1. Student will assess the needs of an elderly client within a sociocultural context and physical context by assessing their home environment. A report of findings will be submitted and presented. Use the Home evaluation checklist provided.

2. Role play the administration of an assessment and the results of assessments and evaluation (as allowed of an Occupational Therapy Assistant).

3. Develop ergonomic principles and safety procedures in order to facilitate the home modifications. List a total of 10 -15 environmental barriers or hazards that could contribute to fall and safety issues.

4. Submit and explain via PowerPoint and present an oral presentation to a classroom audience utilizing multimedia outlets

• Review practice agreements in your state. FLorida
• Identify whether your state requires physician collaboration or supervision for nurse practitioners, and if so, what those requirements are.
• Research the following:
  • How do you get certified and licensed as an Advanced Practice Registered Nurse (APRN) in your state?
  • What is the application process for certification in your state?
  • What is your state’s board of nursing website?
  • How does your state define the scope of practice of a nurse practitioner?
  • What is included in your state practice agreement?
  • How do you get a DEA license?
  • Does your state have a prescription monitoring program (PMP)?
  • How does your state describe a nurse practitioner’s controlled-substance prescriptive authority, and what nurse practitioner drug schedules are nurse practitioners authorized to prescribe?

Post a summary of your findings on your state based on the questions listed above. Explain the types of regulations that exist and the barriers that may impact nurse practitioner independent practice in your state. Be specific. Also, describe what surprised you from your research.

Running Head: SOAP NOTE

SOAP NOTE 1- DEPRESSION

Name of Instructor:

Course Title:

Due Date:

IDENTIFYING DATA

A.D is a 55-year-old Hispanic male who came to the clinic accompanied by one of his daughter due to feeling hopeless and depressed more each day, feeling muscle tension. Both are worried with this condition, and are looking for a close are of of his situation

CHIEF COMPLAINT: “I notice I feel more depressed everyday.”.

FAMILY HISTORY

Mother- passed away 2 months ago, of a Myocardial Infarction. Father alive- history of Colon cancer, patient has 1 daughter healthy with no medical history. Patient has a brother, current with diabetes mellitus type 2. No other conditions reported between those family members.

PERSONAL HISTORY

The patient equation has enjoyed good health throughout his life. He has never been troubled by anything and has been able to handle all the challenges that come his way. He has been able to establish social networks that help him during difficulties. However, the patient in question has been living an isolated life. There is a possibility he has not been getting the support he had before. This possibly worsened his mental status resulting in depression.

MEDICAL HISTORY

That was a point in the past when the patient broke his arm in a minor accident. It is an event that it’s believed to have caused him stress. This is because it made him hard to work for himself as he is used to. His absence from the workplace could have contributed to his feeling of depression. As a person known to love his work, this accident likely caused the depression case in question.

SOCIAL HISTORY

The patient is not a social person. He prefers to be alone in the majority of cases. He is also known to be a private person with his issues. It is suspected there is a possibility that he is undergoing an issue he is afraid to communicate with others (Palgi, Shrira, Ring, Bodner, Avidor, Bergman & Hoffman, 2020). This is why the patient must be approached with care to diagnose his issue and medical conditions.

OCCUPATIONAL HISTORY

Deficient in question has been productive in most of his years. His occupation has been more office-based; therefore, he has spent most of his time indoors. There are a few scenarios where the patient was subjected to fieldwork. As a less going person, the feedback could have gone better with him. He was pushed to the Limit, and at some point, he felt like quitting his job.

PAST PSYCHIATRIC HISTORY

The best psychiatric history of the patient is shallow and needs more information. The limited data provided makes it difficult to ascertain a psychiatric history.

HISTORY OF PRESENT ILLNESS

Patient has been depressed for a couple of months. The patient wanted to seek medical advice and support, but the current case of depression has not allow him. Today came accompanied by his daughter, due to as per patient, he is aware that every day he feels more depressed, hopeless, feeling with muscle tension and constantly. Patient denied any suicidal ideation, but report feeling really bad. This is why the patient needs further medical attention to manage his medical condition. The patient is in direct need of help because of his disturbed mental status. This is why his case has to be considered objectively and treated as the cause of his depression.

IMPRESSIONS

From the diagnosis, the patient seems ready for any medical treatment, he will be subjected to. If it were therapies, the patient would be ready to go through all necessary therapies to recover from his mental status (Strawbridge, Carter, Marwood, Bandelow, Tsapekos, Nikolova & Young, 2019). If the patient has to be treated through medication, he is also ready for all the processes.

PRIMARY DIAGNOSIS

— Depression : A group of conditions associated with the elevation or lowering of a person’s mood. A mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life.

According to the DSM5 (American Psychiatric Association, 2013). Patient presents with more than five of the following symptoms:

Combination of biological, psychological, and social sources of distress.

The persistent feeling of sadness or loss of interest.

Changes in sleep, appetite, energy level, concentration, daily behavior, or self-esteem.

Depression can also be associated with thoughts of suicide.

Anxiety may occur as a symptom of clinical (major) depression.

Feeling muscle tension as cause of the stress caused the depression.

Isolation person don’t involve in social activities.

DIFFERENTIAL DIAGNOSIS

1. Social Anxiety Disorder

Focus of the fear involves concerns over being embarrassed and negatively evaluated by others.

Panic sensations are cued by anticipated and actual exposure to social and evaluative situations.

2. Separation anxiety disorder: Anxiety sensations are cued by perceived and actual separation from family members, rather than fears of being negatively evaluated or criticized by others.

