NRNP 6635 Week 8 Assignment – Step-by-Step Guide
The first step before starting to write the NRNP 6635 Week 8 Assignment: Assessing And Diagnosing Patients With Substance-Related And Addictive Disorders, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.
How to Research and Prepare for NRNP 6635 Week 8 Assignment
The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility.
Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.
How to Write the Introduction for NRNP 6635 Week 8 Assignment
The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.
How to Write the Body for NRNP 6635 Week 8 Assignment
The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.
How to Write the In-text Citations for NRNP 6635 Week 8 Assignment
In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:
The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.
How to Write the Conclusion for NRNP 6635 Week 8 Assignment
When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.
How to Format the Reference List for NRNP 6635 Week 8 Assignment
The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded, in sentence sentence care. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication.
Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:
References
Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456
Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.
An Example NRNP 6635 Week 8 Assignment Follows:
Week 8 Assignment: Assessing And Diagnosing Patients With Substance-Related And Addictive Disorders
Subjective:
CC (chief complaint): “I have been experiencing significant pain in my elbow and headaches that do not respond well to usual pain medications.”
HPI: Daniela Petrov, a 47-year-old female, presents with chronic elbow pain and headaches. Initially, Daniela attempted over-the-counter solutions such as ibuprofen and acetaminophen without significant relief. Due to persistent symptoms, she sought stronger pain management options, including oxycodone, which was found effective. Daniela reports a history of allergies to codeine and adverse reactions to other narcotics like morphine and Demerol. She also discusses a comprehensive approach to pain management, including alternative therapies such as yoga and meditation, which provide temporary relief.
Past Psychiatric History:
- General Statement: No history of inpatient detox or rehab denied self-harm hx.
- Medications: Daniela has been prescribed various pain medications but is currently not on any due to concerns about their health impact.
- Psychotherapy: No history of psychotherapy.
- Substance Use: Daniela admits to occasional alcohol use and marijuana for headache relief, acknowledging past use of cocaine and other substances socially.
Substance Current Use and History: Denies regular use of alcohol, with consumption limited to social occasions. Daniela uses marijuana a few times a week for headache relief and has a history of recreational drug use, including past trials of ecstasy and LSD.
Family Psychiatric: She has a younger one brother three older sisters. Denied family mental health or substance use issues.
Psychosocial History: Daniela has an active social life, although recent health concerns have led to increased stress and lifestyle adjustments. She strongly values natural health and expresses reservations about pharmaceutical treatments, preferring natural supplements and remedies. She works as a part-time cashier at Save A Lot Grocery Store. Dropped out of high school in 10th grade. Sleeps 5-6 hours on average, appetite good.
Medical History:
- Current Medications: Daniela is not currently on any prescription medications due to her preference for natural health solutions. However, she occasionally uses over-the-counter pain relievers like ibuprofen for acute symptoms and takes daily supplements, including fish oil and a multivitamin.
- Allergies: Daniela is allergic to codeine, which causes severe itching and rash. She also has environmental allergies to pollen and dust, which sometimes exacerbate her respiratory symptoms.
- Reproductive History: Daniela has no children and is currently uses condoms for birth control. She has regular menstrual cycles and has not reported any reproductive health issues.
ROS:
- GENERAL: Daniela reports general fatigue associated with her chronic pain but maintains a healthy appetite. She has experienced a recent weight loss of 5 pounds over the past month, which she attributes to stress.
- HEENT (Head, Eyes, Ears, Nose, Throat): No significant headaches beyond her chronic condition. Vision is normal with corrective lenses. No hearing loss, nasal congestion, or sore throats reported.
- SKIN: Daniela describes her skin as generally clear but notes occasional eczema flare-ups on her arms, which she manages with a moisturizing lotion.
- CARDIOVASCULAR: No history of chest pain, palpitations, or edema. Daniela experiences occasional episodes of tachycardia during stressful situations.
- RESPIRATORY: Reports occasional shortness of breath during episodes of acute stress but otherwise has clear lung functions with no history of asthma or chronic bronchitis.
- GASTROINTESTINAL: Normal bowel patterns and no history of gastrointestinal diseases. Daniela mentions occasional acid reflux, for which she takes over-the-counter antacids.
- GENITOURINARY: No complaints of urinary frequency, urgency, incontinence, or other urinary problems. Normal menstrual cycles without significant dysmenorrhea.
