NURS 6630 Discussion Foundational Neuroscience

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Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.

It’s important to understand what agonist and antagonist means when answering these questions. Agonists are drugs that bind to the intended receptors and the receptors produce a response (Berg & Clarke, 2018). Compared to antagonists drugs which bind to the intended receptor but do not produce a response (Berg & Clarke, 2018). Examples of agonist drugs are opioids. They bind to opioid receptors which produce a response and block pain sensation. An example of an antagonist is naloxone because it binds to opioid receptors but does not produce a response instead blocks the response of opiods. A partial agonist is what it sounds like. Basically it binds to the targerted receptor, but can’t produce the maximal and most efficient response compared to a full agonist. Inverse agonists are drugs that bind to the same receptors as an agonist but produce the opposite response of an agonist (Berg & Clarke, 2018).

Compare and contrast the actions of g couple proteins and ion gated channels.

Both G protein coupled receptors (GPCRs) and ion gated channels are membrane-bound proteins and react to ions or molecules. GPCRs are located on the cell’s surface and convert extracellular signals into intracellular responses (Li et al., 2014). GPCRs need to interact with different proteins to produce intracellular response. Ion gated channels are pores in the cell membrane which regulate flow of ions across the plasma membrane (Li et al., 2014). These pores open and close when ions and molecules bind.

Explain how the role of epigenetics may contribute to pharmacologic action.

According to the Centers for Disease Control and Prevention (2022), epigenetics is the study of how our behaviors and the environment can cause changes that affect the way our genes work. In comparison to genetics, epigenetic changes are reversible. Our behaviors and environment cannot change a person’s genetic sequence, but they can change how our bodies read gene expression. This contributes to pharmacological actions because everyone reacts differently to medication. Certain factors, such as our actions and surroundings, can influence how receptors respond. Certain diseases are linked to epigenetic changes, and certain drugs can reverse these changes and treat the disease.

Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Understanding if a medication is an agonist or an antagonist is crucial in understanding what kind of response the medication will produce. Knowing the difference between a full agonist and partial agonist allows the prescriber to know how efficient the medication will be for the patient. Buprenorphine is a partial agonist and is used to treat addiction to pain medication but it also can treat pain. Understanding this drug is a partial agonist is important when perscribing because depending on the dose it will bind to a different receptor and produce different responses. A high dose of buprenorphine is typically used to address addiction issues and lower doses is used to treat pain. This medication is highly addictive, therefore understanding epigenetic factors is vital when prescribing it.

References

Berg, K. A., & Clarke, W. P. (2018). Making sense of pharmacology: inverse agonism and functional selectivity. The International Journal of

Neuropsychopharmacology, 21(10), 962–977.

https://doi.org/10.1093/ijnp/pyy071

Centers for Disease Control & Prevention (CDC) (2022).What is Epigenetics? Retrieved from https://www.cdc.gov/genomics/disease/epigenetics.htm

Li, S., Wong, A. H., & Liu, F. (2014). Ligand-gated ion channel interacting proteins and their role in neuroprotection. Frontiers in Cellular Neuroscience, 8, 125.

https://doi.org/10.3389/fncel.2014.00125

A psychiatric nurse practitioner’s need for a strong foundation in fundamental neuroscience is almost self-evident. To effectively treat and diagnose patients, it is necessary to understand not only the pathophysiology of psychiatric disorders, but also how medications for these disorders affect the central nervous system. These fundamental concepts of neuroscience can be difficult to grasp. As such, this Discussion is intended to encourage you to think critically about these concepts, to articulate your reasoning, and to deepen your understanding through interaction with your colleagues.

Photo Credit: Getty Images/Cultura RF

For this Discussion, review the Learning Resources and reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients.

By Day 3 of Week 2 of NURS 6630 Discussion Foundational Neuroscience

Post a response to each of the following:

Include how partial and inverse agonist functioning may affect the effectiveness of psychopharmacologic therapies in your explanation of the agonist-to-antagonist spectrum of action of psychopharmacologic drugs.

Drugs are absorbed, and each person’s mode of action is unique. Each person’s response to drugs varies, thus extra care must be given when giving prescriptions. A medication that binds to and activates a receptor to mimic the effects of the signal ligand is known as an agonist. Contrarily, an antagonist is a substance that often attaches to a receptor without activating it but instead makes the receptor less susceptible to being activated by a subsequent agonist.

