NURS 6660 Assignment 1: Practicum: Decision Tree

NURS 6660: NURS 6660 PMH Nurse Practitioner Role I: Child and Adolescent

Assignment 1: Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.

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

The Assignment:

Examine Case 2: 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.

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 families.

BACKGROUND

Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.

Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street.

His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”

Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.

OBJECTIVE

During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.

When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.

MENTAL STATUS EXAM

Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.

Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

Decision Point One

Obsessive Compulsive Disorder

Decision Point Two

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-blue.pngBegin Fluvoxamine immediate release 25 mg orally at bedtime

RESULTS OF DECISION POINT TWO

· Client returns to clinic in four weeks

· Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She states that the frequency of the handwashing has decreased, and Tyrel seems a bit more “relaxed” overall.

· She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. She reported that over this past weekend, Tyrel went outside to play with his friend from across the street, which he has not done in a while.

Decision Point Three

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6660/05/mm/decision_tree/img/pill-red.pngIncrease Fluvoxamine to 50 mg orally at bedtime

Guidance to Student

In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.

Fluvoxamine immediate release is FDA-approved for the treatment of OCD in children aged 8 years and older. Fluvoxamine’s sigma-1 antagonist properties may cause sedation and as such, it should be dosed in the evening/bedtime.

At this point, it would be appropriate to consider increasing the bedtime dose, especially since the child is responding to the medication and there are no negative side effects.

Atypical antipsychotics are typically not used in the treatment of OCD. There is also nothing to tell us that an atypical antipsychotic would be necessary (e.g., no psychotic symptoms). Additionally, the child seems to be responding to the medication, so there is no rationale as to why an atypical antipsychotic would be added to the current regimen.

Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. The PMHNP should augment medication therapy with CBT. If further assessment determines that Tyrel has social anxiety disorder, CBT is effective in treating this condition as well.

Case #1  A young girl with difficulties in school

BACKGROUND

In psychopharmacology you met Katie, an 8-year-old Caucasian female, who was brought to your office by her mother (age 47) and father (age 49). You worked through the case by recommending possible ADHD medications. As you progress in your PMHNP program, the cases will involve more information for you to sort through.

For this case, you see Katie and her parents again. The parents have reported that the medication given to Katie does not seem to be helping. This has prompted you to reconsider the diagnosis of ADHD. You will consider other differential diagnoses and determine what information you need to accurately assess the DSM-5 criteria to make the diagnosis of ADHD or another disorder with similar diagnostic features.

When parents bring their child to your office, they may have read symptoms on the internet or they may have been told by the school “your child has ADHD”. Your diagnosis will either confirm or refute that diagnosis.

Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine a differential diagnosis and to begin medication, if indicated. The PMHNP makes this diagnostic decision based on interviews and observations of the child, her parents, and the assessment of the parents and teacher.

To start, consider what assessment tools you might need to evaluate Katie.

  • Child Behavior Check List
  • Conners’ Teacher Rating Scale

The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised” (Available at: https://www.ncbi.nlm.nih.gov/projects/gap/cgi-bin/GetPdf.cgi?id=phd000099.1 ). This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, makes careless mistakes in her schoolwork, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. She has difficulty interacting with peers in the classroom and likes to play by herself at recess.

When interviewing Katie’s parents, you ask about pre- and post-natal history and you note that Katie is the first born with parents who were close to 40 years old when she was born. She had a low 5 minute Apgar score. The parents say that she met normal developmental milestones and possibly had some difficulty with sleep during the pre-school years. They notice that Katie has difficulty socializing with peers, she is quiet at home and spends a lot of time watching TV.

 

SUBJECTIVE

You observe Katie in the office and she is not able to sit still during the interview. She is constantly interrupting both you and her parents. Katie reports that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds some subjects boring or too difficult, and sometimes hard because she feels “lost”. She admits that her mind does wander during class. “Sometimes” Katie reports “I will just be thinking about something else and not looking at the teacher or other students in the class.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. She offers no other concerns at this time.

Katie’s parents appear somewhat anxious about their daughter’s problems. You notice the mother is fidgeting with her rings and watch while you are talking. The father is tapping his foot. Other than that, they seem attentive and straight forward in the interview process.

