What matters at the end of life and Palliative care, a  different voice in healthcare. There are two Utube videos above and you  need to pick only one and tell about it. Here is what you can report on:

a) What is the subject that the speaker is covering?

b) Does it effect the ideas that you have already about palliative care?

c) It is very important for someone to think about and be able to  converse about the subject of death and dying if they are considering  working as a nurse in this area. Why would that be?

Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Instructions:

Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.

Compare and contrast your initial posting with those of your peers.  

1. How are they similar or how are they different?

2. What information can you add that would help support the responses of your peers?

3. Ask your peers a question for clarification about their post.

4. What most interests you about their responses? 

5. Summaries at least 1 evidence based article that supports there point.

Please be sure to validate your opinions and ideas with citations and references in APA format.

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Response 1 400 words IA

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This case scenario is quite interesting since this is about a young female patient who reports multiple symptoms starting three weeks ago. This is where one researches and I believe this patient may be having an episode of major depressive disorder. I dare to come to come up with this diagnosis since she presents multiple symptoms starting about three weeks ago. Going over the multiple sections to cover this week in the “Diagnostic and Statistical Manual of Mental Disorders” I found that she presents with subjective information such as having insomnia, diminished ability to concentrate, lack of interest, weight loss due to loss of appetite, crying spells with no apparent reason. This young lady also reports feeling “tired & fatigued” and has lost interest in activities she usually enjoys. The key for me here was finding all these symptoms under the diagnostic criteria for major depressive disorder box (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). Although she does not meet all the criteria, she presents more than five symptoms with onset about three weeks ago and according to our manual symptoms must be present at least two weeks (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

Regarding her headache, and according to our book this patient can be reporting somatic complaints such as pain and aches instead of reporting an actual feeling of sadness (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

The classification of medication that I would recommend for this patient would be antidepressants. Our prescriber's book has a long list such as sertraline, paroxetine, trazodone, and escitalopram among many (Stahl, 2021). I would focus on a common drug that I see very often, and that is sertraline. Sertraline would be a good option for her since is an SSRI (selective serotonin reuptake inhibitor) (Stahl, 2021)

and I remember Dr. Kubiak mentioning that serotonin can be the usual one to blame for depression along with norepinephrine. This drug can boost the neurotransmitter serotonin and can also block the serotonin reuptake pump (Stahl, 2021)

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Response 2. 400 words sy

What diagnosis do you believe may apply to this individual?

This patient presented with symptoms of headache, fatigue, sleep disturbance, weight loss, loss of interest in activities, and frequent crying spells, all of which are indicative of major depressive disorder (MDD). Signs that a patient might be suffering from MDD include avoiding certain situations that they enjoy, inability to concentrate, and being unable to go to work due to fatigue. MDD can disrupt the patient's daily life by affecting their home, work, and social life (Salvo et al., 2022). According to the DSM-5, to be diagnosed with MDD, patients must experience 5 or more symptoms in the last week.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

Treatment for this patient will include antidepressants. Antidepressants are classified into different types based on their work and chemical structures. There are four main groups: monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs are a broad category of antidepressant medications. Since this patient has no significant past medical or psychiatric history and takes no regular medications, my recommendation would be fluoxetine 10 mg for 4 weeks, then increasing the dose to 20 mg daily if the drug is well tolerated by the patient (Arcangelo et al., 2021). SSRIs tend to be well-tolerated and are relatively cost-effective. Patients who take SSRIs exhibit fewer side effects in comparison to those who take Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Therefore, SSRIs are often considered the first line and primary choice for the treatment of mood and anxiety disorders. The class of SSRIs includes Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), and Escitalopram (Lexapro). Side effects include weight gain, insomnia, sexual dysfunction, gastrointestinal issues, and agitation (Arcangelo & Peterson, 2021).

References

Arcangelo, V. & Peterson, A. (2021). Pharmacotherapeutics for advanced practice: A practical approach. (5th ed.). Wolters Kluwer

Imiuwa, M. E., Baynes, A., & Routledge, E. J. (2023). Understanding target-specific effects of antidepressant drug pollution on molluscs: A systematic review protocol. PLoS One, 18(6) https://doi.org/10.1371/journal.pone.0287582Links to an external site.

Salvo, G. D., Bianco, M., Teobaldi, E., Maina, G., & Rosso, G. (2022). A Psychoanalytic-Derived Brief Psychotherapeutic Approach in the Treatment of Major Depression: Monotherapy Studies. Medicina, 58(10), 1335. https://doi.org/10.3390/medicina58101335

• Review the readings in the White, Dudley-Brown, and Terhaar text. With your current health care organization (psychiatric behavioral hospital), or an organization you are targeting for your DNP Project, in mind, consider the area(s) of greatest challenge with regard to translating and applying evidence for a practice change initiative, e.g., leadership, technology, collaboration, stakeholder buy-in. Focus on the relevant text chapter(s) in your Discussion preparation.
• Consider theories and best practice recommendations for addressing your identified challenges and barriers to translating and applying evidence that would support practice change initiatives.
• Reflect on the philosophy of nursing practice that you developed. Consider your role as a DNP in creating an organizational culture that embraces evidence-based practice and quality improvement. 

With these thoughts in mind …

Post an explanation of the challenges and barriers to translating and applying evidence for practice change in your target health care organization (Behavioral health hospital). Briefly explain your issue(s) of concern and describe specific approaches for addressing these challenges. Explain how you view your role as a DNP in creating a health care culture that promotes translation of evidence for quality improvement and explain why. Then, recommend actions and activities you could model and lead, including through an EBP QI project, to advocate for quality improvement and social change in nursing. Be specific and provide examples and at least 3 references.

• White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2019). Translation of evidence into nursing and healthcare (3rd ed.). Springer.
  • Chapter 15, “Interprofessional Collaboration and Teamwork for Translation” (pp. 299–314)
  • Chapter 16, “Creating a Culture That Promotes Translation” (pp. 315–334)
  • Chapter 17, “Best Practices in Translation: Challenges and Barriers in Translation” (pp. 337–346)

• Week 7: Intervention for Proposed Clinical Change Project