Drugs can engage in a range of interactions with certain pharmacological subtypes of G-protein-linked receptors, including agonist, antagonist, inverse agonist, and partial agonist actions (Van den Houvel 2014). If the medication’s intended pharmacological effect fails because it is not bound to the receptors necessary for an effect to take place, another strategy needs to be investigated.

In order to function, neurotransmitters must carry information from a first extracellular messenger to a second intracellular messenger via transduction cascades. Ion-gated channels and G-coupled proteins are opened as a result of these cascades (Mclnemey 2014). According to Mclnemey (2014), altering the activities of G-protein-linked receptors is a frequent activity of psychiatric drugs used largely in clinical practice. This alteration can have either a therapeutic response or adverse effects.

Given medications can trigger conformational changes in these receptors to produce any state, including complete agonist, partial agonist, silent antagonist, or inverse agonist, due to the agonist spectrum that G-protein-linked receptors show. According to Stern et al., ion channels function by controlling iron firing, synaptic proteins that affect synaptic efficacy, and cytoskeletal elements (2016).

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When a gene’s function changes without its genetic coding changing, this is known as epigenetics. Epigenetics is known to produce changes in the DNA’s structure, and these changes are frequently inherited (Stern et al., 2016). Stern et al. (2016) claim that medications that impact chromatin structures can be used to treat gene modifications that also affect chromatin structure changes.

According to Van den Houvel (2014), the expression or silencing of genes may affect how some neurons function normally compared to how others do not, as well as whether or not they are indeed neurons as opposed to some other form of cell. Since certain receptors and neurons target specific genes, neurotransmission, medications, genes, and the environment all interact to control which genes are expressed or silenced as well as which genes decide the entire person.

As part of NURS 6630 Discussion Foundational Neuroscience, Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Having knowledge on how the body works is very important in prescribing medication safely and effectively. It is important to understand how certain medication bind with certain receptors and the expected effects. It is crucially important that the psychiatric mental health practitioner (PMHNP) understands the basic action of psychotropic medications with neurotransmitters as well as transmission across receptors and neurons. It is important to understand that ions-gated receptors create a fast cascade of reaction necessary in quick actions that occur with the administration of benzodiazepines in the management of anxiety.

KIt is also crucial to understand that G-protein linked acts in a slower cascade of initiation in the necessary with the management of depression If the medication is supposed to work as a blocking agent or as an activating agent while increasing the expected effect, it is very imperative to keep into consideration into all these information when prescribing medication. A good example is when you have a patient with mood changes and in this case, mood stabilizer medication is required to target the behavior. Knowing the action of mood stabilizers therefore is important because through that knowledge of understanding the patient needs and the intervention to target the need is very essential.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2 of NURS 6630 Discussion Foundational Neuroscience

Respond to at least two of your colleagues on two different days in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

Thank you for your great discussion post; you were so detailed here. I will be glad to add that neuroscience is the study of the nervous system including its structure, development, degeneration, functions both in health and in a disease state

According to Rosenthal and Burcham (2021), agonists are drugs that mimic the actions of endogenous regulatory molecules, whereas the antagonist action is produced when the drug blocks the action of the endogenous regulatory molecules. I also agree with you that every individual reacts to drugs differently; hence extra care must be considered when prescribing drugs. However, the effect a partial agonist can produce is lower than that of a full agonist. Partial agonist med they are also referred to as agonists-antagonists (Katzung et al., 2019). Epigenetics studies human behaviors and how the environment causes changes that affect them. The study of epigenetics is essential in the healthcare industry. This will help advanced nurse practitioners to understand how human behavior and environment interact to affect the genetic make-up of a person. It will also enable the providers to make the right diagnosis and also the right treatment. Understanding the agonist-to-antagonist spectrum of drugs will prevent prescription medication; however, the study will lead to the right practices. Thank you.

NURS 6630 Discussion Foundational Neuroscience References

Katzung, B. G., Hall, M. K., & Trevor, A. J. (2019). Katzung & Trevor’s Pharmacology

Examination & Board Review (12^th ed.). McGraw-Hill Education.

Rosenthal, L. D., & Burchum, J. R. (2021). Lehne’s Pharmacotherapeutics for advanced

St. Louis, MO: Elsevier practice nurses and physician assistants (2^nd ed.).

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

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Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

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Week 2 Discussion

NURS 6630 Discussion Foundational Neuroscience

What’s Coming Up in Week 3?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will explore medication adherence and strategies to help overcome non-adherence to pharmacotherapeutics. You will also complete a Quiz that addresses the content covered throughout this module.

