NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women – Step-by-Step Guide
The first step before starting to write the NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women, 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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women
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. 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.
NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women Instructions
After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.
In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman. Have a look at NRNP 6675 Week 10 Assignment – Nurse Practitioner Professional Career Planner.
To Prepare:
Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5 to use.
Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved off-label drug, and one nonpharmacological intervention for treating the disorder in that population.
By Day 3 of Week 9
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.
NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women Example 1
Disruptive Mood Dysregulation Disorder in Pregnant Women
Extreme and persistent anger and temper outbursts characterize Disruptive Mood Dysregulation Disorder (DMDD). DMDD can greatly influence everyday functioning and social relationships and, therefore, requires prompt management.
Pharmacological and Non-pharmacological Interventions
FDA-approved drug: Sertraline – For pregnant women with DMDD, this selective serotonin reuptake inhibitor (SSRI) is generally safe and licensed to treat major depressive disorder. It helps to lessen irritability and stabilize mood (Gilliam et al., 2019).
Off-label drug: Lamotrigine – Lamotrigine is occasionally used off-label to treat mood problems, even though it is not FDA-approved for DMDD specifically. A study on pregnant, epileptic women who took this drug showed a comparatively reduced risk of birth abnormalities (Naguy & Al-Enezi, 2019). It also has mood-stabilizing effects.
Non-pharmacological intervention: Cognitive-Behavioral Therapy (CBT) is a recognized psychotherapeutic strategy for treating mood problems. It can be modified to help pregnant people with DMDD recognize and alter negative thought patterns and create coping mechanisms for emotional control without needing medication.
Risk Assessment
A thorough risk assessment is essential when choosing a course of treatment for pregnant women with DMDD to protect the health and safety of both the mother and the growing fetus. Improved mood stability and less irritability may result from using FDA-approved medications like Sertraline, improving the woman’s overall quality of life during pregnancy. However, certain risks should be considered, such as possible side effects, including nausea or shifts in sleeping patterns. SSRI use may also be connected with a modest incidence of birth abnormalities, necessitating cautious monitoring.
The benefits of the off-label medication Lamotrigine may include mood stability, but due to DMDD’s lack of FDA approval, caution is advised. Although findings suggest a low risk of birth abnormalities, the lack of data on its safety during pregnancy must be carefully considered. It is crucial to balance the potential advantages of using off-label drugs against the unidentified hazards and risks that could arise.
The risk evaluation must consider non-pharmacological therapies like Cognitive-Behavioral Therapy (CBT), which may offer benefits without imposing drug-related risks. To balance optimizing treatment benefits and limiting possible risks for the mother and the growing baby, collaborative decision-making, including healthcare providers, the pregnant woman, and her support network, is crucial (Zemestani & Fazeli Nikoo, 2019).
Practice Guidelines
There are clinical practice guidelines for DMDD, which can be useful for guiding treatment choices. Usually, the best available data from studies and consensus among experts serve as the foundation for these recommendations. Due to their well-established efficacy and safety profile, they may advise FDA-approved drugs like Sertraline as a first-line treatment for DMDD in pregnant women.
Guidelines may also advise against using off-label medications like Lamotrigine during pregnancy due to the limited knowledge available on their safety. However, since there are no particular recommendations for treating DMDD in pregnant women, it would be necessary to look at more information from studies on the use of drugs during pregnancy, potential dangers and benefits, and non-pharmacological therapies like CBT. Making informed treatment choices for this population requires consulting with psychiatric and maternal-fetal medicine experts.
References
Gilliam, F. G., Black, K. J., Carter, J., Freedland, K. E., Sheline, Y. I., Tsai, W., & Lustman, P. J. (2019). A trial of sertraline or cognitive behavior therapy for depression in epilepsy. Annals of Neurology, 86(4), 552–560. https://doi.org/10.1002/ana.25561
Naguy, A., & Al-Enezi, N. (2019). Lamotrigine Uses in Psychiatric Practice. American Journal of Therapeutics, 26(1), e96–e102. https://doi.org/10.1097/mjt.0000000000000535
Zemestani, M., & Fazeli Nikoo, Z. (2019). Effectiveness of mindfulness-based cognitive therapy for comorbid depression and anxiety in pregnancy: A randomized controlled trial. Archives of Women’s Mental Health, 23. https://doi.org/10.1007/s00737-019-00962-8
NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women Example 2
ZOLOFT is an FDA-approved medication for major depressive disorder. It is used to treat panic attacks, obsessive-compulsive disorder, post-traumatic stress disorder, and premenstrual syndrome. It can help improve sleep, appetite, and energy levels that can restore interest in daily living. For off-label medications, doxepin is often prescribed for depression and anxiety (Hardy & Reichenbacker, 2019). It is in the class of medications known as tricyclic antidepressants.
