NURS 6630 Week 10 Assignment 1: Management of Gambling Disorder Co-occurring with Alcohol Use Disorder Case Study
NURS 6630 Week 10 Assignment 1: Management of Gambling Disorder Co-occurring with Alcohol Use Disorder Case Study
Alcohol use disorder contributes a significant proportion of the mental disorder substance use disorder which often occurs as a consequence of maladaptation to pressures in life. Alcohol use disorder co-occurrence with gambling disorder is increasing in prevalence over the years. Each disorder is a known predisposing factor for the other. There is a greater predisposition to morbidity and mortality than when the disorders occur separately (Atkinson, 2018). The purpose of this paper is to discuss the management of this patient in line with pharmacotherapy and psychotherapy, the expectations during and after treatment, and the ethical considerations during management.
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Introduction to the Case
This week’s case study discusses a 53-year-old Puerto Rican female Mrs. Perez who has had alcohol use disorder for more than 25 years and has been part of Alcoholic Anonymous though intermittently. Her alcohol use has deteriorated over 2 years since a casino was opened close to her home. She also reports spending huge sums of money on gambling and her alcohol consumption also increases during gambling sprees. She also reports an increase in the frequency of smoking cigarettes over the past 2 years. She has gained 7lb. In her mental state exam, she is alert and oriented with clear speech. She cannot maintain appropriate eye contact and is avoidant. Her subjective mood is sad and her impulse control is impaired. She has no hallucinations, no involuntary stereotyped movements, no suicidal ideations, and her insight and judgment are intact. Her diagnosis is gambling disorder co-occurring with alcohol use disorder. In this case, decision-making in treatment is influenced by the goal of therapy, treatment duration, the dosage of the drug, socioeconomic status of the patient, gender, the individual drug pharmacokinetics, side effects, and toxicity profile. The purpose of this paper is to discuss the management of this patient in line with pharmacotherapy and psychotherapy, the expectations during and after treatment, and the ethical considerations during management.
Decision 1
Naltrexone 380mg Intramuscularly every 4 weeks.
Why did you select this decision?
Naltrexone is considered one of the first-line drugs in the management of alcohol use disorder. Naltrexone is highly efficacious in the prevention of relapse and reduction in heavy consumption of alcohol. It has also been found to have an average efficacy in the promotion of total abstinence in alcohol use disorder patients (Kedia et al., 2022). According to the American Psychiatry Association, naltrexone proves to have modest efficacy in the treatment of alcohol use disorder with few side effects. The extended-release intramuscular naltrexone greatly improves the adherence to medication by reducing the pill burden and limiting the dose to one monthly injection (Edelman et al., 2018). Naltrexone has also been shown to extinguish the urge to gamble (Kraus et al., 2020). These reasons make Naltrexone the most appropriate in Mrs. Perez’ management.
Why did you not select the other two options provided in the exercise?
Acamprosate offers an alternative to naltrexone in the case of a contraindication to naltrexone use. The three-times daily dose of 666mg of Acamprosate is high and often associated with severe side effects like suicidal ideations, anxiety, and tipping into major depression, especially for this patient whose subjective mood is already sad. Disulfiram is an FDA-approved second-line pharmacotherapy for alcohol use disorder (Stokes & Abdijadid, 2019). Disulfiram usage is marred with a lot of adverse effects ranging from confusion states, and convulsions, to death (Patel & Balasanova, 2021). Its use is restricted to patients who are highly motivated to cease alcohol use. Because of these serious side effects, disulfiram use is marred with non-adherence to therapy. For this particular patient, it may be used when the first-line therapy fails. There is no approved pharmacotherapy for gambling disorder hence there is a further need for patient counseling and cognitive behavioral therapy.
What were you hoping to achieve by making this decision?
After induction of treatment, it is expected that the patient will abstain completely from alcohol and there will be long periods before relapse. Reduced craving for alcohol and reduce total alcohol consumption during therapy (Fairbanks et al., 2020). Few adverse effects are expected as the long-acting slow release is effective at minimizing side effects. The patient is expected to be adherent to the medication as there is no pill burden and the injection is only once a month (Kedia et al., 2022). It is expected that the patient will continue smoking and gambling as these drugs do not treat gambling disorders.