Next Week

To go to the next week:

Week 3

Discussion week 2

COLLAPSE

Agonist-to-antagonist Spectrum of Action of Psychopharmacologic Agents

Foundational neuroscience is understanding the components of any mental condition, as well as their etiology and link to the neurological system. There are two mechanisms of action in psychophysiology agents: agonist and antagonist. Agonists link imitate a receptor as well as stimulate it. On the other hand, as much as antagonists prevent a receptor from manufacturing a specified response, they fasten on them. (Camprodon, J. A., & Roffmaan, J. L 2016). Thus, the activity of the synapse can either be increased (agonists) by psychoactive drugs, or the activity can be reduced (antagonists) by the same psychoactive drugs (Mela et al., 2020). To secure and reinforce receptors, inverse agonists work in a favorable way. Inverse agonists have both partial and full inverse antagonists. For numerous receptors, the degree of comparative understanding and innate action of the inverse agonist are what distinguish between a partial or full inverse antagonist. For opioid use, medications that can be used include; are buprenorphine (partial opioid agonist), methadone (full opioid agonist), naltrexone (opioid antagonist) and Naloxone/buprenorphine (partial opioid agonist or antagonist).

G couple proteins receptors and Ion gated channels.

G-protein coupled receptors are receptors (GPCR) on the surface of cells. The receptors act as the part of the email that receives different types of information in different distinct ways. (Camprodon, J. A., & Roffmaan, J. L 2016). The information is received like sugars, proteins, lipids, light energy and peptides. Ions can pass into the cells and out of them through ion gated channels. These ions are for examples potassium, calcium and chloride (Rollema & Hurst, 2018). The ion emission takes place at the membrane, these receptors can change the binding of the ligand in ion cells. This is what leads to the alteration of the activity or state of receptors. The neurotransmitter dopamine is an example of ion channel activity with G-protein in coupled receptors through dopaminergic regulation; there is the conduction of chloride ions. (Bhatia, A., & Saadabadi, A. 2020).

Epigenetics and Pharmacologic Action.

Epigenetics can be defined as an adaptation in the code alters the function of a gene, its role can contribute to pharmacologic action played by epigenetics. This can be achieved by changing the molecule of DNA, which would lead to a gene expression that has been amended. (Camprodon, J. A., & Roffmaan, J. L 2016). Pharmacologic action is modified whenever a DNA molecule is amended. The DNA molecule chromatin variation can lead to modification of gene articulation (Mela et al., 2020). For example, when a child has an alteration in development because of mistreatment or abuse, the result can be long-term behavior and cognition. Heritability is an example of gene expression’s long-term effect. With medication, it is possible to reverse chromatin structure alterations. (Glaser D. 2014).

Impact on Medical Prescription

The phenomenon of partial or full agonists has a proportionate relationship with psychopharmacologic medications and their efficacy because a drug can influence their primary mechanism of action and another neurotransmitter in the process. This information may change how we communicate pharmacologic treatment to our patients. There could be a difference between how one person responds to the treatment and how another person responds to the same (Rollema & Hurst, 2018). This could call for extra psychotropic therapy. It is important for patients to understand how psychiatric mental health nurses prescribe the medication. For instance, when using medication to treat cardiovascular disease, it is important for the nurse involved to relay proper information regarding the action of the medication, (Choo, J., Hutchinson, A., & Bucknall, T. 2010). Especially if the medication can alter the effects of the drugs used to treat depression. This, in turn, leads to even more depression.

Catherine. M.

References

Camprodon, J. A., & Roffmaan, J. L (2016). Phychiatric neuroscience: Incorporating pathophysiology into clinical case formation. In T. A Stern, M. Favo, T. E Wilens, & J. F. Rosenbaum. (Eds). Massachusetts General Hospital Psychopharmacology and aerotherapeutics (pp. 1-19). Elsevier

Choo, J., Hutchinson, A., & Bucknall, T. (2010). Nurses’ role in medication safety. Journal of nursing management, 18(7), 853–861. https://doi.org/10.1111/j.1365-2834.2010.01164.x

Bhatia, A., & Saadabadi, A. (2020). Biochemistry, Dopamine Receptors. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538242/

Glaser D. (2014). The effects of child maltreatment on the developing brain. The Medico-legal journal, 82(3), 97–111.