- NEUROLOGICAL: Chronic headaches associated with her musculoskeletal pain. No history of seizures, syncope, or numbness.
- MUSCULOSKELETAL: Chronic elbow pain as previously noted. No other joint or muscle complaints. Adequate range of motion in all extremities.
- HEMATOLOGIC: No history of anemia, bleeding, or clotting disorders. Normal healing from cuts and bruises.
- LYMPHATICS: No history of enlarged nodes, no history of splenectomy or lymph node removal.
- ENDOCRINOLOGIC: No signs of diabetes, thyroid dysfunction, or other hormonal issues. Normal energy levels except when experiencing fatigue related to her pain condition.
Objective:
Physical exam:
- General Appearance: Daniela appears well-nourished and well-kept but displays signs of mild distress due to her chronic pain. Her posture and movements are cautious, likely to avoid exacerbating her elbow pain.
Vital Signs:
- Blood Pressure: 132/90 mmHg
- Heart Rate: 84 bpm, regular
- Respiratory Rate: 20 breaths per minute, unlabored
- Temperature: 98.8°F
- Oxygen Saturation: 98% on room air
- Ht 5’8 Wt 128lbs
HEENT (Head, Eyes, Ears, Nose, Throat):
- Head: Normocephalic, atraumatic
- Eyes: Pupils are equal, round, and reactive to light. Corrective lenses worn. No scleral icterus or conjunctival pallor.
- Ears: Tympanic membranes intact without erythema or effusion. Hearing grossly intact.
- Nose: Nasal mucosa moist without discharge. Septum is midline.
- Throat: Oropharynx is moist and without erythema or exudates.
Skin: Warm and dry with good turgor. No rashes or significant lesions noted. Chronic eczema patches on both arms, currently mild without acute flare.
Cardiovascular: Heart sounds are normal with a regular rhythm. No murmurs, rubs, or gallops noted. Peripheral pulses are 2+ and symmetrical in both upper and lower extremities.
Respiratory: Chest is clear to auscultation bilaterally. No wheezes, rales, or rhonchi.
Abdomen: Soft, non-tender, non-distended, with no guarding or rebound tenderness. Bowel sounds normal in all quadrants. No hepatosplenomegaly.
Musculoskeletal: Normal muscle tone and bulk throughout. Chronic tenderness noted on palpation of the left elbow without visible swelling or redness. Range of motion is slightly limited in the left elbow due to pain.
Neurological: Alert and oriented to person, place, and time. Cranial nerves II-XII are grossly intact. Sensation intact to light touch and pinprick in all extremities. Coordination tests (finger-to-nose, heel-to-shin) are normal.
Psychiatric: Mood is anxious due to chronic pain but is otherwise normal in affect. Thought processes are coherent and goal-directed. No evidence of hallucinations, delusions, or suicidal ideation.
Assessment:
Mental Status Examination:
Daniela Martinez, a 25-year-old woman, presents for evaluation due to chronic pain and associated headaches, which have notably impacted her overall functioning and psychological state. This examination aims to assess her cognitive and emotional health as part of her comprehensive healthcare evaluation.
Appearance: Daniela arrives well-dressed, appropriate to the season and setting, though she appears slightly fatigued. Her posture and movements suggest discomfort, likely linked to her chronic pain. There is no unusual attire or peculiarities in grooming that suggest neglect.
Behavior: She displays cooperative behavior throughout the evaluation. Her eye contact is adequate, though occasionally she seems distracted, which could be attributed to her physical discomfort. There are no overt signs of psychomotor agitation or retardation.
Speech: Daniela’s speech is clear, coherent, and goal-directed. The rate, tone, and volume of her speech are within normal limits, though at times, she speaks slowly, possibly due to pain.
Mood and Affect: Daniela describes her mood as “frustrated” due to her ongoing pain issues but denies feelings of hopelessness or helplessness. Her affect is somewhat constricted with limited variability, likely reflecting her current physical and emotional distress.
Thought Process and Content: Her thought processes are logical, and goal-directed without evidence of disorder in the form of loosening associations, tangentiality, or circumstantiality. Daniela denies any delusions or paranoid ideation. She expresses realistic concerns about her health and treatment options.
Perceptions: There are no reported hallucinations or deceptions. Daniela does not report any auditory or visual hallucinations, and she denies any delusional perceptions related to her physical health.