It works by boosting the levels of certain natural chemicals in the brain that are necessary for mental equilibrium. Doxepin can also be taken as a pill to help with insomnia. Cognitive-behavioral therapy (CBT) is a safe and effective treatment for a generalized anxiety disorder during pregnancy.
Risk and Benefit Assessment
The main risk for Zoloft is that it can cause congenital disabilities in children. These defects include atrial septal defects, cleft palate, and omphalocele. The benefit is that the medication raises the amount of serotonin in the brain Cuomo et al. 2918). As the level of serotonin increases, so does the patient’s mood. Patients, therefore, experience improvements in appetite, sleep, mood, and energy levels.
Doxepin works on the central nervous system to increase the levels of various chemicals in the brain. The medication can improve energy levels and sleep for patients (Akmasi & Meza, 2019). The risk is that it may cause a condition that affects the heart rhythm and fainting symptoms that require medical attention immediately.
Clinical Practice Guidelines
The treatment of depression necessitates a thorough examination and accurate diagnosis. The evaluation must be based on a complete medical history, a thorough physical examination, and a thorough mental state examination (Gautam et al., 2017). All sources, especially the family, must be used to gather information about the past. The diagnosis must be documented using the most up-to-date diagnostic criteria.
References
Almasi, A., & Meza, C. E. (2019). Doxepin. https://europepmc.org/article/NBK/nbk542306
Cuomo, A., Maina, G., Neal, S. M., De Montis, G., Rosso, G., Scheggi, S. & Fagiolini, A. (2018). Using sertraline in postpartum and breastfeeding: balancing risks and benefits. Expert Opinion On Drug Safety, 17(7), 719-725. https://doi.org/10.1080/14740338.2018.1491546
Gautam, S., Jain, A., Gautam, M., Vahia, V. N., & Grover, S. (2017). Clinical practice guidelines for the management of depression. Indian Journal Of Psychiatry, 59(Suppl 1), S34.
Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactation. Archives of Psychiatric Nursing, 33(3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001
NRNP 6675 Week 9 Discussion: Prescribing for Older Adults and Pregnant Women Example 3
Generalized Anxiety Disorder (GAD)
A prevalent mental health condition known as generalized anxiety disorder (GAD) is defined by unwarranted and irrepressible worry about many different elements of life. Physical symptoms, including muscle tension, restlessness, and sleep difficulties, are also frequently present. The guidelines for GAD treatment in older persons will be the main topic of this study. GAD can significantly impact the quality of life in this population; hence, effective therapies are essential. FDA-approved pharmaceuticals, drugs taken off-label, and non-pharmacological therapy are the main treatments for GAD. This essay will offer suggestions for each category, consider risk assessment, discuss the availability of clinical practice guidelines, and cite reliable academic sources to support the recommendations.
FDA-Approved Medication
The class of medicines known as Selective Serotonin Reuptake Inhibitors (SSRIs) stands out for the pharmacological aspect of treating GAD in older persons. Paroxetine (Paxil), one of these SSRIs, is suggested. It has been proven successful in easing anxiety symptoms in senior citizens. Due to their efficacy and often manageable adverse effect profile, SSRIs are considered a first-line treatment for GAD in older persons (Yohannes, Jin & Kunik, 2022). However, it is crucial to consider any hazards, particularly in a population with multiple comorbidities. Examples of such risks include the increased risk of falls brought on by dizziness and the potential for drug-drug interactions.
Buspirone is an off-label drug alternative that may be considered for treating GAD in older persons in addition to FDA-approved drugs. Buspirone has proven adequate and suitable tolerability in older persons with anxiety disorders despite not being FDA-approved, particularly for GAD (Garakani et al., 2021). Buspirone is particularly appealing since, in contrast to benzodiazepines, which can be more problematic in older populations, it has a lower risk of dependence and withdrawal. However, possible adverse effects like nausea, headaches, and vertigo should be closely watched.
