient make transaction, the goal or goals will be achieved.
• If the goal or goals are achieved, satisfaction will occur.
• If transactions are made in nurse-patient interactions, growth and development will be enhanced.
• If role expectations and role performance as perceived by the nurse and patient are congruent, transaction will occur. Goal Attainment Nursing Theory Essay.
• If role conflict is experienced by either the nurse or the patient (or both), stress in the nurse-patient interaction will occur.
• If a nurse with special knowledge communicates appropriate information to the patient, mutual goal-setting and goal achievement will occur.

There are also assumptions made in the model. They are:

• The focus of nursing is the care of the human being (patient).
• The goal of nursing is the health care of both individuals and groups.
• Human beings are open systems interacting with their environments constantly.
• The nurse and patient communicate information, set goals mutually, and then act to achieve those goals. This is also the basic assumption of the nursing process. Goal Attainment Nursing Theory Essay.
• Patients perceive the world as a complete person making transactions with individuals and things in the environment.
• Transaction represents a life situation in which the perceiver and the thing being perceived are encountered. It also represents a life situation in which a person enters the situation as an active participant. Each is changed in the process of these experiences.

According to King, a human being refers to a social being who is rational and sentient. He or she has the ability to perceive, think, feel, choose, set goals, select means to achieve goals, and make decisions. He or she has three fundamental needs: the need for health information when it is needed and can be used; the need for care that seeks to prevent illness; and the need for care when he or she is unable to help him or herself. Goal Attainment Nursing Theory Essay.
Health involves dynamic life experiences of a human being, which implies continuous adjustment to stressors in the internal and external environment through optimum use of resources to achieve maximum potential for daily living. Environment is the background for human interaction. It involves the internal and external environments. The internal environment transforms energy to enable a person to adjust to continuous external environment changes. The external environment involves formal and informal organizations. In this model, the nurse is part of the patient’s environment.
The Goal Attainment Nursing Theory Essay defines nursing as “a process of action, reaction and interaction by which nurse and client share information about their perception in a nursing situation” and “a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.” In this definition, action is a sequence of behaviors involving mental and physical action, and reaction is included in the sequence of behaviors described in action. King states that the goal of a nurse is to help individuals to maintain their health so they can function in their roles. The domain of the nurse “includes promoting, maintaining, and restoring health, and caring for the sick, injured and dying.” The function of a professional nurse is “to interpret information in the nursing process to plan, implement, and evaluate nursing care.” Goal Attainment Nursing Theory Essay.
King gives detailed information about the nursing process in her model of nursing. The steps of the nursing process are: assessment, nursing diagnosis, planning, implementations, and evaluation.
The theory explains that assessment occurs during interaction. The nurse brings special knowledge and skills whereas the patient brings knowledge of him or her self, as well as the perception of problems of concern to the interaction. During the assessment, the nurse collects data regarding the patient including his or her growth and development, the perception of self, and current health status. Perception is the base for the collection and interpretation of data. Communication is required to verify the accuracy of the perception, as well as for interaction and translation.
The nursing diagnosis is developed using the data collected in the assessment. In the process of attaining goals, the nurse identifies problems, concerns, and disturbances about which the patient is seeking help. Goal Attainment Nursing Theory Essay.
After the diagnosis, the nurse and other health care team members create a care plan of interventions to solve the problems identified. The planning is represented by setting goals and making decisions about the means to achieve those goals. This part of transaction and the patient’s participation is encouraged in making decisions on the means to achieve the goals. Goal Attainment Nursing Theory Essay.
The implementation phase of the nursing process is the actual activities done to achieve the goals. In this model of nursing, it is the continuation of transaction.
Evaluation involves determining whether or not goals were achieved. The explanation of evaluation in King’s theory addresses meeting goals and the effectiveness of nursing care. Goal Attainment Nursing Theory Essay.

Orem’s Self-Care Deficit Theory – Nursing Essays
The Self-Care Deficit Theory developed as a result of Dorothea E. Orem working toward her goal of improving the quality of nursing in general hospitals in her state. The model interrelates concepts in such a way as to create a different way of looking at a particular phenomenon. The theory is relatively simple, but generalizable to apply to a wide variety of patients. It can be used by nurses to guide and improve practice, but it must be consistent with other validated theories, laws and principles. Orem’s Self-Care Deficit Theory – Nursing Essays.
ORDER A PLAGIARISM-FREE PAPER HERE
The major assumptions of Orem’s Self-Care Deficit Theory are:

• People should be self-reliant, and responsible for their care, as well as others in their family who need care.
• People are distinct individuals.
• Nursing is a form of action. It is an interaction between two or more people.
• Successfully meeting universal and development self-care requisites is an important component of primary care prevention and ill health. Orem’s Self-Care Deficit Theory – Nursing Essays.
• A person’s knowledge of potential health problems is needed for promoting self-care behaviors.
• Self-care and dependent care are behaviors learned within a socio-cultural context.