Cognitive Function: Daniela is alert and oriented to time, place, and person. Her immediate and recent memory is intact, as evidenced by her ability to recall recent events and follow the conversation. Concentration is maintained during the interview, although she occasionally appears distracted by discomfort. Abstract thinking is intact, demonstrated by her ability to describe similarities and differences and to interpret proverbs.
Insight and Judgment: Daniela exhibits good insight into her condition. She acknowledges the impact of her pain on her daily life and understands the need for medical evaluation and management. Her judgment is deemed appropriate; she makes reasonable decisions regarding her health, including seeking medical care and following prescribed treatments.
Differential Diagnoses:
1. Chronic Pain Disorder with Both Psychological and General Medical Conditions:
- Daniela reports persistent elbow pain and headaches not adequately controlled by standard analgesics. She experiences significant distress and functional impairment due to her pain, influencing her mood and daily activities (Pagé et al., 2021).
- DSM-5-TR Criteria: This diagnosis requires pain in one or more anatomical sites that is persistent and severe enough to warrant clinical attention, causing significant distress or impairment. The psychological factors must also be judged to have a role in the onset, severity, exacerbation, or maintenance of the pain.
- Pertinent Positives: Chronic pain, use of multiple pain management strategies, significant life impact.
- Pertinent Negatives: No evidence of intentional production or feigning of symptoms (as seen in factitious disorders or malingering).
2. Adjustment Disorder with Depressed Mood:
- Daniela’s onset of symptoms follows the exacerbation of her chronic pain, which she finds distressing and frustrating. Her mood is described as frustrated, and she experiences a reduced range of affect (Dragan et al., 2021).
- DSM-5-TR Criteria: Adjustment disorders are characterized by emotional or behavioral symptoms in response to an identifiable stressor occurring within three months of the onset of the stressor. These symptoms or behaviors are clinically significant, as evidenced by marked distress that is out of proportion to the severity or intensity of the stressor.
- Pertinent Positives: Clear temporal relationship between the stressor (chronic pain) and her depressive symptoms, significant distress impacting social and occupational functioning.
- Pertinent Negatives: Lack of a major depressive episode or more pervasive mood disorder symptoms.
3. Major Depressive Disorder (MDD):
- Reports feelings of frustration and chronic pain, which could contribute to depressive symptoms. However, Daniela does not report significant changes in sleep, appetite, or core depressive symptoms such as feelings of worthlessness or recurrent thoughts of death (Mosiołek et al., 2021).
- DSM-5-TR Criteria: Diagnosis requires the presence of five or more symptoms during the same 2-week period, representing a change from previous functioning; at least one of the symptoms is either depressed mood or loss of interest or pleasure.
- Pertinent Positives: Depressed mood (frustration and stress related to pain).
- Pertinent Negatives: Insufficient number of depressive symptoms and lack of significant impairment in social, occupational, or other important areas of functioning directly due to depression.
Critical-Thinking Process Leading to the Primary Diagnosis
The primary diagnosis considered for Daniela is Chronic Pain Disorder, largely due to the persistent nature of her symptoms and their significant impact on her emotional well-being and daily functioning. The decision is supported by the chronicity and severity of her pain, which does not fully respond to standard medical treatment and is associated with significant psychological distress (Pagé et al., 2021).
Adjustment Disorder with Depressed Mood was considered due to the temporal association between her pain exacerbation and mood symptoms. However, her symptoms do not exceed the typical response expected in an adjustment disorder, where the distress is out of proportion to the stressor. Major Depressive Disorder was less likely because Daniela does not meet the full criteria, particularly the requirement for five or more specific symptoms over two weeks. Her primary issues stem from the pain itself and its direct impact on her life rather than an independent depressive disorder.
Reflections:
Reflecting on the session with Daniela Martinez, several adjustments could enhance the effectiveness of her treatment and overall care. The initial evaluation provided significant insights into her medical and psychological conditions. However, a deeper exploration of her social environment, including her relationships and daily stressors, would provide a richer understanding of the context in which she experiences her chronic pain. This understanding is crucial, as social support systems and stress levels can significantly impact both the perception of pain and the success of its management.
Considering Daniela’s ethnic background and potential socioeconomic factors, a more nuanced approach could be employed. Cultural beliefs and socioeconomic status often influence perceptions of pain and treatment, which could affect Daniela’s willingness to pursue certain types of treatment or even fully disclose her symptoms. Addressing possible cultural stigmas connected to medication or therapeutic interventions could encourage a more open dialogue and enhance treatment adherence.