 

MENTAL STATUS EXAM

The client is an 8-year-old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is neutral. Katie says that she doesn’t hear any ‘voices’ in her head but does admit to having an imaginary friend, ‘Audrey’. No reports of delusional or paranoid thought processes. Attention and concentration are somewhat limited based on Katie’s short answers to your questions.

Decision Point One

BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHAT IS YOUR DIAGNOSIS FOR KATIE?

In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

 299.00 Autism Spectrum Disorder (ASD), mild and co-occurring; 300.23 Social Anxiety Disorder

 315.0 Specific Learning Disorder with Impairment in Reading and 315.1 Impairment in Mathematics

 314.00 Attention Deficit Hyperactivity Disorder, predominantly inattentive presentation

NURS 660 Week 4: Trauma and Stressor-Related Disorders in Childhood

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. They hauled him away, but I know he will be back. She always lets him come back.”

Avery, age 14

In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments.

Photo Credit: StaffordStudios / Getty Images

Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

· Chapter 31, “Child Psychiatry” (pp. 1216–1226)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

· “Trauma- and Stressor-related Disorders”

Note: You will access this book from the Walden Library databases.

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry, 52(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

· Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)

· Chapter 58, “Disorders of Attachment and Social Engagement Related to Deprivation” (pp. 795–805)

· Chapter 59, “Post Traumatic Stress Disorder” (pp. 806–821)

· Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Learning Objectives

Students will:

· Recommend strategies for assessing for abuse

· Analyze influences of media and social media on mental health

· Evaluate the need for mandatory reporting of abuse

To Prepare for this Discussion:

· Read the Learning Resources concerning treating childhood abuse.

· Read the Child Abuse Case Study in the Learning Resources. See Child Abuse Case Study

Assignment Question to be addressed

· What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.

· How might exposure to the media and/or social media affect the patient?

· What type of mandatory reporting (if any) is required in this case? Why?

Child Abuse Case Study

NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child

and Adolescent

Child Abuse Case Study
NURS 6660: Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent
Morgan, a 19-year-old male comes to your office to discuss his current mood and symptoms. This is his first visit to a mental health clinic. “I’ve had 26 jobs in the last 2years; I finally have a job that I like and I want to make it work.” As you begin to get to know him, he tells you that his mood is down and that he also has times where he has “more energy and motivation”: “That’s when I am able to get a new job.” He says that he has difficulty interacting with coworkers. “I feel like I can’t talk to them.” If it wasn’t for his supportive girlfriend, he wouldn’t be able to function. “She understands me and accepts me; she knows what I have been through.”
As the PMHNP listens to the client and explores what he means by some of his statements, you try to put together his story. He mentions that he has been having nightmares and is not sleeping well. He says he startles easily. He becomes withdrawn when he begins to talk about the reason for the nightmares.“This all started a few weeks ago when a cousin of mine got out of jail.” He haltingly tells the story of his parents’ mental illness and how he had to live with various relatives. “One cousin who I stayed with a lot took advantage of me. He molested me.” They found out he also molested other children and he went to jail. “It gives me the creeps that he is out of jail. I have to face what he did to me.” Morgan asks about his diagnosis. The PMHNP tells him that he has some symptoms that sound like depression and anxiety, and that when a child has a traumatic experience, it can reoccur and stay with a person for many years. He acknowledges that he thought about PTSD but wasn’t sure what the symptoms look like.
As you think about Morgan’s story, consider the following questions: Where did he fall between the cracks? Are there agencies who advocate for children like him? There are thousands of children like Morgan. They were in a vulnerable family situation and the “responsible” adult was not able to care for the child. Sometimes it takes yearsfor clients to remember and disclose the abuse.

Week 4: Trauma and Stressor-Related Disorders in Childhood

“He was drunk again, so I should have known better. I should have stayed away from the house, but that would have made him madder. He has done this before, but not nearly this bad. He broke my wrist as I was protecting my mom. The neighbor heard the screaming and called the cops. They hauled him away, but I know he will be back. She always lets him come back.”