3. Panic Disorder: High anticipatory anxiety across various social situations. Recurrent, unexpected panic attacks in the absence of phobic cues. Patients may interpret their intense physical symptoms as threatening or dangerous.

PLAN:

Labs will be drawn: -TSH, -CBC. Exams: ECG.

Safety: -Patient must not be alone, due to suicide risk. This patient has had depression for months. If his sad state persists, the patient can begin thinking about committing suicide.

Pharmacological Treatment: Celexa to 60 mg daily which patient states she has used in the past with good results. The possible side effects are: Headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigue, or having trouble sleeping (insomnia).

REFERENCES:

Palgi, Y., Shrira, A., Ring, L., Bodner, E., Avidor, S., Bergman, Y., … & Hoffman, Y. (2020). The loneliness pandemic: Loneliness and other concomitants of depression, anxiety and their comorbidity during the COVID-19 outbreak.  Journal of affective disorders,  275, 109-111.

Strawbridge, R., Carter, B., Marwood, L., Bandelow, B., Tsapekos, D., Nikolova, V. L., … & Young, A. H. (2019). Augmentation therapies for treatment-resistant depression: systematic review and meta-analysis.  The British Journal of Psychiatry,  214(1), 42-51.

SCHOLARLY ACTIVITY SUMMARY 2

2

SCHOLARLY ACTIVITY SUMMARY

Marian Alli

Grand Canyon University

Scholarly Activity Summary

Professor Mary Sizemore

May 12, 2022.

Scholarly Activity Summary

During my vacation, I participated in a quality improvement committee meeting for a community-based group. A quality improvement committee consists of a group of people who are tasked with the job of ensuring that the processes of a company are continually improved (Vessey et al., 2021). Additionally, the participants of this panel hoped to fix numerous issues inside the business and devise strategies for progress. The group included representatives from all relevant parties including beneficiaries. I attended the event in my capacity as a project beneficiary who also happens to be the target market. Because I work as a nurse, the exercise helped me to improve my understanding of how to recognize a concern or a risk and devise strategies for enhancing the overall quality of care.

A number of issues needed to be addressed by the quality improvement committee. First, there was a worry about beneficiary engagement in programs. Beneficiaries were apprehensive about participating in projects that were intended to help them. It posed a dilemma because it jeopardized the program’s effectiveness as well as the long-term viability of the intervention’s results. The issue would have ramifications for both the implementing partners and even the program beneficiaries. This is because the project implementation group will, or may not reach their aim and the beneficiaries will continue suffering as a result of this. One of the key issues that the panel had to deal with was a misalignment in communication between the benefactors and the program managers. It is truly a regret that most of the beneficiaries were unable to comprehend the jargon utilized by the officials. It may have even led to the first issue. Furthermore, a lack of comprehension led in a lack of effective implementation of the programs. There have been reports that the officials speak in technical language that the beneficiaries are not familiar with. As a result, inadequate communication occurred, which was a significant component to the project’s failure.

In order to resolve the issue, the committee established an effective communications network that would suit all parties while also ensuring cooperation and integration of actions. The staffs were informed of their objectives, which included implementing tactics that would be beneficial to them when interacting with beneficiaries. The team was energized and eager to succeed. At the end of the program, participants were informed about the advantages of participating in programs.

The panel identified the following competencies as being necessary for it to enhance the standard of performance:

• Establishing realistic expectations for work

• Collaboration, cooperation, and effective communications

• Establishing a work group of employees

As a certified nurse, I have learnt that in order to make sure that a project is effective, everyone involved must have a mutual understanding of what is being done. When it comes to other professions, nurses and clinicians must work together to develop a shared understanding of the patient’s contributions to treatment so as to ensure that the patient’s contributions are effective. I also learned that while tackling a specific problem, it is critical to have a wide picture of the situation and build a remedy that considers other elements that may have an indirect impact on the problem.

Reference

Vessey, J. A., Wentzell, K., Wendt, J., & Glynn, D. (2021). DNP scholarly projects: Unintended consequences for academic-practice partnerships.  Journal of Professional Nursing, 37(3), 516-520.  https://doi.org/ 10.1016/j.profnurs.2021.03.007

For this Discussion, you select a topic that has both legal and ethical implications for PMHNP practice and then perform a literature review on the topic. Your goal will be to identify the most salient legal and ethical facets of the issue for PMHNP practice, and also how these facets differ in the care of adult patients versus children. Keep in mind as you research your issue, that laws differ by state and your clinical practice will be dictated by the laws that govern your state.

• Select one of the following ethical/legal topics:
  • Autonomy
  • Beneficence
  • Justice
  • Fidelity
  • Veracity
  • Involuntary hospitalization and due process of civil commitment
  • Informed assent/consent and capacity
  • Duty to warn
  • Restraints
  • HIPPA
  • Child and elder abuse reporting
  • Tort law
  • Negligence/malpractice
• In the Walden library, locate a total of four scholarly, professional, or legal resources related to this topic. One should address ethical considerations related to this topic for adults, one should be on ethical considerations related to this topic for children/adolescents, one should be on legal considerations related to this topic for adults, and one should be on legal considerations related to this topic for children/adolescents.
• Briefly identify the topic you selected. Then, summarize the articles you selected, explaining the most salient ethical and legal issues related to the topic as they concern psychiatric-mental health practice for children/adolescents and for adults. Explain how this information could apply to your clinical practice, including specific implications for practice within your state. Attach the PDFs of your articles.