Discuss dietary concerns and barriers for an older adult to maintain appropriate nutrition levels. Identify the types of concerns and barriers they may encounter. Include two client teaching and nursing interventions for prevention of nutritional deficits as well as the consequences of inadequate nutrition and hydration.
MSN 5550 Health Promotion: Prevention of Disease
Case Study Module 10
Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers. APA, 7th ed. must be followed.
Deadline: Due by Saturday at 23:59 p.m.
CASE STUDY: Preschool Child: Ricky
Ricky, age 4 years, arrives in the clinic with his mother. Ricky lives with his mother and father,
who both work full-time, and his infant sister. Their extended family lives in a different state
more than 100 miles away. Both parents are of average height and in good health. Ricky’s
mother mentions that Ricky often expresses frustration, particularly in regard to food. Conflict
over food occurs every day. Mealtime is a battle to get him to eat, unless his mother feeds him.
Ricky’s baby sister seems to tolerate all baby foods but requires her mother to spoon-feed.
Ricky’s mother is quite frustrated and concerned that he will become malnourished.
Reflective Questions
1. What additional assessment information would you collect?
2. What questions would you ask, and how would you further explore this issue with the
mother?
3. In what ways does the distance of the extended family influence this family’s approach
to health promotion?
4. What factors would you consider to determine whether malnourishment is a factor in
this family?
Advanced Psychopharmacology and Health Promotion
Unit 7 Discussion
Peer Response. Medications for Psychosis and Schizophrenia Related Disorders 600W. APA. 4 references due 10-20-23.
Instructions:
Please read and respond to at least two of your peers' initial postings. You may want to consider the following questions in your responses to your peers:
· Compare and contrast your initial posting with those of your peers.
· How are they similar or how are they different?
· What information can you add that would help support the responses of your peers?
· Ask your peers a question for clarification about their post.
· What most interests you about their responses?
Please be sure to validate your opinions and ideas with citations and references in APA format.
JS1
Which antipsychotics are considered first-generation, and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?
The first-generation antipsychotic (FGA) medications include chlorpromazine, fluphenazine, droperidol, loxapine, haloperidol, pimozide, perphenazine, thioridazine, prochlorperazine, thiothixene, and trifluoperazine. FGA drugs exert their therapeutic effects by antagonizing dopamine (D2) receptors, specifically addressing the positive symptoms associated with schizophrenia. According to Chokhawala & Stevens, 2023), first-generation antipsychotics are considerably more likely to elicit extrapyramidal movements (i.e., tardive dyskinesia) than second-generation and are thus used less commonly. Second-generation antipsychotic (SGA) medicines have antagonistic effects on the D2 receptor but are often called serotonin-dopamine antagonists. There is also some evidence to suggest that antipsychotics of the second generation provide better symptom management than those of the first generation (Chokhawala & Stevens, 2023). The efficacy of second-generation antipsychotics in addressing the negative symptoms of schizophrenia surpasses that of first-generation antipsychotics, while also demonstrating use in managing the positive symptoms of the disorder.
Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.
Tardive dyskinesia (TD) is a collection of involuntary, repeated movements resulting from disrupting or blocking dopamine receptors. Involuntary motions may range from akathisia and dystonia to buccolingual stereotypy and myoclonus to chorea and tics (Paudel et al., 2023). There is currently no therapy available for TD. However, there are a variety of therapy methods available for reducing symptoms. While other drugs may also contribute to TD, conventional antipsychotics are the most common culprits. Paudel et al. (2023) provide a cautious estimate that around 5% of individuals experience TD annually when on conventional antipsychotics. Statistically speaking, older people have a far greater incidence rate.
Tardive dyskinesia, athetosis, acute dystonia, and tics are all instances of involuntary movements, as stated by Paudel et al. (2023). Repetitive muscular contractions, known as tics, often affect only one part of the body and are sometimes suppressed. Acute dystonia is characterized by sustained, repeated muscular contractions typically triggered by an intentional activity. Slow, writhing motions are characteristic of athetosis, often affecting the arms and hands.
References
Chokhawala, K., & Stevens, L. (2023). Antipsychotic medications. In StatPearls [Internet]. StatPearls Publishing.
https://www.ncbi.nlm.nih.gov/books/NBK519503
Links to an external site.
Paudel, S., Donovan, A. L., Petriceks, A., Vyas, C. M., Van Alphen, M. U., & Stern, T. A. (2023). Drug-Induced Abnormal Involuntary Movements: Prevalence and Treatment. The Primary Care Companion for CNS Disorders, 25(3), 47041.
https://www.psychiatrist.com/pcc/effects/drug-induced-abnormal-involuntary-movements-prevalence-and-treatment/
Links to an external site.