How ethical considerations may impact the treatment plan and communication
The treatment of this patient is based on the four tenets of ethical considerations which include justice, non-maleficence, beneficence, and autonomy. Informed consent is important in patient care. The condition is explained to the patient and she is provided with the best treatment choices based on her condition. The side effects of each of the drug choices are explained to the patient (Davis, 2020). Continuous monitoring of these side effects and the well-being of the patient is mandatory. Preservation of patient confidentiality is essential.
Decision 2
Refer to a counselor to address gambling issues
Why did you select this decision?
Counseling is the mainstay of the management of gambling disorders. According to Atkinson et al (2018), psychotherapy is the most effective treatment of gambling disorder. The aspects of counseling may include gambling anonymous groups, cognitive behavioral therapy, and group therapy (Jonas et al., 2019). Pharmacotherapy only deals to reduce the co-morbidities associated with gambling disorder which in this case is alcohol use.
Why did you not select the other two options provided in the exercise?
Mrs. Perez’ anxiety is a direct consequence of gambling disorder. Psychotherapy is provides a higher efficiency in the management of anxiety than pharmacotherapy (Jonas et al., 2019). For this reason, diazepam will be ineffective. Diazepam is not an indicated treatment for gambling disorder. Diazepam would potentiate depression of the central nervous system. Varenicline is effective in aiding in quitting smoking as a nicotine replacement therapy when used alongside counseling as an adjunct therapy (Rigotti et al., 2022). However, it is important to maintain a monotherapy to prevent any drug-drug interactions.
What were you hoping to achieve by making this decision?
Following counseling, the patient’s anxiety is expected to be allayed. The gambling disorder and smoking are expected to have regressed and stopped after 12 weeks of counseling and cognitive behavioral therapy. With continuation and adherence to the monthly dose of naltrexone, the alcohol use disorder is expected to be distinguished with no withdrawal effects.
How ethical considerations may impact the treatment plan and communication
Counseling employs patient privacy and confidentiality to help build trust between the patient and the counselor. Competence and empathetic listening are vital values for a counselor (Palmer & Burrows, 2020). Informed consent is pivotal. The counselor must be registered under the professional body of counselors. Other tenets like justice, beneficence, and nonmaleficence still apply.
Decision 3
Explore the issue that the patient has with the counselor and encourage attendance of the Gamblers’ anonymous meetings.
Why did you select this decision?
The counseling sessions, however, the challenges ensued prove to have started working for this patient. The anxiety is resolved and she feels supported in the support group she joined. This is a worthwhile path that is proving efficacious in her management. There is a need to look into the issue that the patient holds against the counselor and resolve it if possible. If it is unresolvable, referral to another counselor would be the best course (Atkinson, 2018). This poor relationship would lead to default in therapy. Default in therapy may lead to reverting to gambling.
Why did you not select the other two options provided in the exercise?
Naltrexone use in the treatment of alcohol use disorder runs for a minimum of 6 months (Kedia et al., 2022). Discontinuation of naltrexone after 8 weeks of therapy is too soon and this may give room for relapsing to alcohol use disorder. If the patient continues visiting the counselor yet has an issue with her, it could prove detrimental to the course of therapy (DeAngelis, 2019). From this, it is key to aim at improving the patient-counselor relationship.
What were you hoping to achieve by making this decision?
Exploration of the issue with the counselor will fuel a positive interaction with the patient which in turn will improve the outcome of therapy (DeAngelis, 2019). The patient is also expected to stay in remission for the whole duration of therapy. There will be no adverse effects of the drugs.
How ethical considerations may impact the treatment plan and communication
The right of a patient to choose their counselor is important. Respecting the autonomy of the patient in decision-making is another important consideration (Davis, 2020). Maintenance of patient privacy and confidentiality of patient information is golden.