Orem’s theory is comprised of three related parts: theory of self-care; theory of self-care deficit; and theory of nursing system. Orem’s Self-Care Deficit Theory – Nursing Essays.
The theory of self-care includes self-care, which is the practice of activities that an individual initiates and performs on his or her own behalf to maintain life, health, and well-being; self-care agency, which is a human ability that is “the ability for engaging in self-care,” conditioned by age, developmental state, life experience, socio-cultural orientation, health, and available resources; therapeutic self-care demand, which is the total self-care actions to be performed over a specific duration to meet self-care requisites by using valid methods and related sets of operations and actions; and self-care requisites, which include the categories of universal, developmental, and health deviation self-care requisites. Orem’s Self-Care Deficit Theory – Nursing Essays.
Universal self-care requisites are associated with life processes, as well as the maintenance of the integrity of human structure and functioning. Orem identifies these requisites, also called activities of daily living, or ADLs, as:

1. the maintenance of sufficient intake of air, food, and water
2. provision of care associated with the elimination process
3. a balance between activities and rest, as well as between solitude and social interaction
4. the prevention of hazards to human life and well-being. Orem’s Self-Care Deficit Theory – Nursing Essays.
5. the promotion of human functioning

Developmental self-care requisites are associated with developmental processes. They are generally derived from a condition or associated with an event. Orem’s Self-Care Deficit Theory – Nursing Essays.
Health deviation self-care is required in conditions of illness, injury, or disease. These include:

1. Seeking and securing appropriate medical assistance
2. Being aware of and attending to the effects and results of pathologic conditions
3. Effectively carrying out medically prescribed measures
4. Modifying self-concepts to accept onseself as being in a particular state of health and in specific forms of health care
5. Learning to live with the effects of pathologic conditions.

The second part of the theory, self-care deficit, specifies when nursing is needed. According to Orem, nursing is required when an adult is incapable or limited in the provision of continuous, effective self-care. The theory identifies five methods of helping: acting for and doing for others; guiding others; supporting another; providing an environment promoting personal development in relation to meet future demands; and teaching another. Orem’s Self-Care Deficit Theory – Nursing Essays.
The theory of nursing systems describes how the patient’s self-care needs will be met by the nurse, the patient, or by both. Orem identifies three classifications of nursing system to meet the self-care requisites of the patient: wholly compensatory system, partly compensatory system, and supportive-educative system.
Orem recognized that specialized technologies are usually developed by members of the health care industry. The theory identifies two categories of technologies. Orem’s Self-Care Deficit Theory – Nursing Essays.
The first is social or interpersonal. In this category, communication is adjusted to age and health status. The nurse helps maintain interpersonal, intra-group, or inter-group relations for the coordination of efforts. The nurse should also maintain a therapeutic relationship in light of pscyhosocial modes of functioning in health and disease. In this category, human assistance adapted to human needs, actions, abilities, and limitations is given by the nurse.
The second is regulatory technologies, which maintain and promote life processes. This category regulates psycho- and physiological modes of functioning in health and disease. Nurses should promote human growth and development, as well as regulating position and movement in space. Orem’s Self-Care Deficit Theory – Nursing Essays.
Orem’s approach to the nursing process provides a method to determine the self-care deficits and then to define the roles of patient or nurse to meet the self-care demands. The steps in the approach are thought of uas the technical component of the nursing process. Orem emphasizes that the technological component “must be coordinated with interpersonal and social pressures within nursing situations.
The nursing process in this model has three parts. First is the assessment, which collects data to determine the problem or concern that needs to be addressed. The next step is the diagnosis and creation of a nursing care plan. The third and final step of the nursing process is implementation and evaluation. The nurse sets the health care plan into motion to meet the goals set by the patient and his or her health care team, and, when finished, evaluate the nursing care by interpreting the results of the implementation of the plan. Orem’s Self-Care Deficit Theory – Nursing Essays.

NSG6999 Graduate Project in Nursing SU01 Discussions and Essay Assignment Papers & Exams

Week 2 Discussion