SY-2
Which antipsychotics are considered first-generation and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?
Both first-generation antipsychotics and second-generation antipsychotics are used for the treatment of psychiatric disorders such as schizophrenia. First-generation antipsychotics, also known as typical antipsychotics, such as phenothiazines (perphenazine, prochlorperazine), and butyrophenones (haloperidol) are classified by their chemical structure (Chokhawala, 2023). Whereas second-generation antipsychotics also known as atypical antipsychotics such as risperidone, olanzapine, quetiapine, aripiprazole, and clozapine are classified based on pharmacological proprieties (Chokhawala, 2023).
First-generation antipsychotics tend to be used less often than second-generation antipsychotics due to their long list of adverse effects that include extrapyramidal side effects, anticholinergic side effects (dry mouth, urinary retention, constipation), prolonged QT intervals, sedation, as well as the rare but fatal neuroleptic malignancy syndrome (Chokhawala, 2023). In comparison, second-generation antipsychotics have a decreased risk of extrapyramidal side effects but are associated with weight gain and metabolic syndrome, therefore patients should be monitored for diabetes, dyslipidemia, and weight gain (Chokhawala, 2023). Although second-generation antipsychotics tend to be the drug of choice when it comes to treating psychiatric disorders, and this is mainly due to the less severe side effects, this does not necessarily indicate that it is more effective. A study done by Fabrazzo et al. (2022) showed that second-generation antipsychotics showed no clear evidence of their effectiveness on cognitive deficit, however, it did prove to be more effective than first-generation antipsychotics in treating negative symptoms, relapse-free survival, and hospitalization rate.
Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.
Tardive Dyskinesia
(TD) is a disorder characterized by repetitive movement such as facial and tongue movement, tongue protrusion, facial grimacing, chewing, and quick, jerking limb movements. These movements are involuntary and can range in severity (slight tremor to full body movement) thus, making daily function difficult. Its main cause is long-term use of antipsychotics, and this disorder tends to be irreversible (Bergman & Soares-Weiser, 2018).
Acute Dystonia is a neurological symptom characterized by muscle contractions that cause repetitive movements by arms, legs, neck, face, or abnormal posture (Stahl, 2022). The cause of this reaction is due to a dopaminergic-cholinergic imbalance in the basal ganglia (Lewis, 2023). Early intervention can prevent the onset and development of dystonia and neurological damage and treatments include benzodiazepines, baclofen, muscle relaxants, and dopamine depletes (VMAT-2 inhibitors) (Bledsoe et al., 2020).
Akathisia and Tics syndromes are seen in patients treated with D2 blockers and are characterized by inner restlessness and mental unease (Stahl, 2022). Akathisia is a neuropsychiatric syndrome characterized by the inability to remain still and it typically involves the lower extremity (Patel, 2023). Tics on the other hand such as Tourette syndrome are neurodevelopmental disorders characterized by motions, noise, and words and are involuntary (Jones, 2023).
References
Bergman, H., & Soares-Weiser, K. (2018). Anticholinergic medication for antipsychotic-induced tardive dyskinesia.
Cochrane Database of Systematic Reviews,
2018(1). https://doi.org/10.1002/14651858.cd000204.pub2
Bledsoe, I. O., Viser, A. C., & San Luciano, M. (2020). Treatment of dystonia: Medications, neurotoxins, neuromodulation, and rehabilitation.
Neurotherapeutics,
17(4), 1622–1644. https://doi.org/10.1007/s13311-020-00944-0
Chokhawala, K. (2023, February 26).
Antipsychotic medications. StatPearls – NCBI Bookshelf.
https://www.ncbi.nlm.nih.gov/books/NBK519503/Links to an external site.
Fabrazzo, M., Cipolla, S., Camerlengo, A., Perris, F., & Catapano, F. (2022). Second-Generation Antipsychotics’ Effectiveness and Tolerability: A Review of Real-World Studies in Patients with Schizophrenia and Related Disorders.
Journal of Clinical Medicine,
11(15), 4530. https://doi.org/10.3390/jcm11154530
Jones, K. S. (2023, May 8).
Tourette syndrome and other TIC disorders. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499958/
Lewis, K. (2023, May 1).
Dystonic reactions. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK531466/#:~:text=An%20acute%20dystonic%20reaction%20is,to%20abnormal%20movements%20or%20postures.
