Assignment: Week 8 For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders
Assignment: Week 8 For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders
For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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Assignment: Week 8 For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders
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To Prepare:
- Review the interactive media piece assigned by your Instructor.
- Reflect on the patient’s symptoms and aspects of the disorder presented in the interactive media piece.
- Consider how you might assess and treat patients presenting with the symptoms of the patient case study you were assigned.
- You will be asked to make three decisions concerning the diagnosis and treatment for this patient. Reflect on potential co-morbid physical as well as patient factors that might impact the patient’s diagnosis and treatment.
*******PLEASE YOU MUST WATCH REQUIRED MEDIA IN ORDER TO CORRECTLY COMPLETE ASSIGNEMENT***
REQUIRED MEDIA
- Walden University, LLC. (Producer). (2019b). Alzheimer’s diseaseLinks to an external site.[Interactive media file]. Baltimore, MD: Author.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat Alzheimer’s disease.
- Walden University, LLC. (Producer). (2019e). Complex regional pain disorderLinks to an external site.[Interactive media file]. Baltimore, MD: Author. http://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_07/index.html
- (THIS IS THE INTERACTIVE MEDIA LINK YOU MUST GO TO IN ORDER TO COMPLETE ASSIGNMENT!!!!!! DO NOT SKIP THIS PLEASE
*MY LAST NAME STARTS WITH P-Z SO THIS IS MY ASSIGNED DECISION POINT (If your last name begins with P – Z)
**Decision Point 3: Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed***
- Click on your respective decision option. This will provide you ADDITIONAL details on the case based on your selection and from there you will need to select a SECOND treatment option, providing appropriate clinical justification. Click on your second option.
- Based on the results from the second option, you will select the THIRD option, click on that option and provide clinical justification for the third option.
As you can see, this case is pretty involved. You have to assess each of your three treatment options, evaluating the results of each option, and what you would decide to do next providing appropriate clinical justification.
In this interactive media piece, you will engage in a set of decisions for prescribing and recommending pharmacotherapeutics to treat complex regional pain disorders.
Disorders of The Nervous System
- Reflect on the comprehensive review of disorders of the nervous system and think about how you might recommend or prescribe pharmacotherapeutics to treat these disorders. (15m)
- Speed Pharmacology. (2019). Drugs for Parkinson’s Disease (Made Easy)Links to an external site.[Video]. https://www.youtube.com/watch?v=Z84iypHdftQ&t=13s
Note: This media program is approximately 9 minutes.
- Speed Pharmacology. (2019). Pharmacology- Drugs for Alzheimer’s Disease (Made Easy)Links to an external site.[Video]. https://www.youtube.com/watch?v=euzRPrvrwj0&t=31s
Note: This media program is approximately 7 minutes.
You will have to evaluate those treatment options and determine if you would make any changes to the regimen in terms of the medication, dosage, and evaluation of adverse effects and or contraindications that could complicate treatment.
(As you start your decision tree assignment in Week 6 and complete by Day 7 for Week 8, please keep in mind on how to clinically justify your choices for treatment options for patients.
Always think through the patient’s current medications and their past medical history to evaluate new therapies.
When evaluating new therapies, think about whether the patient has any contraindications to treatment, potential drug interactions, and the safety profile of the drug. Are there any medical conditions that may prevent the patient from taking the new medication?
Finally, consider counseling points for the patient. What are the things you would inform the patient to monitor for while on therapy? As a clinician, are there specific labs or assessments you would need to complete at baseline, during, or after therapy?
Hope this helps as you evaluate the treatment options for your patients!)
| Assignment: Decision Tree for Neurologic and Musculoskeletal Disorders |
If your last name begins with P – Z Decision Point 3: Neurontin 300 mg po BEDTIME with weekly increases of 300 mg per day to a max of 2400 mg if needed |
ASSIGNMENT:
Write a 1- to 2-page summary paper that addresses the following:
- Briefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented.
- Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.
- What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.
- Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
***PLEASE PROVIDE AT LEAST 4 CREDIBLE SOURCES***
- NURS_6521_Week8_Assignment_Rubric
| NURS_6521_Week8_Assignment_Rubric | ||||||
| Criteria | Ratings | Pts | ||||
| This criterion is linked to a Learning OutcomeBriefly summarize the patient case study you were assigned, including each of the three decisions you took for the patient presented. Be specific. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeBased on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources. |
|
25 pts | ||||
| This criterion is linked to a Learning OutcomeWhat were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeExplain any difference between what you expected to achieve with each of the decisions and the results of the decisions in the exercise. Describe whether they were different. Be specific and provide examples. |
|
20 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
|
5 pts | ||||
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list. |
|
5 pts | ||||
| Total Points: 100 | ||||||
A Sample Of This Assignment Written By One Of Our Top-rated Writers
Decision Tree for Neurological and Musculoskeletal Disorders
The case study depicts a 43-year-old male with a seven-year history of chronic pain after he sustained a fall and walks with crutches. His family physician suspected he has psychological pain and referred him for psychiatric evaluation. He was diagnosed with complex regional pain syndrome (CRPS). ). The purpose of this paper is to discuss the intervention taken and explore if they are supported by evidence-based literature.
Decisions Taken
The first decision was initiating Neurontin (gabapentin) 300 mg orally at BEDTIME with weekly increases of 300 mg per day to a max of 2,400 mg if needed. In the second decision, Neurontin was discontinued and the patient was initiated on Zoloft (sertraline) 50 mg orally daily and titrated at weekly intervals to a dose of 200 mg. In the third decision, Wellbutrin (bupropion) XL 150 mg orally in the MORNING was added. In addition, the client was prescribed a short course (2 weeks) of Ativan to relieve anxiety.
Whether the Decisions Provided Were Supported By the Evidence-Based Literature
Initiating the patient on Neurontin is supported by evidence-based literature, which shows that the drug provides adequate pain relief in persons with postherpetic neuralgia and peripheral diabetic neuropathy. A study by Wiffen et al. (2018) found Neurontin to have an outcome of at least a 50% decrease in pain severity, which in turn led to improved pain-related symptoms like fatigue, sleep disturbance, and depression. The recent guidelines from the National Institute for Health and Care Excellence (2020) recommend using sertraline among other antidepressants to manage primary chronic pain. Thus, starting the patient on Zoloft in the second decision is supported by the literature. Wellbutrin was added to manage erectile dysfunction, which is a common side effect of SSRIs like Zoloft. According to Atmaca (2020), bupropion can be beneficial for SSRI-induced sexual dysfunction. It leads to improved desire, arousal, and pleasure in persons with SSRI-induced sexual dysfunction. Furthermore, adding Ativan is supported by Strawn et al. (2018), which indicates that the drug is effective in relieving anxiety in adults.
What Were You Hoping To Achieve With the Decisions
In the first decision, the PMHNP hoped Neurontin would alleviate the patient’s pain by at least half to about 3/10 within four weeks of treatment (Wiffen et al., 2018). In the second decision, the PMHNP hoped that changing treatment from Neurontin to Zoloft would alleviate the patient’s pain to an acceptable degree since the initial drug was ineffective (NICE, 2020). In the third decision, I hoped that adding Wellbutrin would correct the erectile dysfunction caused by Zoloft and that Ativan would alleviate the reported anxiety.
Difference between What You Expected and the Results of the Decisions
The difference between the expected and outcome of pain alleviation in decision one can be attributed to a slower onset of action since it can take more than a month to see improvements in some patients. In the second decision, the expected outcome and results were similar as the patient’s pain alleviated to a manageable level. This can be attributed to the action of Zoloft in relief of neuropathic pain.
Conclusion
The patient was initiated on Neurontin 300 mg, but it was ineffective in alleviating pain. The treatment was changed to Zoloft, which alleviated the pain to a manageable level. In the last decision, Wellbutrin and Ativan were added to the treatment to relieve erectile dysfunction and anxiety, respectively.
References
Atmaca, M. (2020). Selective Serotonin Reuptake Inhibitor-Induced Sexual Dysfunction: Current Management Perspectives. Neuropsychiatric disease and treatment, 16, 1043–1050. https://doi.org/10.2147/NDT.S185757
Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy for generalized anxiety disorder in adult and pediatric patients: an evidence-based treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070. https://doi.org/10.1080/14656566.2018.1491966
National Institute for Health and Care Excellence. (2020). Chronic pain in over 16s: assessment and management www.nice.org.uk/guidance/gid-ng10069/documents/draft-guideline
Wiffen, P. J., Derry, S., Bell, R. F., Rice, A. S., Tölle, T. R., Phillips, T., & Moore, R. A. (2018). Gabapentin for chronic neuropathic pain in adults. The Cochrane Database of systematic reviews, 6(6), CD007938. https://doi.org/10.1002/14651858.CD007938.pub4
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Assignment: Week 8 For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module’s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders
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