Mela, M., Hanlon-Dearman, A., Ahmed, A. G., Rich, S. D., Densmore, R., Reid, D., … & Loock, C. (2020). Treatment algorithm for the use of psychopharmacological agents in individuals prenatally exposed to alcohol and/or with diagnosis of fetal alcohol spectrum disorder (FASD). Journal of Population Therapeutics and Clinical Pharmacology, 27(3), e1-e13.

Rollema, H., & Hurst, R. S. (2018). The contribution of agonist and antagonist activities of α4β2* nAChR ligands to smoking cessation efficacy: a quantitative analysis of literature data. Psychopharmacology, 235(9), 2479-2505.

Hello Catherine

Medication effects are designed to be agonistic, partial-agonistic, or antagonistic (Camprodon & Roffman, 2016). An agonistic medicine will open ion channels to boost neurotransmitters and will have a greater effect at the synaptic cleft or the presynaptic cleft (Nutt & Lingford-Hughes, 2017). A partial-agonistic effect will partially stimulate and partially inhibit neurotransmissions, and is therefore classified as an antagonist-agonist (Nutt & Lingford-Hughes, 2017). An antagonistic medication will fully obstruct the opening of neurotransmitter channels and prevent transmissions (Nutt & Lingford-Hughes, 2017). Because they block neurotransmissions, SSRIs, MAOIs, and benzodiazepines are termed antagonists (Nutt & Lingford-Hughes, 2017). Dopamine is considered a partial agonist, whereas GABA is considered an agonist (Nutt & Lingford-Hughes, 2017). Depending on whether you wish to promote neurotransmissions, block neurotransmitter reuptake, or limit neurotransmitter transmission, different medications are required for mental care.

Psychiatric medications target either ion channels or g-protein-coupled neurotransmitter receptor sites (Camprodon & Roffman, 2016). Ion channels are rapid-effect neurotransmitter sites (Camprodon & Roffman, 2016). Ion gated channels have an immediate impact on membrane potential and neuronal activity (Camprodon & Roffman, 2016). G-protein-coupled proteins operate more slowly and necessitate a second messenger that initiates an enzymatic cascade (Camprodon & Roffman, 2016).

The concept of epigenetics is that a gene can be altered by environmental events and be inherited (Camprodon & Roffman, 2016). A prime example of this is child maltreatment, which alters gene expression by changing the chromatin surrounding the gene (Camprodon & Roffman, 2016). “Epigenetics is the study of how your behaviour and environment can influence the way your genes function” (Centers for Disease Control and Prevention, 2020). This is crucial to comprehend so that early interventions can be made in the lives of children to prevent gene mutations. Some alterations may be reversed with the use of drugs and behavioral therapies (Camprodon & Roffman, 2016). With the knowledge of epigenetics, we can better comprehend how the environment influences our genes.

When prescribing pharmaceuticals, it is crucial to understand how they function. To achieve the desired effect, it is vital to comprehend the mechanisms underlying the effects of psychiatric medicines on behavior. SSRIs, for instance, inhibit serotonin reuptake, making it more accessible to enhance neuron communication in the brain (Mayo Clinic, 2021). Some drugs inhibit neurotransmitters, boost their levels, or do both. A provider will be able to select the correct treatment if he or she is aware of the drug’s effects.

References

Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics. Elsevier.

Centers for Disease Control and Prevention. (2020). What is epigenetics? https://www.cdc.gov/genomics/disease/epigenetics.htm

Mayo Clinic (2021). Selective serotonin reuptake inhibitors (SSRI). https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825

Nutt, D., and Lingford-Hughes, A., (2017). Key concepts in psychopharmacology. http://www.med.monash.edu.au/assets/docs/scs/psychiatry/psychopharmacology/nutt-pharmacodynamics-2007.pdf