Conclusion
Co-occurrence of gambling disorder with alcohol use disorder is rising in prevalence as one is likely to tip a person into the other. This co-occurrence increases morbidity and mortality among these patients. This case study offers a perfect avenue for discussion of alcohol use disorder co-occurring with gambling disorder and cigarette smoking. The management is mainly based on pharmacotherapy and cognitive behavioral therapy. This patient displays binge alcohol drinking, smoking cigarettes, and spending excess money in her gambling endeavors. The first line of treatment for Alcohol use disorder co-occurring with a gambling disorder is naltrexone and acamprosate (Kedia et al., 2022). Combination therapy of naltrexone and cognitive behavioral therapy is highly efficacious in the management of this particular case (Jonas et al., 2019). Naltrexone is indicated to reduce alcohol cravings, minimize relapse, and abstain and it is also proven to greatly reduce the urge and the frequency of gambling sprees. The slow-release naltrexone greatly improves adherence. Acamprosate on the other hand has a limited advantage profile. It only promotes abstinence. Disulfiram is an FDA second line in the treatment of alcohol use disorder with limited use only in patients who aim at the complete cessation of alcohol use. Its adverse effects profile is severe ranging from light autonomic disturbances to commas and death (Stokes & Abdijadid, 2019). the pharmacotherapy of choice is greatly influenced by the goal of therapy, treatment duration, the dosage of the drug, socioeconomic status of the patient, the individual drug pharmacokinetics, side effects, and toxicity profile of the drug. The ethical considerations are based on justice, non-maleficence, beneficence, and autonomy. Informed consent, preservation of patient confidentiality, privacy, and respect for a patient’s decision is pivotal (Davis, 2020). The effective treatment of alcohol use disorder co-occurring with gambling disorder and cigarette smoking requires a wholesome treatment of the patient involving physical therapy and psychotherapy.
References
Atkinson, J. (2018). Commonalities in the Association of Behavioral Activation and Behavioral Inhibition with Problem Gambling and Alcohol Use in Young Adult College Students. Journal of Gambling Studies, 35(1), 125–141. https://doi.org/10.1007/s10899-018-9788-5
Davis, C. N. (2020). Guidelines and recommendations for training ethical alcohol researchers. Training and Education in Professional Psychology, 14(1), 52–59. https://doi.org/10.1037/tep0000257
DeAngelis, T. (2019, November 1). Better relationships with patients lead to better outcomes. Https://Www.apa.org. https://www.apa.org/monitor/2019/11/ce-corner-relationships
Edelman, E. J., Moore, B. A., Holt, S. R., Hansen, N., Kyriakides, T. C., Virata, M., Brown, S. T., Justice, A. C., Bryant, K. J., Fiellin, D. A., & Fiellin, L. E. (2018). Efficacy of Extended-Release Naltrexone on HIV-Related and Drinking Outcomes Among HIV-Positive Patients: A Randomized-Controlled Trial. AIDS and Behavior, 23(1), 211–221. https://doi.org/10.1007/s10461-018-2241-z
Fairbanks, J., Umbreit, A., Kolla, B. P., Karpyak, V. M., Schneekloth, T. D., Loukianova, L. L., & Sinha, S. (2020). Evidenced-Based pharmacotherapies for Alcohol Use Disorder. Mayo Clinic Proceedings, 95(9). https://doi.org/10.1016/j.mayocp.2020.01.030
Jonas, B., Leuschner, F., Eiling, A., Schoelen, C., Soellner, R., & Tossmann, P. (2019). Web-Based Intervention and Email-Counseling for Problem Gamblers: Results of a Randomized Controlled Trial. Journal of Gambling Studies. https://doi.org/10.1007/s10899-019-09883-8
Kedia, S. K., Ahuja, N., Dillon, P. J., Jones, A., Kumar, S., & Satapathy, S. (2022). Efficacy of Extended-Release Injectable Naltrexone on Alcohol Use Disorder Treatment: A Systematic Review. Journal of Psychoactive Drugs, 1–13. https://doi.org/10.1080/02791072.2022.2073300
Kraus, S. W., Etuk, R., & Potenza, M. N. (2020). Current pharmacotherapy for gambling disorder: a systematic review. Expert Opinion on Pharmacotherapy, 21(3), 287–296. https://doi.org/10.1080/14656566.2019.1702969
Palmer, K. M., & Burrows, V. (2020). Ethical and Safety Concerns Regarding the Use of Mental Health–Related Apps in Counseling: Considerations for Counselors. Journal of Technology in Behavioral Science. https://doi.org/10.1007/s41347-020-00160-9
Patel, A. K., & Balasanova, A. A. (2021). Treatment of Alcohol Use Disorder. JAMA, 325(6), 596. https://doi.org/10.1001/jama.2020.2012
Rigotti, N. A., Kruse, G. R., Livingstone-Banks, J., & Hartmann-Boyce, J. (2022). Treatment of Tobacco Smoking. JAMA, 327(6), 566. https://doi.org/10.1001/jama.2022.0395
Stokes, M., & Abdijadid, S. (2019, April 10). Disulfiram. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459340/
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Credit Hours
5 credits in 11 weeks
Walden University assigns credit hours based on the number and type of assignments that enable students to achieve the course learning objectives. In general, each semester credit equals about 42 hours of total student work and each quarter credit equals about 28 hours of total student work. This time requirement represents an approximate average for undergraduate work and the minimum expectations for graduate work. The number and kind of activities estimated to fulfill time requirements will vary by degree level and student learning style, and by student familiarity with the delivery method and course content.