Avery, age 14

In August of 2005, thousands of children lost their homes in Hurricane Katrina. On December 14, 2012, the students at Sandy Hook Elementary School experienced the death of 20 of their classmates and six of their teachers. Every day, children experience physical and sexual abuse and neglect by their parents or caregivers. These types of trauma have a lifelong impact on the children involved and those witnessing the events. As much as we try to prevent unwanted childhood trauma and stressors, the phenomena are present in our culture. Childhood trauma is a significant contributor to both physical and mental health problems in children and adults.

This week, you examine several cases of child abuse and neglect, and you recommend strategies for assessing for abuse. You analyze influences of media and social media on mental health and evaluate the need for mandatory reporting of abuse. You also submit your Practicum Journal and Assignments.

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 31, “Child Psychiatry” (pp. 1216–1226)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Trauma- and Stressor-related Disorders”

Note: You will access this book from the Walden Library databases.

Pfefferbaum, B., & Shaw, J. A. (2013). Practice parameter on disaster preparedness. Journal of the American Academy of Child & Adolescent Psychiatry52(11), 1224–1238. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00550-9/pdf

American Psychiatric Nurses Association. (2017). Childhood and adolescent trauma. Retrieved from http://www.apna.org/i4a/pages/index.cfm?pageID=4545

Document: Childhood Abuse Case Study (PDF)

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.

To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Review the following medications:

Posttraumatic stress disorder
citalopram
clonidine
desvenlafaxine
escitalopram
fluoxetine
fluvoxamine
mirtazapine
nefazodone
paroxetine
prazosin (nightmares)
propranolol (prophylactic)
sertraline
venlafaxine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”

Optional Resources

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

  • Chapter 50, “Provision of Intensive Treatment: Intensive Outreach, Day Units, and In-Patient Units” (pp. 648–664)
  • Chapter 58, “Disorders of Attachment and Social Engagement Related to Deprivation” (pp. 795–805)
  • Chapter 59, “Post Traumatic Stress Disorder” (pp. 806–821)
  • Chapter 64, “Suicidal Behavior and Self-Harm” (pp. 893–912)

Discussion: Treating Childhood Abuse

In 2012, statistics in the United States indicated that state CPS agencies received 3.4 million referrals for child abuse and neglect. Of these, nearly 700,000 children were found to be victims of maltreatment: 18% were victims of physical abuse and 78% were victims of neglect (CDC, 2014). Child sexual abuse makes up roughly 10% of child maltreatment cases in the United States (CDC, 2014). The CDC considers sexual abuse at any age a form of violence. Child abuse of any kind can lead to an increased state of inflammatory markers in adulthood, as well as multiple physical illnesses and high-risk behavior such as alcoholism and drug abuse. If a PMHNP identifies child abuse, there may be a need to report the abuse to authorities. Once able to provide treatment, the PMHNP can be instrumental in reducing the long-term effects of child abuse.

In this Discussion, you recommend strategies for assessing for abuse and analyze influences of media and social media on mental health. You also evaluate the need for mandatory reporting of abuse.

Learning Objectives

Students will:

  • Recommend strategies for assessing for abuse
  • Analyze influences of media and social media on mental health
  • Evaluate the need for mandatory reporting of abuse

To Prepare for this Discussion:

  • Read the Learning Resources concerning treating childhood abuse.
  • Read the Child Abuse Case Study in the Learning Resources.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking Submit!

By Day 3

Post:

  • What strategies would you employ to assess the patient for abuse? Explain why you selected these strategies.
  • How might exposure to the media and/or social media affect the patient?
  • What type of mandatory reporting (if any) is required in this case? Why?

By Day 6

Respond to at least two of your colleagues by providing at least two ways that their strategies may be expanded or improved.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 4 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 4 Discussion

Assignment 1: Practicum: Week 1 Practicum Journal

By Day 7

Submit your Assignment. Refer to Week 1 for additional guidance.