Name: NURS_6630_Week2_Discussion_Rubric

	Excellent Point range: 90–100	Good Point range: 80–89	Fair Point range: 70–79	Poor Point range: 0–69
Main Posting: Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.	Points Range: 40 (40%) – 44 (44%) Thoroughly responds to the Discussion question(s). Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. No less than 75% of post has exceptional depth and breadth. Supported by at least three current credible sources.	Points Range: 35 (35%) – 39 (39%) Responds to most of the Discussion question(s). Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module. 50% of the post has exceptional depth and breadth. Supported by at least three credible references.	Points Range: 31 (31%) – 34 (34%) Responds to some of the Discussion question(s). One to two criteria are not addressed or are superficially addressed. Is somewhat lacking reflection and critical analysis and synthesis. Somewhat represents knowledge gained from the course readings for the module. Post is cited with fewer than two credible references.	Points Range: 0 (0%) – 30 (30%) Does not respond to the Discussion question(s). Lacks depth or superficially addresses criteria. Lacks reflection and critical analysis and synthesis. Does not represent knowledge gained from the course readings for the module. Contains only one or no credible references.
Main Posting: Writing	Points Range: 6 (6%) – 6 (6%) Written clearly and concisely. Contains no grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 5 (5%) – 5 (5%) Written concisely. May contain one to two grammatical or spelling errors. Adheres to current APA manual writing rules and style.	Points Range: 4 (4%) – 4 (4%) Written somewhat concisely. May contain more than two spelling or grammatical errors. Contains some APA formatting errors.	Points Range: 0 (0%) – 3 (3%) Not written clearly or concisely. Contains more than two spelling or grammatical errors. Does not adhere to current APA manual writing rules and style.
Main Posting: Timely and full participation	Points Range: 9 (9%) – 10 (10%) Meets requirements for timely, full, and active participation. Posts main Discussion by due date.	Points Range: 8 (8%) – 8 (8%) Posts main Discussion by due date. Meets requirements for full participation.	Points Range: 7 (7%) – 7 (7%) Posts main Discussion by due date.	Points Range: 0 (0%) – 6 (6%) Does not meet requirements for full participation. Does not post main Discussion by due date.
First Response: Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic, may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic, lacks depth.
First Response: Writing	Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
First Response: Timely and full participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Second Response: Post to colleague’s main post that is reflective and justified with credible sources.	Points Range: 9 (9%) – 9 (9%) Response exhibits critical thinking and application to practice settings. Responds to questions posed by faculty. The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.	Points Range: 8 (8%) – 8 (8%) Response has some depth and may exhibit critical thinking or application to practice setting.	Points Range: 7 (7%) – 7 (7%) Response is on topic, may have some depth.	Points Range: 0 (0%) – 6 (6%) Response may not be on topic, lacks depth.
Second Response: Writing	Points Range: 6 (6%) – 6 (6%) Communication is professional and respectful to colleagues. Response to faculty questions are fully answered, if posed. Provides clear, concise opinions and ideas that are supported by two or more credible sources. Response is effectively written in Standard, Edited English.	Points Range: 5 (5%) – 5 (5%) Communication is mostly professional and respectful to colleagues. Response to faculty questions are mostly answered, if posed. Provides opinions and ideas that are supported by few credible sources. Response is written in Standard, Edited English.	Points Range: 4 (4%) – 4 (4%) Response posed in the Discussion may lack effective professional communication. Response to faculty questions are somewhat answered, if posed. Few or no credible sources are cited.	Points Range: 0 (0%) – 3 (3%) Responses posted in the Discussion lack effective communication. Response to faculty questions are missing. No credible sources are cited.
Second Response: Timely and full participation	Points Range: 5 (5%) – 5 (5%) Meets requirements for timely, full, and active participation. Posts by due date.	Points Range: 4 (4%) – 4 (4%) Meets requirements for full participation. Posts by due date.	Points Range: 3 (3%) – 3 (3%) Posts by due date.	Points Range: 0 (0%) – 2 (2%) Does not meet requirements for full participation. Does not post by due date.
Total Points: 100

Excellent

Point range: 90–100

Good

Point range: 80–89

Fair

Point range: 70–79

Poor

Point range: 0–69

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

Points Range: 40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

Points Range: 35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

Points Range: 31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with fewer than two credible references.

Points Range: 0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

Main Posting:

Writing

Points Range: 6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

Points Range: 4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

Points Range: 0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

Points Range: 9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

Points Range: 8 (8%) – 8 (8%)

Posts main Discussion by due date.

Meets requirements for full participation.

Points Range: 7 (7%) – 7 (7%)

Posts main Discussion by due date.

Points Range: 0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

First Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.

Points Range: 9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

Points Range: 8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

Points Range: 7 (7%) – 7 (7%)

Response is on topic, may have some depth.

Points Range: 0 (0%) – 6 (6%)

Response may not be on topic, lacks depth.

Second Response:
Writing

Points Range: 6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in Standard, Edited English.

Points Range: 5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in Standard, Edited English.

Points Range: 4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

Points Range: 0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation

Points Range: 5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

Points Range: 4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

Points Range: 3 (3%) – 3 (3%)

Posts by due date.

Points Range: 0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name: NURS_6630_Week2_Discussion_Rubric