Stahl, S. M. (2021).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).
Patel, J. (2023, July 24).
Akathisia. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK519543/#:~:text=Akathisia%20is%20defined%20as%20an,usually%20involves%20the%20lower%20extremities.
Choose one of the articles below, and address the essay prompt associated with it.
Park, M. (2009). Ethical issues in nursing practice. Journal of Nursing Law, 13(3), 68-77. doi:10.1891/1073-7472.13.3.68
Link:
Ethical issues in nursing practice Links to an external site.
Essay Prompt: Identify primary areas for legal and ethical issues faced by oncology nurses in this study (Park, 2009), and strategies they may have developed to work with those ethical issues.
Or,
Croke, E. (2006). Nursing malpractice: determining liability elements for negligent acts. Journal of Legal Nurse Consulting, 17(3), 3.
Link:
Nursing malpractice: determining liability elements for negligent actsLinks to an external site.
Essay Prompt: Identify primary problems that led to the malpractice suits (Croke, 2006), and identify the role the nurse played and what the nurse did wrong.
Your 1-2 page paper should include adhere to APA formatting and references/ citations for the article. Additional sources are optional.
Define and describe the pathophysiology of fibromyalgia. Include clinical manifestations, evaluation, & treatment.
Please discuss the importance of USPSTF Screening Recommendations in Primary Care.
Please include 400 words in your initial post and 200 words in your answers to your peers. The initial post is due Wednesday at midnight and the answers to your peers Saturday at 23:59pm.
please complete the attached table
Explain, with concrete examples, the differences among leadership, management, and followership. Then, discuss the following:
Submission Instructions:
Answer the following three questions, then design a proposed logo for your prospective business:
Propose and design a logo for your business that conveys your mission, your product or services and qualities that you want potential customers to associate with your business. Post your proposal and/or logo to the discussion forum for peer and faculty feedback.
Expectations
Initial Post:
use US sources and easily reproduced searches
Maybe for business a business that is able to support and help nurses with burn out and feeling supported and have a place to turn too for coaching and guidance.
Select one of the discussion prompts below and respond to it with an initial post by Day #4 of the unit week. Your initial post needs to thoroughly address all parts of the selected prompt and be supported by at least one scholarly source. Then, respond to at least two threads on two additional days to drive the weekly discussions. All posts must demonstrate critical thinking and effective written communication including proper spelling, grammar, professional language, and APA formatting of references and in-text citations. All posts must also be submitted no later than the last day of the unit week.
Discussion
1
Discuss a time when you may have had difficulty discussing an issue related to oppression, privilege, or intersectionality due to struggles with using the terminology. In this situation, what sort of uncertainty or struggle did you face? What was the outcome? What did you learn during this unit that can help you overcome the struggle with discussing the issue?
(USLO 2.1)
2
Please watch the following video that is comprised of several short clips demonstrating stereotypes, microaggressions, and instances of prejudice and discrimination: “Power of One” (Thomas, 2007).
After you’ve watched the short video, answer the following questions:
(USLO 2.3)
4
What does it mean to be an “American?” Is there an overriding definition of what it means to be an American? How would we encompass the multitude number of races, ethnicities, cultures, religions, and various more identities into one single national identity? Is that even possible? What is the danger behind pushing for a single “story?” Reflect on these questions critically in your answer.
(USLO 2.4)
5
Discuss the privileges ‘natural’ born U.S. citizens enjoy that people with different immigrant and migrant identities do not. What institutional or systemic factors give rise to nationalism for in-groups and oppression of the non-citizen groups?
(USLO 2.6)
6
Immigrants, migrants, and asylum seekers belong to various race, gender, age, religion, and more identities. How does the intersectionality of multiple identities affect these non-citizen groups? Provide a couple of examples and discuss ways to mitigate the detrimental effects and trauma these groups face in the host country.
(USLO 2.4)
7
In recent times, there is a growing fear of diversability regarding people with immigrant identities. Historically, the U.S. is a nation formed with groups of people who fled their countries due to various threats to their lives and safety. Then, on what basis is the current fear of immigrants, migrants, and refugees, justified? How would you change the narrative to mitigate such fears?
(USLO 2.5)
8
Despite the immigrant, migrant, and undocumented workers’ contributions to the U.S. economy, the groups experience various socio-economic, political, and legal barriers to inclusion. Why is immigrant inclusion vital to a nation? What are the critical challenges to inclusive practices for these groups? And as a society, what can we do to ensure equitable access to resources for the immigrant groups?
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