Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

Psychiatric notes are a way to reflect on your practicum experiences and connect them to the didactic learning you gain from your NRNP courses. Comprehensive psychiatric evaluation notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.
For this Assignment, you will document information about a patient that you examined in a group setting during the last 4 weeks, using the Comprehensive Psychiatric Evaluation Note Template provided. You will then use this note to develop and record a case presentation for this patient.

Joe Clark, 79 years of age, is a male patient who is receiving hospice care for his terminal illnesses that include lung cancer and chronic obstructive pulmonary disease (COPD). He developed bilateral pleural effusion (fluid that accumulates in the pleural space of each lung), which has compromised his lung expansion. He states that he is short of breath and feels anxious that the next breath will be his last.

Joe Clark, 79 years of age, is a male patient who is receiving hospice care for his terminal illnesses that include lung cancer and chronic obstructive pulmonary disease (COPD). He developed bilateral pleural effusion (fluid that accumulates in the pleural space of each lung), which has compromised his lung expansion. He states that he is short of breath and feels anxious that the next breath will be his last. The patient is admitted to the hospital for a thoracentesis (an invasive procedure used to drain the fluid from the pleural space so the lung can expand). The thoracentesis is being used as a palliative measure to relieve the discomfort he is experiencing. Low dose morphine is ordered to provide relief from dyspnea or discomfort. The patient is prescribed Proventil (albuterol) inhaler 2 puffs per day, as needed, and Flovent (fluticasone propionate) inhaler 2 puffs twice a day. The patient has 2 L/min of oxygen ordered per nasal cannula as needed for comfort. (Learning Objective 9)  What nursing measures should the nurse use to manage the patient’s dyspnea? The patient complains that he has no appetite and struggles to eat and breathe. What nursing measures should the nurse implement to manage this physiologic response to the terminal illnesses?  Ms. Williams underwent a lobectomy for lung cancer 6 months ago, followed by treatment with radiation therapy and chemotherapy. On her most recent visit to the oncologist, she is told that despite the treatments, there is evidence of metastatic disease in her spine. The physician explains that there are no further treatment options, and refers Ms. Rogers to Hospice for continuing care. (Learning Objective 4)  What are the underlying principles of hospice? To be eligible for Medicare and Medicaid Hospice benefits, what information needs to be provided by Ms. Williams’ physician? Williams has severe back pain and is concerned whether the hospice will assist with her pain management.

What group therapy techniques were demonstrated? How well do you believe these techniques were demonstrated? What evidence from the literature supports the techniques demonstrated?

3 pages
What group therapy techniques were demonstrated? How well do you believe these techniques were demonstrated?
What evidence from the literature supports the techniques demonstrated?
What did you notice that the therapist did well?
Explain something that you would have handled differently.
What is an insight that you gained from watching the therapist handle the group therapy?
Now imagine you are leading your own group session. How would you go about handling a difficult situation with a disruptive group member? How would you elicit participation in your group? What would you anticipate finding in the different phases of group therapy? What do you see as the benefits and challenges of group therapy?
Support your reasoning with at least three peer-reviewed, evidence-based sources, and explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.

Write  a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments.

Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
Select one type of diabetes to focus on for this Discussion.
Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.
Write  a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples. 3APA references

Expand on your own post. Discuss the phenomenon of depression effects on appetite. Describe from a pathophysiologic basis why some people with depression experience a lack of appetite resulting in weight loss while others will experience increased food intake and have weight gain.

Response #1: Expand on your own post. Discuss the phenomenon of depression effects on appetite. Describe from a pathophysiologic basis why some people with depression experience a lack of appetite resulting in weight loss while others will experience increased food intake and have weight gain.

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?
Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.
In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a PowerPoint presentation with an infographic (graphic that visually represents information, data, or knowledge. Infographics are intended to present information quickly and clearly.) to educate others on the role of nurse as knowledge worker.
Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.
To Prepare:
Review the concepts of informatics as presented in the Resources.
Reflect on the role of a nurse leader as a knowledge worker.
Consider how knowledge may be informed by data that is collected/accessed.
The Assignment:
Explain the concept of a knowledge worker.
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
Include one slide that visually represents the role of a nurse leader as knowledge worker.
Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom.
Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.
To Prepare
Review the case study assigned,
Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.
Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder.
Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
ASSIGNED CASE STUDY
Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and
diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is
currently taking the following prescription drugs:
Synthroid 100 mcg daily
Nifedipine 30 mg daily
Prednisone 10 mg daily
THE QUESTION
Explain your diagnosis for the patient, including your rationale for the diagnosis.
Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.
Justify why you would recommend this drug therapy plan for this patient. Be specific and provide examples.

Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples. Identify the technologies required to implement this project and explain why.

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:
Describe the project you propose.
Identify the stakeholders impacted by this project.
Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
Identify the technologies required to implement this project and explain why.
Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.
Use APA format and include a title page and reference page.