Course Description
At times, psychotherapy is not enough to alleviate the emotional difficulties that some patients face. To that end, psychopharmacologic approaches are needed. Psychiatric nurse practitioners (PNPs) must have a strong basis in psychopharmacology, extending from a prior education in pharmacology, to make appropriate medication choices for their patients. Learners in this course consider psychopharmacologic approaches to major behavioral health disorders including, but not limited to, major depressive disorders, bipolar disorder, anxiety disorders, and psychotic disorders. Learners explore key considerations associated with medication selection, monitoring efficacy, and long-term management.
Course Prerequisites
MSN core courses (NURS 6002/6003, 6050, 6051, 6052, 6053)
NURS 6501: Advanced Pathophysiology
NURS 6521: Advanced Pharmacology
NURS 6512: Advanced Health Assessment and Diagnostic Reasoning
Course Learning Outcomes
By the conclusion of this course, you should be able to:
Evaluate foundational neuroscience as it relates to caring for patients with psychiatric disorders across the lifespan
Analyze the impact of non-adherence on treatment success and strategies to mitigate risk factors with non-adherence
Assess mechanisms of action of medications used to treat psychiatric conditions
Apply patient-centric concepts and evidence-based medicine to select appropriate psychopharmacologic agents
Synthesize pathophysiology and health assessment concepts in the psychopharmacologic treatment of behavioral health disorders
Analyze ethical and legal implications of prescribing psychotropic medications across the lifespan
Evaluate the efficacy and adverse reactions of psychotropic medications
College of Nursing Alignment of Learner Outcomes
Click on the following link to access the College of Nursing Alignment of Learner Outcomes:
Document: NURS 6630 SON Alignment of Learning Outcomes (PDF)
Course Materials
Please visit the university bookstore via your Walden student portal to ensure you are obtaining the correct version of any course texts and/or materials noted in the following section. When you receive your materials, make sure that all required items are included.
Course Text
Stern, T. A., Favo, M., Wilens, T. E., & Rosenbaum, J. F. (2016). Massachusetts General Hospital psychopharmacology and neurotherapeutics. Elsevier.
The following course text is available through the Walden Library:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association.
Note: If the print edition of these books are referenced here, electronic versions also may be available and may be acceptable for use in this course. If an electronic version is listed, no print version is available.
Other readings (journal articles, websites, book excerpts, etc.) are assigned throughout the course and may be found within each Module.
Media
Assigned course media elements may be found in one or more modules of the course and are available via a streaming media player or a hyperlink to the individual item.
Primary and Secondary Sources
Review the following information prior to selecting resources for assignments.
Primary: A primary source is an original document that is the first account of what happened. A research report is primary, and you can tell because it includes materials and methods demonstrating how the research was done. Some creative work is also primary, such as poetry, novels, and interviews of people who experienced something firsthand. In nursing, which is an evidence-based discipline, we strive to use primary research that is published in scholarly, peer-reviewed journals.