Submission and Grading Information NURS 6660 Trauma and Stressor-Related Disorders

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK4Assgn1+last name+first initial.(extension)” as the name. NURS 6660 Trauma and Stressor-Related Disorders
  • Click the Week 4 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn1+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 4 Assignment 1 Rubric NURS 6660 Trauma and Stressor-Related Disorders

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 1

Assignment 2: Practicum: Week 3 Decision Tree

By Day 7 NURS 6660 Trauma and Stressor-Related Disorders

Submit your Assignment. Refer to Week 3 for additional guidance.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK4Assgn2+last name+first initial.(extension)” as the name.
  • Click the Week 4 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 4 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK4Assgn2+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric: NURS 6660 Trauma and Stressor-Related Disorders

Week 4 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 4 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 4 Assignment 2 NURS 6660 Trauma and Stressor-Related Disorders

Assignment 3: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability. NURS 6660 Trauma and Stressor-Related Disorders

You can access Board Vitals through the link sent to you in email or by following the link below:

By Day 7 NURS 6660 Trauma and Stressor-Related Disorders

Complete the Board Vitals questions.

Practicum Reminder

Time Logs

You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections

This week, you examined several cases of child abuse and neglect and recommended strategies for assessing for abuse. You analyzed influences of media and social media on mental health and evaluated the need for mandatory reporting of abuse. You also submitted your Practicum Journal and Assignments.

Next week, you analyze case studies to determine the diagnosis and treatment of anxiety disorders.

NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Working from a lifespan approach, this course introduces child and adolescent psychiatry. Emphasis is placed on the psychiatric and/or mental health disorders that begin in childhood and adolescence. Topics include psychiatric assessment; differential diagnosis; and application of diagnostic criteria, appropriate diagnostic testing, and diagnostic formulation. The learner will select a combination of psychotherapeutic modalities coupled with psychopharmacologic approaches to treat common psychiatric mental health conditions of children and adolescents. The focus of the practicum experience is on application of didactic concepts to actual patient care situations. Legal and ethical considerations for working with children and adolescents will be addressed. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

BUY NURS 6600 EXAM HERE

Assignments and Projects

An Assignment or Project often is a writing assignment submitted to the Instructor for evaluation. Complete Assignment or Project directions are in the Assignments or Projects areas, including how and where to submit the Assignment or Project and the due date. Please note that you should keep copies of your Assignments and Projects on your computer in case of any technical difficulties. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Information on scholarly writing may be found in the APA manual and at the Walden Writing Center website.

Please refer to the APA Guide or visit the Walden University Online Writing Center at http://writingcenter.waldenu.edu/.

Walden University expects you to act with integrity and honesty in your academic courses. Refer to the Guidelines and Policies and Academic Integrity areas for more details.

Check the Course Information area for any rubrics relating to the Assignments and Projects.

All assignments must be completed to pass the course. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Practicum Activities

The practicum experience in this course will assist your transition from the role of learner to that of scholar-practitioner. To achieve this transition, you will engage in a relationship with a clinical instructor and preceptor, focusing on roles and role functions and the achievement of individualized learning objectives. The primary objective of your practicum is to provide you with the basic skills necessary to serve as a mid-level provider of primary care to selected populations and prepare you to take the appropriate national certification exam. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

The practicum component of the course will be graded as Satisfactory or Unsatisfactory. In order to pass the course, you must earn a grade of Satisfactory on all required practicum activities including journal entries and time logs.

At the end of the course, you must also ensure that your practicum preceptor submits an online evaluation of your performance. You will also complete an online evaluation of your practicum experience at the end of the course. These evaluations will not only provide information about the progress of individual students, but also help program leadership to continuously work on the course review and improvements. You will receive an Incomplete (I) as a grade if any of the above evaluations are not received by the posted deadlines. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Time Logs: Students are required to keep a log of the time spent related to their practicum experience and enter every patient they see each day. Students can access their time log from the Welcome Page in their Meditrek account. Students will track time individually for each patient they work with. Students are required to continuously input their hours throughout the term. Logs are reviewed by instructors in Weeks 4, 7, and 10. Please print and keep your completed Meditrek Log at the end of your clinical experiences for future use as a component of your portfolio. NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

