NURS 6630 Week 8 Assignment 2 – Step-by-Step Guide
The first step before starting to write the NURS 6630 Week 8 Assignment 2: Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult, 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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2
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 NURS 6630 Week 8 Assignment 2 Follows:
Assessing and Treating Patients with Sleep/Wake Disorders
The DSM 5 TR recommends that when diagnosing insomnia, particular attention must be paid to symptoms that have lasted for more than three months and have caused significant challenges in the individual’s social, academic, occupational, and intellectual facets (American Psychiatric Association, 2022). These individuals, despite having the opportunity for quality sleep, still experience insomnia at least three nights each week, which is not attributable to the use of substances or any existing comorbidities (Perlis et al., 2022). The diagnosis and management of the condition is challenging as it may be mistaken for depression or anxiety, which requires the healthcare professional to take a thorough health history before reaching an accurate diagnosis.
In the case scenario, a male patient, 31 years old, has persistently experienced challenges in falling asleep and staying asleep six months since he lost his fiancé. He operates a forklift for a local chemical company, and his situation has affected his work. He has been taking diphenhydramine, but he does not like the effects of the medication the morning after consumption. He has often fallen asleep at work. He has a history of abusing opiates; he had broken his ankle and was prescribed oxycodone for the management of the pain.
In the past four years, he has not been prescribed any opiates, and he reports that he has been using alcohol to help him get to sleep, using approximately four bottles each night. The patient is alert X4, maintains good eye contact with the healthcare practitioner, and is appropriately dressed. He has intact judgment and insight. He denies experiencing any auditory or visual hallucinations. He denies any suicidal and homicidal ideations. The focus of this paper will be on selecting the most appropriate interventions for the client, assessing his response to treatment, and tailoring the interventions to address any challenges that arise during his management, considering any ethical issues that are pertinent to his case.
Decision #1: Trazodone 50 mg PO at bedtime
The initial best choice is to select a 50mg dosage of Trzodone at this point. Trazodone has been shown to have a minimal risk of dependence and addiction and has been routinely used in the management of depression and insomnia. The medication has been recommended for the management of Morbid illnesses that exist with insomnia, such as depression and anxiety.
Despite the patient not being diagnosed with depression, he experienced the death of his fiancé six months ago, which is a significant life event that increases the risk of developing depression. The onset of Insomnia occurred suddenly after the passing away of their fiancé, which shows that the significant life event led to difficulties in sleeping. Trazodone increases the concentration of serotonin in the brain, which helps to improve symptoms of depression and helps to improve mood and sleep. However, the drug has been associated with side effects such as dry mouth, headache, nausea, drowsiness, and dizziness.
Zolpidem and hydroxyzine were not selected because of their interactions with alcohol. Zolpidem should be used cautiously when dealing with individuals who have a prior history of drug and alcohol misuse. Zolpidem has been associated with the development of tolerance among patients, requiring that they use higher dosages to achieve the same effect (Edinoff et al., 2021), considering that the patient has a history of opiate abuse, it may not be a desirable option for this case. On the other hand, the long-term use of Hydroxyzine may not be desirable because its anticholinergic actions can lead to side effects such as dry mouth, urinary retention, blurred vision, and constipation (Burgazli et al., 2023).
It is expected that after the prescription of the medication, the patient will report having less trouble falling asleep and will not experience any trouble remaining asleep during the day, which will help him perform his work well. The healthcare worker needs to consider the principle of non-maleficence. The patient has a history of abusing opioids and has been using alcohol to help him fall asleep. The principle of nonmaleficence requires that the healthcare practitioner should induce any harm to the patient. Prescribing the medication while the patient is abusing alcohol may have devastating effects. The healthcare worker should inform the client about the benefits and side effects of the medication to help them make an informed decision about whether they would like the drug to be prescribed to them.
Decision #2: Decrease Trazodone to 25 mg daily at bedtime
Despite the patient responding well to the medication, he had reported experiencing a lengthy erection that lasted for up to 15 minutes. He feels embarrassed and cannot prepare adequately for work. The best intervention at this point is to decrease the dosage to 25 mg every day and administer the medication at bedtime to avoid adverse effects. Priapism has been common in patients using this medication. The medication seems to be effective since the patient has reported an improvement in the symptoms. Other factors, such as the use of alcohol, should be explored as possible risk factors for experiencing lengthy erection.
Studies have shown that patients who take alcohol while using Trazodone may be at an increased risk of developing priapism (Fagiolini et al., 2023). It is crucial for the health care worker to inform the patient of the risk of taking alcohol while using this medication so that they can make informed decisions to prevent any further complications. Due to the reported side effects of the medication, the decision to continue with the doses of 50 mg a day was not viable. Perhaps the continuation of their medication at a lower dose and changing the time of administration can help decrease the risk of developing side effects.
According to Shaha (2023), replacing trazodone with suvorexant has been linked with increased reported cases of insomnia among the patients, making the decision not viable for this case. The decision to explain to the patient that the 15-minute erection would not be described as Priapism was not explored because there was the potential that decreasing the dosage of Trazodone would help to decrease the unwanted side effects, as it already had shown to be effective in improving his symptoms.
Informing the patients of the available medication options is an important ethical and legal consideration at this point. Healthcare workers must explain to the patient that the side effects, such as a prolonged erection, are caused by the administration of the medication. Therefore, he can decide whether to continue with the medication or explore other viable options, promoting autonomy. Including patients in decision-making about matters that affect their health helps to promote adherence to the treatment plan and achievement of the expected goals and health outcomes.