Scholarly, peer-reviewed journal: Scholarly journals publish papers by professional authors and experts in the field using a peer-review process to review the work and assure quality before publishing. The focus of a scholarly journal is to provide accurate information for scholars and other researchers. The focus is on content rather than advertising, a direct contrast to popular media. Scholarly journals publish both primary and secondary papers, the former usually is noted as original research and the latter as reviews and commentaries. Letters to the editor may also be published but should be recognized as opinion pieces.
Note: When selecting articles for course assignments, you are advised (unless you are referencing seminal information) to focus on work published within the past 5 years.
Secondary: A secondary source is one step removed from the original source. This work interprets and often compiles other work, and it includes review articles, textbooks, fact sheets, and commentaries about a topic. It also includes news reports of original research. Secondary work is more prone to error and bias than primary work because it is being filtered through an additional person or persons. Review papers can be useful to glean information about a topic and to find other sources from the reference list, but it is the original, primary research that should be relied on most heavily in demonstrating scholarship, depth, and validation of factual information.
Course Assignments
1. Participation in weekly Discussions: The exchange of ideas among colleagues engaged in scholarly inquiry is a key aspect of learning and is a requisite activity in this course. You are expected to participate each week that a Discussion is assigned by posting a response to a prompt or question in the weekly Discussion area. In addition, you are expected to respond to your fellow students’ postings. To count as participation, responses need to be thoughtful; that is, they must refer to the week’s readings, relevant issues in the news, information obtained from other sources, and/or ideas expressed in the postings of other class members. You may ask questions or offer further information or links about the subject. Please pay attention to grammar and spelling, as consistently poorly written posts will receive grade penalties. In grading the required Discussion postings, your Instructor will be using the Discussion Posting and Response Rubric, located in the Course Information area.
Note: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least 3 different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.
2. Assignments: The Assignments provide you with the opportunity to apply the skills and knowledge gained through the Learning Resources and the practicum experience. See the Assignment area of specific weeks for detailed descriptions of the Assignments. In grading the required Assignments, your Instructor will be using rubrics located in the Course Information area.
Note: The course Assignments will require that you completely and accurately demonstrate critical thinking via assimilation and synthesis of ideas when using credible outside and course-specific resources (i.e., video, required readings, textbook), when comparing different points of view, highlighting similarities, differences, and connections, and/or when lending support to your Assignment responses.
Academic Integrity Originality Policy
Walden encourages students to use critical thinking to produce original thoughts in discussion posts, assignments, and other scholarly work. This “…will require that you completely and accurately demonstrate critical thinking via assimilation and synthesis of ideas when using credible, outside and course specific resources (i.e., video, required readings, textbook); when comparing different points of view, highlighting similarities, differences, and connections; and/or when lending support to your responses.†Using too many direct quotes or ineffective paraphrasing does not demonstrate originality.
To demonstrate originality requires the use of paraphrasing. According to the Walden Writing Center (n.d.), “Paraphrasing in academic writing is an effective way to restate, condense, or clarify another author’s ideas while also providing credibility to your own argument or analysis†(“Introduction to Paraphrasingâ€). “As you discuss those sources, paraphrasing allows you to use your own words and sentence structure to talk about the information you gleaned from those sources.†(Walden Writing Center, n.d., “Introduction to Paraphrasingâ€).
“Ineffective paraphrasing occurs when authors paraphrase a source but do not use their own sentence structure or vocabulary to effectively reword that source. The issue here is often that the student’s paraphrase simply uses synonyms for the source’s original wording and is not different enough from the original source’s wording. Ineffective paraphrasing can occur when an author does not use his or her own wording or voice to paraphrase entire paragraphs or individual sentences.†(Walden Writing Center, n.d., “Examples of Paraphrasing,†slide 10).
For more information, refer to the Writing Center’s Introduction to Plagiarism & Intellectual Property at https://academicguides.waldenu.edu/writingcenter/modules/plagiarism#s-lg-box-8548804
Assignments, discussion posts, or other scholarly work that does not demonstrate originality and/or lacks proper citation to credit original sources/authors will receive a grade reduction amounting up to 10%.
Grading Criteria and Total Components of a Grade
Course grades will be based on participation (postings) and completion of assignments listed below.
Note: All assignments must be completed to pass the course.
Letter grades will be assigned as follows:
90%–100% = A
80%–89% = B
70%–79% = C
< 70% = F
Note: Please see below the policy on Incomplete (I) grades.