Week 1 Comprehensive Integrated Psychiatric Assessment
Learning Resources Required Readings
Required Media
Optional Resources
Discussion Comprehensive Integrated Psychiatric Assessment
Assignment Practicum Journal Entry: Analyzing an Ethical Decision
Making Connections
Looking Ahead Didactic Assignments
Practicum Assignments
Week 2 Assessment in Child and Adolescent Psychiatry
Learning Resources Required Readings
Optional Resources
Discussion Working With Children and Adolescents Versus Adults
Assignment 1 Practicum: Cover Letter, Resume, and Portfolio
Assignment 2 Board Vitals
Making Connections
Looking Ahead
Week 3 Autism Spectrum Disorder, ADHD, ODD, and ICD
Learning Resources Required Readings
Required Media
Optional Resources
Discussion Parent Guide
Assignment 1 Practicum: Decision Tree
Assignment 2 Board Vitals
Making Connections
Week 4 Trauma and Stressor-Related Disorders in Childhood
Learning Resources Required Readings
Optional Resources
Discussion Treating Childhood Abuse
Assignment 1 Practicum: Week 1 Practicum Journal
Assignment 2 Practicum: Week 3 Decision Tree
Assignment 3 Board Vitals
Practicum Reminder
Making Connections
Week 5 Anxiety Disorders in Childhood and Adolescence
Learning Resources Required Readings
Required Media
Optional Resources
Discussion Clinical Supervision
Assignment 1 Practicum: Decision Tree
Assignment 2 Board Vitals
Making Connections
Looking Ahead
Week 6 Emergency Psychiatric Care in Childhood and Adolescence
Learning Resources Required Readings
Optional Resources
Discussion Treatment of Psychiatric Emergencies in Children Versus Adults
Assignment 1 Midterm Exam
Assignment 2 Board Vitals
Making Connections NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
Looking Ahead
Week 7 Learning and Motor Disorders in Childhood
Learning Resources Required Readings
Optional Resources
Discussion Parent Guide
Assignment 1 Practicum Journal: Voluntary and Involuntary Commitment
Assignment 2 Practicum: Week 5 Decision Tree
Assignment 3 Board Vitals
Practicum Reminder Time Logs
Making Connections NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
Week 8 Mood Disorders
Learning Resources Required Readings
Optional Resources
Discussion Pediatric Bipolar Depression Disorder Debate
Assignment Board Vitals
Making Connections
Looking Ahead NURS 6660 Midterm and Final Exam Study Guide Questions and Answers
Week 9 Early-Onset Schizophrenia
Learning Resources Required Readings
Required Media
Optional Resources
Assignment 1 Early Onset Schizophrenia
Assignment 2 Practicum: Decision Tree
Assignment 3 Board Vitals
Making Connections
Week 10 Feeding, Eating, and Elimination Disorders in Childhood
Learning Resources Required Readings
Optional Resources
Discussion Parent Guide
Assignment 1 Practicum: Week 2 Cover Letter, Resume, and Portfolio
Assignment 2 Practicum: Week 9 Decision Tree
Assignment 3 Board Vitals
Practicum Reminder Time Logs
Making Connections
Week 11 Special Topics in Child and Adolescent Psychiatry
Learning Resources Required Readings
Optional Resources
Discussion Special Topics in Child and Adolescent Psychiatry
Assignment 1 Final Exam
Assignment 2 NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Giles, L. L., & Martini, D. R. (2016). Challenges and promises of pediatric psychopharmacology. Academic Pediatrics, 16(6), 508-518.

Hargrave, T. M., & Arthur, M. E. (2015). Teaching child psychiatric assessment skills: Using pediatric mental health screening tools. International Journal of Psychiatry in Medicine, 50(1), 60-72.

Kaltiala-Heino, R. (2010). Involuntary commitment and detainment in adolescent psychiatric inpatient care. Social Psychiatry Epidemiology, 45, 785-793. doi: 10.1007/s00127-009-0116-3.

Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth. General Hospital Psychiatry, 32, 300-309. doi:10.1016/j.genhosppsych.2010.01.007

McClelland, M., Crombez, M., Crombez, C., Wenz, C., Lisius, M., Mattia, A., & Marku, S. (2015). Implications for advanced practice nurses when pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) is suspected: A qualitative study. Journal of Pediatric Healthcare, 29(5), 442-452. doi:10.1016/j.pedhc.2015.03.005

McGavey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors. Psychiatric Services, 64(2), 120-126.

NURS 6660 Midterm and Final Exam Study Guide Questions and Answers

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