In older adults aged 65 years or older living in the community with diabetes (Population) does a nurse practitioner led evidence based health education program on diabetes self-management (Intervention) compared to current protocols (Control) increase diabetes self-management efficacy (Outcome) in a period of  4 months? (Time)”

Reply to the following discussion by challenging the post. You will want to focus on their point of view, asking pertinent questions, adding to the responses by including information from other sources, and respectfully challenging a point of view, supported by references to other sources. Be objective, clear, and concise. Always use constructive language.
It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources.
KR Discussion:
PICOT Question “ In older adults aged 65 years or older living in the community with diabetes (Population) does a nurse practitioner led evidence based health education program on diabetes self-management (Intervention) compared to current protocols (Control) increase diabetes self-management efficacy (Outcome) in a period of  4 months? (Time)”
Who will benefit from receipt of this evidence?
Two groups of people will benefit from this evidence. That is, primary care providers, (nurse practitioners), and registered nurses, as well as community residing older adults with diabetes. The evidence from the EBP will assist registered nurses and nurse practitioners in developing and implementing evidence based programs for improving diabetes self-management informed by current research. Nurse practitioners are skilled and trained to provide care in population groups across all ages, and are crucial in implementing evidence based preventive interventions and chronic disease management such as diabetes (Woo et al., 2017).
Where will this evidence have the greatest impact?
The evidence will greatly impact diabetes self-management efficacy for older community dwelling adults that are at elevated risks for diabetes associated poor health outcome and complications due to specific risk factors such as low social support, pre-existing conditions, inadequate diabetes self-management knowledge and low health services utilization (Kalyani et al., 2017).
What resources are needed?
Being a health education based type of EBP, the program is relatively inexpensive and includes costs for education materials such as posters, brochures, and hiring of venue for administering health education.  Technology for projection educational material s may also increase costs.
Who is the most appropriate audience?
Nurse practitioners, registered nurses, home based care givers.
What are the benefits of this evidence to your selected audience?
Sharing of the evidence will improve diabetes self-management efficacy in community dwelling older adults thus reducing the burden of mortality, comorbidity, and associated treatment costs (Kalyani et al., 2017).
What are the potential risks of failing to disseminate this evidence?
When left unmanaged, type 2 diabetes can cause various forms of serious health complications that are categorized as micro vascular and macro vascular. Micro vascular complications of type 2 diabetes entail nervous system disorders (neuropathy), damage to the renal system (nephropathy), and eyesight complications (retinopathy)  (Kalyani et al., 2017). Common macro vascular complications for type 2 diabetes  are cardiovascular diseases , heightened chances of stroke,  and peripheral vascular diseases that  are characterized by amputations originating from  non-healing  surface injuries and gangrene(Kalyani et al., 2017).Diabetes also puts a huge cost burden to the health system  making self-management desirable. Failure to disseminate the evidence from the EBP translates to missed opportunities of reducing diabetes health and cost burdens in community dwelling older adults.
What are the barriers to dissemination of evidence?
According to Kreuter and Wang (2016), major barriers in dissemination of evidence can be traced to inappropriate audience choice, poor communication strategy, and limitations in dissemination mediums or methods. The major barrier in evidence dissemination for this project is access to the vital audience, and difficulty in identifying an appropriate mode of dissemination due to the large volume of information involved.
The preferred mode of dissemination is a PowerPoint presentation. PowerPoint allows collaborative presentations of data with multiple uses that enhances effective way of communication with the audience through various designs as well as facilitating exportation to different formats (Shigli et al., 2016).
References
Kreuter, M. W., & Wang, M. L. (2016). From evidence to impact: Recommendations for a dissemination support system. New Directions for Child and Adolescent Development, 2015(149), 11-23. https://doi.org/10.1002/cad.20110
Kalyani, R. R., Golden, S. H., & Cefalu, W. T. (2017). Diabetes and aging: Unique considerations and goals of care. Diabetes Care, 40(4), 440-443. https://doi.org/10.2337/dci17-0005
Shigli, K., Agrawal, N., Nair, C., Sajjan, S., Kakodkar, P., & Hebbal, M. (2016). Use of PowerPoint presentation as a teaching tool for undergraduate students in the subject of gerodontology. The Journal of Indian Prosthodontic Society, 16(2), 187. https://doi.org/10.4103/0972-4052.167940
Woo, B. F., Lee, J. X., & Tam, W. W. (2017). The impact of the advanced practice nursing role on quality of care, clinical outcomes, patient satisfaction, and cost in the emergency and critical care settings: A systematic review. Human Resources for Health, 15(1). https://doi.org/10.1186/s12960-017-0237-9
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Identify two (2) additional questions that were not asked in the case study and should have been? 1b) Explain your rationale for asking these two additional questions.

BEFORE ANSWERING THE QUESTIONS BELOW PLEASE READ THE ENTIRE CASE STUDI ATTACHED TO THIS POST. PLEASE USE APA STYLE REFERENCES NO LONGER THEN 5 YEARS OLD.
DOMAIN: HISTORY
1a) Identify two (2) additional questions that were not asked in the case studI and should have been?
1b) Explain your rationale for asking these two additional questions.
1c) Describe what the two (2) additional questions might reveal about the patient’s health.
DOMAIN: PHYSICAL EXAME
For each system examin in this case;
2a) Explain the reason the provider examin each system.
2b) Describe how the exame findings would be abnormal based on the information in this case. If it is a wellness visit, based on the patient’s age, describe what exame findings could be abnormal.
2c) Describe the normal findings for each system.
2d) Identify the various diagnostic instruments you would need to use to examin this patient.
DOMAIN: ASSESSMENT (Medical Diagnosis)
Discuss the pathophysiology of the:
3a) Diagnosis and,
3b) Each Differential Diagnosis
3c) If it is a Wellness, type ‘Not Applicable’
DOMAIN: LABORATORY & DIAGNOSTIC TESS
Discuss the following:
4a) What labs should be ordered in the case?
4b) Discuss what lab results would be abnormal.
4c) Discuss what the abnormal lab values indicate.
4d) Discuss what diagnostic procedures you might want to order based on the medical diagnosis.
4e) If this is a wellness visit, discuss what the U.S. Preventive Taskforce recommends for patients in this age group.