Assignment Total Points Percentage
(Weighted)
Discussion
Participation in Discussion*
(2 @ 100 points)
200
10%
Assignments
Short Answer Assessments
(2 @ 75 points each)
Study Guide
(1 @ 100 points)
250
8%
Decision Tree Assignments
(6 @ 100 points each)
600 30%
Self Assessments x 2
0
0%
Midterm Exam (100 points)
Final Exam (100 points)
200 52%
Practicum Application Assignment
(1 @ 0 points [graded S/U]) S/U 0%
Total
1,250
100%
* Each Discussion requires that you make one initial posting and at least two response postings to colleagues. See the Discussion Posting and Response Rubric for posting details.
Incomplete Grade Policy
Per University policy, Incomplete grades can be granted only to students who have already met the minimum criteria for active weekly participation in a course (including weekly postings in online courses) and have completed at least 80% of other coursework. Incompletes can be awarded when, because of extenuating circumstances, a student has not met additional course requirements, including but not limited to written assignments, group projects, and research papers, as applicable. All Incomplete grades are awarded at the discretion of the course Faculty.
Students who are eligible for an Incomplete must contact the course Faculty to request the grade as soon as possible. Students who do not meet the criteria listed above will not be allowed to earn an Incomplete. If the Incomplete is approved, the Faculty Member will work with the student to outline the due date(s) for remaining work. Under no circumstances will the new due dates extend beyond 50 days from the last day of the term. Faculty will then have 10 days to assess the work and post the permanent grade before the University-allotted Incomplete time limit of 60 days expires. All Incomplete grades not resolved within the time allotted will convert to permanent grades of F.
Instructor Feedback Schedule
The Instructor will log in to the course during the week to monitor the weekly Discussion area. Feedback will be provided via the My Grades area, the Discussion area, and/or the Announcements page.
You can expect your weekly assignment grades to be posted within 10 calendar days of a due date. Instructor feedback and explanation is provided whenever full credit is not achieved. Depending on the nature of the feedback, Instructor responses may be posted to the Discussion area or included in the My Grades area. The goal of your Instructor is to act as a discussion and learning facilitator rather than a lecturer. The Instructor will not respond to every posting by every individual, so please feel free to ask your Instructor if you would like some personal feedback on a particular assignment posting or anytime you have any questions regarding your assignments or your grade.
Course Procedures
All class Discussions take place in the weekly Discussion areas.
You are encouraged to post course-related questions to the Contact the Instructor area, as they may be of interest to all; however, if your question is urgent, it is often best to email the Instructor. If your emailed question is thought to be of benefit to all, it may be responded to by the Instructor via email to all or posted as an announcement.
Instructor feedback on content and writing issues that is thought to be of benefit to the entire class may be posted to the Contact the Instructor area; however, most personal critique will be done privately in the Grade Center. Be sure to check the Grade Center for comments every week even if you received full credit.
Please feel free to use the Class Café to initiate and participate in conversations not directly related to the course. This is an excellent opportunity to get to know other students better. The Instructor will browse the Class Café occasionally but generally will not respond to conversations posted there unless students have specific questions for him or her.
Check the email account you use for official Walden University business on a regular basis. The expectation is that you are checking this email account daily during the week. If you experience difficulty sending or receiving Walden email, please contact the Student Support Team right away. Contact information for the Student Support Team is located in the Student Support area.
Review all materials in the Course Information area, as well as the materials contained under each of the weekly buttons.
Resubmission of assignments is not permitted after due dates. Students are expected to review their work and submissions of work carefully prior to due dates. Faculty may open a second submission area for assignment resubmission prior to due dates if students report submission errors. Assignments are graded after due dates as the final product ready for grading. Errors in submissions noted after due dates may result in a grade of zero.
Note: There are Optional Readings located within the Learning Resources section of each week in the course. You are encouraged to explore these readings, as needed, in order to enhance your understanding of the course content.
Preferred Methods for Delivering Assignments
Be sure that you post to the correct Discussion area each week, if assigned. Do not email postings to the Instructor. For all initial Discussion postings, make sure that the first sentence of your posting reads Main Question Post. For your responses to others’ response postings, make sure that the first sentence of your response reads Response. These actions will ensure easily identifiable subject lines for your postings and responses.
