NURS6670 Walden Psychiatric Mental Health Nurse Practitioner Certification Plan Paper

NURS6670 Walden Psychiatric Mental Health Nurse Practitioner Certification Plan Paper NURS6670 Walden Psychiatric Mental Health Nurse Practitioner Certification Plan Paper I will provide sample papers to help guide writer Part 1 ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Checkpoint for Psychiatric Mental Health Nurse Practitioner Certification Plan Learning Objectives : Students will: Evaluate progress on certification plans Report your progress on the Certification Plan What have you done to prepare for your certification? NURS6670 Walden Psychiatric Mental Health Nurse Practitioner Certification Plan Paper Have you completed the scheduled tasks assigned on your timeline? If not, what are your plans to stay on schedule? Part 2 State Practice Agreements In many states, nurse practitioners are completely autonomous professionals. In other states, however, NPs have a wide range of “restrictive” practice ranging from requirements for a “supervising” physician to requirements for a “collaborative” agreement with a physician. In this Practicum Journal Assignment, you will examine the requirements Texas state in order to prepare yourself for the realities of practice upon graduation. Learning Objectives: Students will: Analyze state PMHNP practice agreements Analyze physician collaboration issues Analyze barriers to PMHNP independent practice Create plans for addressing state PMHNP practice issues To Prepare for this Practicum Journal: Review practice agreements in your state. Identify at least two physician collaboration issues in your state. ACTUAL ASSIGNMENT PLEASE Addressed each of the bullets, use the resources or you can use other references within last five years only- from 2015 to 2019. Please do not begin a paragraph with author name(s) (PLEASE USE parenthetical/in-text citations) Briefly describe the practice agreements for PMHNPs in your state. Explain the two physician collaboration issues that you identified. Explain what you think are the barriers to PMHNPs practicing independently in your state. Outline a plan for how you might address PMHNP practice issues in your state. Part 3 Decision Tree For this Assignment, as you examine the client case study, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder. The Assignment: Learning Objectives: Students will: Evaluate clients for treatment of mental health disorders Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders Examine Case 3 : You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment. https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/08/mm/decision_tree/index.html At each Decision Point, stop to complete the following: Decision #1: Differential Diagnosis 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: Treatment Plan for Psychotherapy 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: Treatment Plan for Psychopharmacology 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 #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 and their family. Note: Support your rationale with academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. Case #3 Neurocognitive Disorders BACKGROUND Mr. Charles Wingate is a 76-year-old Caucasian male who presents to your office for an initial psychiatric evaluation. He is accompanied by his eldest son, Mark, who lives with Mr. Wingate. Mr. Wingate was referred to you by his primary care provider who has performed an extensive diagnostic workup to rule out an organic basis for his changes in cognition. Mr. Wingate’s son Mark has verbalized a concern that Mr. Wingate may have Alzheimer’s disease. When questioned, Mr. Wingate states that he is unaware of anyone in his family ever having been diagnosed with Alzheimer’s disease. SUBJECTIVE Mr. Wingate states that he has always been “a little bit forgetful,” but he noticed that in his 60s and 70s, it got worse. Mark states that “for the past 2 years, it has been getting worse. He doesn’t even notice how bad his memory has become.” On at least two occasions, Mr. Wingate has gotten lost when he was driving to the grocery store. Mr. Wingate protested his disagreement with this accusation stating, “but they were doing road construction, anyone could have gotten mixed up!” While his son conceded to this, he pointed out that Mr. Wingate’s memory has caused some other problems, such as errors with paying his monthly utility bills (at one point, the electric company threatened to shut off his electricity due to his nonpayment of the bill). His son Mark also pointed out that the family is concerned for Mr. Wingate’s safety as he twice left his keys hanging in the door and just two evenings ago, put food in oven and forgot about it until the smoke detector in the kitchen began to alarm. Mr. Wingate also has had a few issues with managing his medications. Specifically, he took too many Norvasc tablets a few months ago, which resulted in hypotension and a fall. Since that time, Mark’s wife has been setting up Mr. Wingate’s pills in pill boxes, but recently, multiple “missed doses” have been noted. Mr. Wingate states: “but those are my night pills that I miss—I’m always better at remembering things in the morning.” Mark agrees, stating that Mr. Wingate’s cognition does vary throughout the course of the day and appears to worsen in the evening. He also reports that his father seems much less alert in the evenings, and more alert in the mornings. Mr. Wingate reports that he has had poor sleep for “a long time now.” He does report that over the past few months, he has been having what he describes as “very vivid nightmares.” His son states that sometimes he is awakened by his father’s yelling during nightmares, and enters his father’s room, and sees his father swinging or kicking in his sleep. He reports that his appetite is “alright” and that his energy levels do fluctuate throughout the course of the day. He states: “sometimes, I can concentrate really well; other times I can’t … it is very frustrating!” Specific to substance use, Mr. Wingate notes that he used to enjoy a glass of wine or two with dinner, but states that it just doesn’t interest him, anymore. Plus, he stated that he notices that when he does drink, he develops slow muscle contractions. Mr. Wingate’s son also shares a concern about his father’s abnormal movements. He states that for about the last 6 months, his father has had problems with coordination. He states that he raised these concerns with the family doctor who suggested it may be “late onset Parkinson’s disease.” However, he was not treated because the symptoms were “not that bad.” OBJECTIVE Mr. Wingate was overall calm and pleasant during the clinical interview. Throughout the clinical interview, you notice that Mr. Wingate is not really involved in the discussion. He seems somewhat indifferent to the assessment and does not seem very concerned with what is being discussed. He only protested when discussing how he got lost on his way to the supermarket and his evening medication dose. Review of systems and screening physical assessment were unremarkable, with the exception of fine resting tremors noted in both of Mr. Wingate’s hands. The psychiatric/mental health nurse practitioner (PMHNP) also reviewed laboratory studies that were sent from Mr. Wingate’s primary care provider; they were within normal limits with the exception of a serum sodium level of 130 mEq/L. MENTAL STATUS EXAM Mr. Wingate is alert. He is oriented to person, place, and partially oriented to time (he knows that it is morning, but cannot tell the hour). His speech is clear, coherent, goal directed, and spontaneous. Mr. Wingate’s self-reported mood is “ok.” Affect is somewhat constricted. His eye contact is fleeting throughout the clinical interview. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes appreciated. Judgment seems well preserved, but insight appears impaired as he is having trouble understanding why his son brought him to this appointment. Concentration and attention also appear impaired, which prompts the PMHNP to perform a mini-mental status exam (MMSE) on Mr. Wingate. RESULTS OF MMSE Score of 17, with primary deficits in orientation; calculation; recall (he was unable to recall any of the three items presented after 5 minutes); and he was unable to perform serial 7’s or spell the word “WORD” in reverse, despite the fact that he is a high school graduate and attended 1 year of college. He also needed prompting with the three-step command. His score suggests severe cognitive impairment. At this point, please discuss any additional diagnostic tests you would perform on Mr. Wingate. 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