Non-pharmacological approaches are essential in controlling GAD in older persons because they complement pharmacological therapies. A well-respected non-pharmacological technique is cognitive-behavioral therapy (CBT), which comes highly recommended. CBT is a valuable alternative for long-term symptom alleviation and enhanced coping abilities since it focuses on recognizing and correcting maladaptive thought patterns and behaviors linked to anxiety (Ellard, Bentley, Maimone & Uribe, 2023). The availability of certified CBT therapists may be restricted in some areas even though CBT has many advantages over medicine, including reduced chances of side effects.
Risk Assessment
In order to guide decision-making, it is crucial to undertake a thorough risk assessment when weighing the advantages and disadvantages of various Generalized Anxiety Disorder (GAD) therapy choices in older persons. The benefits of the FDA-approved drug Paroxetine (Paxil) include its demonstrated effectiveness in lowering anxiety symptoms, enhancing quality of life, and increasing functional ability in older persons (Yohannes, Jin & Kunik, 2022). In comparison to more traditional antidepressants like tricyclic antidepressants, SSRIs often have a more favorable side effect profile, which makes them a good option. However, potential dangers should be considered, particularly in older persons with several comorbidities, such as an increased risk of falls due to dizziness, gastrointestinal problems, and the potential for drug-drug interactions. These possible adverse effects should be carefully examined as a portion of the risk valuation, paying close regard to the patient’s medical history, existing medications, and personal tolerance.
Contrarily, the off-label medication buspirone has several advantages, including its efficiency in lowering anxiety symptoms without the danger of side effects associated with benzodiazepines, such as drowsiness and dependence. Buspirone may also be less likely to cause falls, which is essential to consider in older persons since they are more prone to sustaining injuries from falls. Buspirone does, however, carry specific possible hazards, such as unpleasant side effects like headaches, nausea, and dizziness. Although it has a reduced risk of dependence than benzodiazepines, it could not work as quickly to treat acute anxiety symptoms. Therefore, considering each patient’s unique needs and preferences, the risk assessment for buspirone should compare these potential adverse effects against its advantages.
Existence of Clinical Practice Guidelines
When choosing a course of management for older persons with GAD, healthcare professionals can use the available clinical practice guidelines. To explicitly address the management of GAD among the more aging adult population, the American Geriatrics Society (AGS) and the American Association for Geriatric Psychiatry (AAGP) have collaborated to issue new consensus statements. This advice for healthcare workers is supported by evidence and comes from a well-respected and reliable source.
By adhering to these clinical practice recommendations, healthcare professionals can be sure that their treatment choices are supported by research and consistent with accepted best practices for treating GAD in older persons. These recommendations offer a framework for providing high-quality care adapted to the particular requirements of older adults with GAD, ensuring that their treatment programs are efficient and secure.
The use of Selective Serotonin Reuptake Inhibitors (SSRIs) in treating GAD in older persons is one of the noteworthy recommendations from these clinical practice guidelines. That is consistent with the suggestion made in this paper that Paroxetine (Paxil) be used as a drug that has FDA approval. Due to their shown efficacy and generally benign side effect profile, the recommendations encourage using SSRIs as a first-line pharmacological treatment, which is a solid justification for including Paroxetine in the recommended course of treatment. The recommendations strongly emphasize psychotherapy, particularly CBT, as a crucial non-pharmacological management option. Given that CBT aligns with the recognized best practices indicated in the guidelines, it is essential to advocate for it as a non-pharmacological strategy for managing GAD in older persons.
References
Ellard, K. K., Bentley, K. H., Maimone, J. S., & Uribe, S. (2023). Transdiagnostic CBT for Anxiety and Depressive Disorders. In The Massachusetts General Hospital Handbook of Cognitive Behavioral Therapy (pp. 343-358). Cham: Springer International Publishing.
Garakani, A., Murrough, J. W., Freire, R. C., Thom, R. P., Larkin, K., Buono, F. D., & Iosifescu, D. V. (2021). Pharmacotherapy of anxiety disorders: current and emerging treatment options. Focus, 19(2), 222-242.
Yohannes, A. M., Jin, J. W., & Kunik, M. E. (2022). Benefit–risk assessment of psychotropic drugs in older chronic obstructive pulmonary disease patients. Drugs & Aging, 39(5), 323-332.