Decision #3: Continue Dose. Encourage Sleep Hygiene. Follow up in 4 weeks.
The patient reports that he has been experiencing good sleep even though the dose has sometimes not been effective in helping him to sleep throughout the night. The most effective at this point is to continue with the 25mg daily dosage and follow up with the patient after four weeks. Switching to another medication when the patient has tolerated the current medication and shown significant improvements in the symptoms is not a viable option at this point. It is important to assess the patient if they have been using alcohol on the nights he does not experience quality sleep, as alcohol has been shown by Geoffroy et al. (2020) to lead to an increased risk of having poor sleep patterns that can exacerbate insomnia.
The patient should be assessed if they practice good sleep hygiene practices, such as avoiding any distractions at bedtime and going to bed early. If such poor sleep habits are present, the client should be advised to work on them, which can help to make the dosage of the medication to be effective and rule out the need to start on new medications at this point. It is expected that with good sleep hygiene, the client will have quality sleep throughout the night and decreased side effects of the medications.
There is a probability that the patient is experiencing challenges in implementing quality sleep hygiene behaviors, making it not viable to consider other options before ensuring that the existing issues have been addressed; switching to ramelteon 8mg daily at bedtime is not recommended. Despite ramelteon being an excellent medication in the management of insomnia and having fewer side effects, it will take some time for the patient to tolerate it and for the therapeutic effects to kick in; this can lead to worsening of the symptoms.
Switching to Hydroxyzine 50 mg has not been explored because, despite the medication leading to improvement in the symptoms of insomnia, it is not effective in helping the client to maintain continuous sleep throughout the night (Burgazli et al., 2023). The majority of patients have been reported to develop tolerance to the medication, which may lead to withdrawal symptoms when its use is stopped. Its antihistamine actions may lead to unwanted side effects such as drowsiness and cognitive impairments.
Patient education, at this point, is an essential ethical consideration. They should be taught about the importance of compliance with the treatment plan, how to identify any potential side effects, and when to report to the hospital. They should also be educated on basic sleep hygiene practices and how to implement them to help them experience quality sleep and avoid complications from insomnia that may affect different aspects of their lives.
Conclusion
The initial recommendation for the management of insomnia in this client is to start Trazodone 50mg PO at bedtime. With its antidepressant properties, this medication is associated with minimal dependence and the risk of addiction. The dual role of the medication in the management of depression and insomnia is effective for this client as he has recently experienced a significant loss of his loved one six months ago. Experiencing prolonged erections lasting up to 15 minutes after using the initial dosage of Trazodone calls for a change in the management plan to reduce the dose to 25 mg daily at bedtime.
This decision is grounded on its potential to reduce the side effects and increase the effectiveness of the dose in improving sleep patterns. This choice has also been informed that the patient has reported an increase in the quality of sleep they are experiencing. Continuing the dose and advising the client to consider effective sleep hygiene practices is evidence-based, as these practices have been shown to increase the quality of sleep experienced by the patients when combined with effective medications like trazadone at effective doses.
Healthcare workers should be vigilant in educating their clients about the potential benefits, side effects, and the importance of adhering to the treatment plan. It is also essential to monitor the progress of the patients and change the plan of management if the need arises to promote adherence and achievement of long-term positive healthcare outcomes. All the recommendations are supported by evidence from clinical guidelines on the management of insomnia, considering the history of the client’s symptoms and their response to the administered medications.
NURS 6630 Week 8 Assignment 2 References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Burgazli, C. R., Rana, K. B., Brown, J. N., & Tillman, F. (2023). Efficacy and safety of hydroxyzine for sleep in adults: Systematic review. Human Psychopharmacology: Clinical and Experimental, 38(2). https://doi.org/10.1002/hup.2864
Edinoff, A. N., Wu, N., Ghaffar, Y. T., Prejean, R., Gremillion, R., Cogburn, M., Chami, A. A., Kaye, A. M., & Kaye, A. D. (2021). Zolpidem: Efficacy and side effects for insomnia. Health Psychology Research, 9(1). https://doi.org/10.52965/001c.24927
Fagiolini, A., González-Pinto, A., Miskowiak, K. W., Morgado, P., Young, A. H., & Vieta, E. (2023). Role of trazodone in treatment of major depressive disorder: an update. Annals of General Psychiatry, 22(1), 1–10. https://doi.org/10.1186/s12991-023-00465-y
Geoffroy, P. A., Lejoyeux, M., & Rolland, B. (2020). Management of insomnia in alcohol use disorder. Expert Opinion on Pharmacotherapy, 21(3), 297–306. https://doi.org/10.1080/14656566.2019.1705279
Perlis, M. L., Posner, D., Riemann, D., Bastien, C. H., Teel, J., & Thase, M. (2022). Insomnia. The Lancet, 400(10357), 1047–1060. https://doi.org/10.1016/s0140-6736(22)00879-0
Shaha, D. (2023). Insomnia management: A review and update. The Journal of Family Practice, 72(06 Supp). https://doi.org/10.12788/jfp.0620
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.
Can you provide examples of a well-structured 500-word essay?
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.
What are some effective strategies for writing a personal essay of 500 words?
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.
What topics are suitable for a concise 500-word essay?
Choose topics you can thoroughly address within the word limit, such as a personal anecdote, a critical analysis of a poem, or a focused argument on a singular point or issue.
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.
