NR 547 Discussions Week 2, 3 and Week 5, 6, 7, 8

NR 547 Discussions

NR 547 Week 2 Collaboration Café

Treatment of anxiety can be complex. Psychiatric mental health nurse practitioners (PMHNPs) may provide care to clients with treatment-refractory anxiety.

• Define treatment refractory anxiety.
• Describe two common comorbidities of treatment refractory anxiety.
• Discuss two approaches to treatment for treatment refractory anxiety.
• Identify the most appropriate response to a client who states that they use marijuana to manage their anxiety. Discuss the education the PMHNP should provide.
• Identify the most appropriate response to a client who states that they use Silexan to manage their anxiety. Discuss the education the PMHNP should provide?

NR 547 Week 3 Discussion

Mark is a 37-year-old client with a 15-year history of schizophrenia. When he was first diagnosed, he was prescribed a second-generation antipsychotic medication. He complained about drowsiness and difÏculty concentrating. He experienced a 40 lb. weight gain over a year. His girlfriend complained about his reduced sex drive and ended their relationship. He tried several different medications alone and in combination but found the side effects intolerable. He stopped taking his medications and started self- medicating with alcohol. Over time, he experienced several relapses and his condition declined markedly. He lost his housing and began living in his car. After being involuntarily committed following a psychotic episode, he was referred to the PMHNP at the outpatient clinic. When he presented for his appointment, he told the PMHNP that he stopped taking his medications due to their side effects.

• What is the most appropriate response by the PMHNP?
• How can the PMHNP support adherence for this client?
• What are the ethical and legal obligations for the PMHNP in the above situation?
• Goals that are not mutually shared between providers and patients can be very challenging, both clinically and What steps can the PMHNP take to promote their personal emotional and mental health when working with clients whose health choices are likely to lead to adverse health outcomes?

NR 547 Week 5 Discussion

Kristin is a 26-year-old client who presents to the outpatient clinic with complaints of “not liking myself.” She states she frequently feels angry without provocation and cries often. She has lost 10 lbs. in the past month and states she has no appetite. Kristin reports nightly sleep difficulty, both falling and staying asleep. Her mind just can’t seem to relax enough so she can sleep. She has tried melatonin and the Calm app mindfulness techniques; they help some nights but not always. She endorses having difficulty focusing for long periods, and she has missed several days of work within the past month due to her symptoms. No hallucinations or delusions are voiced. She states “The only thing that makes me feel better is shopping online. I love getting packages every day.” She is not experiencing financial issues from online shopping, but she has depleted her savings account. She reports that when she is not sad, she loves crafting and sometimes has days where she can craft “all day and all night.” The crafting can last for 3-4 days in a row. She denies thoughts of self-harm or suicide….. Continue

1. Select an appropriate screening tool for Kristin and provide a score for the
2. Provide a rationale for the screening tool you
3. Determine the most likely diagnosis for Kristin based on the available
4. Provide the ICD-10-CM code for the selected
5. Provide a treatment plan with rationale for each plan

NR 547 Week 6 Collaboration Cafe

1. How does dementia related psychosis differ than other types of psychosis?
2. Differentiate the clinical presentations of psychosis in clients with the four different types of dementia.
3. Discuss a minimum of two possible approaches to treatment for dementia related psychosis, select a minimum of one pharmacological and one nonpharmacological approach.
4. Identify at least two strategies to suggest to family or staff for a client who is experiencing dementia related psychotic behavior at home and in the long-term care environment.

NR 547 Week 7 Collaboration Cafe

Clients with borderline personality disorder (BPD) often engage in non-suicidal self–injury (NSSI) behavior; many clients also report chronic thoughts of suicide and non-fatal attempts of suicide. Treatment of clients with borderline personality disorder can be complex. Consider the following:

1. Define NSSI behavior.
2. Discuss how the psychiatric mental health nurse practitioner (PMHNP) differentiates between NSSI and suicide attempts.
3. Discuss evidence-based therapy for BPD. How does therapy interrupt the patterns of NSSI and suicidality?
4. What specific ethical and clinical challenges might the clinician face when treating clients with BPD who are suicidal?

NR 547 Week 8 Reflection on Learning

• Describe how learning in this course helped you to meet Program Outcome 1: Provide high quality, safe, patient-centered care grounded in holistic health principles (Holistic Health & Patient-Centered Care). Provide at least two specific examples.
• Select one of the competencies from AACN Essentials Domain 2Links to an external site. listed below and describe how learning in this course helped you to meet the advanced- level nursing education competency. Provide at least two specific examples.
• Select one of the competencies from the NONPF Independent Practice Competency Links to an external site. listed below and describe how learning in this course helped you to meet the competency. Provide at least two specific examples.