• Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
• Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
• Consider what history would be necessary to collect from this patient.
• Consider what interview questions you would need to ask this patient.

The Assignment

Develop a focused SOAP note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:

• Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? 
• Objective: What observations did you make during the psychiatric assessment?  
• Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, and list them in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5-TR criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
• Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy.
• Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient. Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
• Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

By Day 7 of Week 5

Submit your Focused SOAP Note.

Attached

A father of a 17-year-old wants to know whether his child is sexually active.

• What will you tell him?
• What if the child is 14 years old?
• What if the child is 11 years old?
• What is your state law regarding parental notification?

Submission Instructions:

• Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources Within 5 years 2020-2025

  

 

Assignment: Applying a Middle-Range Nursing Theory in Practice

Objective:
Explore how a selected middle-range nursing theory can be integrated into your clinical practice through a concise PowerPoint presentation.​

Instructions:

1. Choose a Middle-Range Nursing Theory:
   Select a middle-range nursing theory that resonates with your area of practice or interest.
    
2. Create a PowerPoint Presentation:
   Develop approximately 20 slides (excluding title and reference slides) that cover the following:
    
   • Introduction to the Theory:
     Provide a brief overview of the chosen theory and its key concepts.
      
   • Philosophical Foundations:
     Discuss the underlying philosophical principles of the theory.
      
   • Comparison with Other Nursing Theories:
     Compare and contrast this theory with nursing conceptual models, grand theories, and other mid-range theories.
      
   • Impact on Research and Practice:
     Examine how this theory influences nursing research and clinical practice.
      
   • Application in Practice:
     Illustrate how the theory can be applied in your clinical setting, including examples of integrating nursing and related sciences to provide care across diverse healthcare environments.
      
   • Evaluation of Clinical Interventions:
     Assess the effectiveness of clinical prevention strategies related to the theory, focusing on outcomes for individuals and populations.
      
   • Evidence-Based Care Planning:
     Demonstrate how knowledge of illness and disease management, guided by the theory, contributes to designing evidence-based care plans for clients, communities, and vulnerable populations within the evolving healthcare system.
      
3. Research Requirements:
   Utilize at least six current scholarly references (published within the last five years) to support your presentation. Access databases such as CINAHL Complete, MEDLINE Complete, and LIRN for your research.
    
4. Formatting and Submission:
    
   • Use APA format for citations and references.​
      
   • Ensure clear and professional slide design.​
      
   • Aim for a Turnitin similarity score of 20% or less.​
      
   • Submit your PowerPoint presentation by 04/02/2025

Reply the following discussion, APA style, 150 words or more, 2 references or more, Turnitin less than 20 %, No IA.
 

Advanced Practice Registered Nurses (APRNs), through telemedicine platforms and remote monitoring technologies, have the opportunity to take advantage of them to monitor medication adherence, evaluate therapeutic response and identify possible drug side effects as they real time consult with patients via video, messaging and electronic health records (EHRs) APRNs can then engage with the patient to reinforce drug regimen, and provide what is needed (Haleem et al., 2021). Applications of telehealth are that APRNs can make video check-in appointments, review digital medication logs and look at patient-reported medication adherence (filling in the gaps of medication use) (Haleem et al., 2021). Monitoring whether patients are taking medications as instructed can also be aided by tracking features of digital pill dispensers. Mobile health (mHealth) applications that have reminders and alert functionality are used to help patients take their medications so that APRNs can use usage patterns to intervene when nonadherence is determined (Haleem et al., 2021).

APRNs are also able to monitor therapeutic responses over time as they can continuously monitor patient data and track them in real-time using remote monitoring technologies. Wearable devices and home monitoring systems allow APRNs to collect vital information on blood pressure, glucose levels, heart rate and oxygen saturation, among other things, to assess if the mandated medication has the desired therapeutic effect. APRNs use devices such as continuous glucose monitoring (CGM) devices, which send blood sugar levels to APRNs in order for them to make quick changes to insulin therapy for diabetic patients (Haleem et al., 2021). They may also use remote blood pressure monitors similarly to monitor trends and to make changes to their antihypertensive treatment plans as indicated. Data analysis can be used to make evidence-based clinical decisions, and the pharmacological interventions can be optimized without any visit.

Additionally, telehealth offers APRNs the opportunity to detect and treat possible adverse drug events. An example of remote monitoring is when the blood pressure fluctuates excessively or when a smartwatch detects a warning sign of an abnormal heart rhythm in real time (Haleem et al., 2021). If patients experiencing dizziness, nausea, or swelling because of the progestin they are filling report their side effects to telemedicine portals, the APRN can easily manage it. Early intervention and medication adjustments can be made to address worrying trends as are sent by wearables and smart medication devices to APRNs (Haleem et al., 2021). Adverse reactions are responded to before becoming complicated, and the hospitalization length is reduced.

Impact of Remote Patient Monitoring on Pharmacological Interventions and APRN Practice

The integration of APRN practice with remote patient monitoring solidifies APRNs as valuable agents of pharmacological interventions by increasing the delivery of more personalized and timely care. With real-time patient data, APRNs can readily alter dosages, change their medications or implement supportive therapies to improve the treatment results (Serrano et al., 2023). Thus, patients get more specific and responsive medication management, their quality of life is increased, and their health outcomes are improved (Serrano et al., 2023).

In addition, remote patient monitoring is a means to streamline the workflows of APRNs and broaden access to care. This enables an APRN to see more high-risk or complex patients in succession without sacrificing the requisite in-person visits needed to best manage others in continuous care through virtual platforms. This technology also supports interdisciplinary collaboration because APRNs’ monitoring data could be shared with physicians, pharmacists, and other healthcare providers and used to monitor coordinated care (Serrano et al., 2023). It can be easily distributed, especially to those living in rural or underserved areas, as a tool for monitoring patients remotely, which facilitates the access of the many who have limited options to reach medical facilities. The use of telemedicine and remote monitoring technologies combined with clinicians’ access through PRNs to obtain proactive and data driven decision making around pharmacologic care, makes APRNs the final ones. By using these tools, the APRN increases patient safety, effective healthcare, medication adherence and the optimal therapeutic response thus reducing the adverse effects (Serrano et al., 2023).