Application Assignments are submitted to the SafeAssign link and named according to the week in which the Assignment is submitted. Directions for naming each Application Assignment are included in each week’s Assignment area. Please be sure that all written Application Assignments are saved and submitted as a “.doc†file.
All email correspondence must contain in the subject line “NURS 6630-XX-NAME†(XX is the section number) followed by a brief description of the subject. This subject line convention ensures that your email will be easily identified and responded to in a timely manner. It is required that the email contain a signature that matches the official name used in the course.
Late Assignment Policy
Students are expected to submit assignments by the due dates noted in the course. In extenuating circumstances, such as illness, the student must contact the Instructor as soon as possible to discuss the situation. In those circumstances, Faculty will determine the appropriate course of action for the student. Depending on the situation, these actions may include recommendations to drop the course (if within the university drop/withdrawal period), acceptance of some or all of the overdue assignments with or without penalties, or failure to accept assignments.
Assignments submitted late without the prior agreement of the Instructor, outside of an emergency absence, or in violation of agreements for late submission, will receive a grade reduction for the assignment amounting up to 20%. Each day late with result in a 4%-point deduction up to day 5. After 5 days, the assignment will be graded a zero. Students should be aware that late assignments may not receive the same level of written feedback as do assignments submitted on time.
Discussion Board, Midterm Exam, and Final Exam Late Policy
The late policy applied to discussion boards, midterms exams, and final exams are different than course assignments and are as follows. Students are expected to complete discussion boards, midterms exams, and final exams by the due dates noted in the course. If students do not complete the discussion boards or initiate exams by the due date, the grade will result in a zero. In the event of an extenuating circumstance, students must let the instructor know prior to the due date. If the student is unable to do so, he or she needs to notify the instructor as soon as possible and those circumstances will be reviewed on a case-by-case basis. Any exam that is permitted to be taken late or permitted a retake may be subject to proctoring with audio and video technology.
Keeping Your Coursework
You will have access to the course and your coursework from the course start date until 60 days after the course ends. After this time, you will no longer be able to access the course or related materials. For this reason, we strongly recommend that you retain copies of your completed assignments and any documents you wish to keep. The University is not responsible for lost or missing coursework.
Course Evaluation
At or near the end of the course, you will receive an email inviting you to submit an online evaluation of the course and instruction. All submitted course evaluations are confidential, and only aggregate data and comments will be shared with the Instructor and Program Director. Your feedback is vitally important to Walden University in its efforts to continuously improve programs.
Students With Disabilities
Students in this course who have a disability that might prevent them from fully demonstrating their abilities should contact the director of Student Wellness & Disability Services at disability@mail.waldenu.edu or at 1-800-925-3368, ext. 312-1205 and +1-612-925-3368 or https://www.waldenu.edu/contact-us for international toll-free numbers as soon as possible to initiate disability verification and discuss accommodations that may be necessary to ensure full participation in the successful completion of course requirements.
Classroom Participation
In accordance with U.S. Department of Education guidance regarding class participation, Walden University requires that all students submit at least one of their required Week 1 assignments (which includes posting to the Discussion Board) within each course(s) during the first 7 calendar days of class. For courses with two-week units, posting to the Discussion Board by Day 7 meets this requirement. The first calendar day of class is the official start date of the course as posted on your myWalden academic page.
Assignments submitted prior to the official start date will not count toward your participation.
Financial Aid cannot be released without class participation as defined above.
Students who are taking their first class with Walden and do not submit at least one of their required Week 1 assignments (or at least one Discussion post) by the end of the 7th day will be administratively withdrawn from the university.
Students who have already taken and successfully completed at least one or more class(es) with Walden, and who do not participate within the first 7 days, will be dropped from that class.
If you have any questions about your assignments, or you are unable to complete your assignments, please contact your Faculty Member.
Checklist
The module course checklist below outlines the assignments due for the course.