The integration of a multidisciplinary team from the outset, including a pain specialist, a psychologist, and perhaps a social worker, could offer a more comprehensive approach to Daniela’s care. This would not only address the physical aspects of her pain but also the psychological and social dimensions, thereby providing a holistic treatment strategy. Beyond the typical concerns of confidentiality and consent, ethical considerations should extend to respecting patient autonomy and ensuring beneficence.
Daniela’s reluctance to use certain medications, due to perceived health risks, necessitates a balanced discussion about the risks and benefits associated with her treatment options. Ensuring that Daniela feels respected in her healthcare decisions and understands all aspects of her treatment options is essential for ethical practice (Silva et al., 2020). Additionally, the potential for dependency on prescribed medications, such as oxycodone, must be addressed, emphasizing the importance of informed decision-making.
Health promotion and disease prevention strategies tailored to Daniela’s specific needs could significantly improve her quality of life. Educating her on lifestyle modifications that can mitigate pain, such as dietary changes, appropriate exercises, and stress reduction techniques like mindfulness, would be beneficial. Regular monitoring through screenings and follow-ups would also play a critical role in managing her condition and preventing the exacerbation of symptoms. Addressing risk factors associated with Daniela’s previous substance use is crucial (Silva et al., 2020).
Understanding her patterns of use and the underlying reasons for turning to substances like marijuana and cocaine, especially in the context of her pain management, is essential. Preventative strategies to avoid the misuse of prescribed medications are essential, given her history and chronic pain condition. Enhancing patient education regarding chronic pain and its impacts, integrating psychological support, and fostering a treatment environment that is sensitive to her cultural and personal values would empower Daniela. Such educational efforts should be designed to resonate with her specific background and preferences to ensure they are effective.
NRNP 6635 Week 8 Assignment References
Dragan, M., Grajewski, P., & Shevlin, M. (2021). Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic. European Journal of Psychotraumatology, 12(1), 1860356. https://doi.org/10.1080/20008198.2020.1860356
Mosiołek, A., Pięta, A., Jakima, S., Zborowska, N., Mosiołek, J., & Szulc, A. (2021). Effects of antidepressant treatment on peripheral biomarkers in patients with major depressive disorder (MDD). Journal of Clinical Medicine, 10(8), 1706. https://doi.org/10.3390/jcm10081706
Pagé, M. G., Lacasse, A., Dassieu, L., Hudspith, M., Moor, G., Sutton, K., & Choinière, M. (2021). A cross-sectional study of pain status and psychological distress among individuals living with chronic pain: the Chronic Pain & COVID-19 Pan-Canadian Study. Chronic Diseases and Injuries in Canada, 41(5) 1-6. https://doi.org/10.24095/hpcdp.41.5.01
Silva, D., Pazzinatto, M. F., Rathleff, M. S., Holden, S., Bell, E., Azevedo, F., & Barton, C. (2020). Patient education for patellofemoral pain: a systematic review. journal of orthopaedic & sports physical therapy, 50(7), 388-396. https://www.jospt.org/doi/10.2519/jospt.2020.9400
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Frequently Asked Questions (FAQs)
When approaching a 500-word essay, it’s essential to understand the nuances of this compact form of writing. These frequently asked questions will guide you through the process of crafting a concise and impactful essay.
How many pages is a 500-word essay typically?
A 500-word essay usually spans about one page if single-spaced or two pages when double-spaced, with standard margins and a 12-point font size.
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Certainly, to see the structure and flow of a well-written essay, you might want to take a look at a student’s writing guide that provides insights and examples.
Are there specific formatting guidelines for a 500-word essay?
Formatting guidelines typically involve using a legible font like Times New Roman or Arial, size 12, with double-spacing and one-inch margins on all sides. Check any specific requirements your instructor might have provided.
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For a personal essay, focus on a singular event or characteristic, ensuring your ideas are clear and you reflect on the significance of the subject matter. Use concise language and powerful imagery to maximize impact.
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How much time should you allocate to write a 500-word essay effectively?
Depending on your familiarity with the topic and writing proficiency, allocate anywhere from one to several hours for planning, drafting, and revising to ensure a well-presented essay.