For full assignment details and directions, refer to each module of the course. All assignments are due by 11:59 p.m. Mountain Time (MT) on the day assigned (which is 1:59 a.m. Eastern Time (ET) the next day). The time stamp in the classroom will reflect Eastern Time (ET), regardless of your time zone. As long as your submission time stamp is no later than 1:59 a.m. Eastern Time (ET), you have submitted on time.
To View the Calendar
To view the Course Calendar:
Course Calendar
To View a Printable Course Schedule
For full assignment details and directions, refer to each Module of the course.
Click on the NURS 6630 Course Schedule (PDF) link to access the Course Schedule.
Document: NURS 6630 Course Schedule (PDF)
Checklist
Module Assignment Title
Module 1
Introduction to Neuroanatomy and Adherence
Week 1
Introduction to Neuroanatomy
Learning Resources
Required Readings
Required Media
Optional Resources
Optional Discussion Forum
PMHNP Study Support Lounge
Assignment
Short Answer Assessment
Week 2
Neurotransmitters and Receptor Theory
Learning Resources
Required Readings
Required Media
Optional Resources
Discussion
Foundational Neuroscience
Week 3
Concepts in Assessing Medication Adherence and Strategies to Mitigate Non-Adherence
Learning Resources
Required Readings
Required Media
Self Assessment
Neurobiology and Medication Adherence Concepts
Module 2
Disorders With Affective Components
Week 4
Therapy for Patients With Major Depressive Disorder (MDD)
Learning Resources
Required Readings
Medication Resources
Required Media
Optional Resources
Assignment
Assessing and Treating Pediatric Patients With Mood Disorders
Week 5
Therapy for Patients With Bipolar Disorders
Learning Resources
Required Readings
Medication Resources
Required Media
Optional Resources
Assignment
Assessing and Treating Patients With Bipolar Disorder
Week 6
Therapy for Patients With Anxiety Disorders and PTSD Treatment
Learning Resources
Required Readings
Medication Resources
Required Media
Assignment
Assessing and Treating Patients With Anxiety Disorders
Midterm Exam
Week 7
Therapy for Patients With Schizophrenia
Learning Resources
Required Readings
Medication Resources
Optional Resources
Discussion
Treatment for a Patient With a Common Condition
Assignment
Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders
Week 8
Therapy for Patients With Sleep/Wake Disorders
Learning Resources
Required Readings
Medication Resources
Required Media
Assignment 1
Short Answer Assessment
Assignment 2
Assessing and Treating Patients With Sleep/Wake Disorders
Week 9
Therapy for Patients With ADHD/ODD
Learning Resources
Required Readings
Medication Resources
Required Media
Assignment
Assessing and Treating Patients With ADHD
Self Assessment
Assessing and Treating Patients With Psychopharmacology
Module 3
Disorders With Behavioral Components
Week 10
Therapy for Patients With Impulsive/Substance Use Disorders (SUD)
Learning Resources
Required Readings
Medication Resources
Required Media
Optional Resources
Discussion
Influencing Social Change
Assignment 1
Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction
Assignment 2 Practicum Application Assignment
Week 11
Therapy for Patients With Dementia/Alzheimer’s and Comorbid States
Learning Resources
Required Readings
Medication Resources
Optional Resources
Final Exam
Bibliography
The bibliography contains the references for all learning materials in the course. For your convenience, a link has been provided to download and save the bibliography.
To access the Bibliography:
Document: NURS 6630 Bibliography (PDF)
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Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Content
Name: NURS_6630_Week10_Assignment1_Rubric
| Excellent
Point range: 90–100 |
Good
Point range: 80–89 |
Fair
Point range: 70–79 |
Poor
Point range: 0–69 |
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| Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. |
Points Range: 9 (9%) – 10 (10%)
The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. |
Points Range: 8 (8%) – 8 (8%)
The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. |
Points Range: 7 (7%) – 7 (7%)
The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. |
Points Range: 0 (0%) – 6 (6%)
The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. |
|
| Decision #1 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
|
| Decision #2 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
|
| Decision #3 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
|
| Conclusion (1 page)
• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. |
Points Range: 14 (14%) – 15 (15%)
The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. |
Points Range: 12 (12%) – 13 (13%)
The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided. |
Points Range: 11 (11%) – 11 (11%)
The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. |
Points Range: 0 (0%) – 10 (10%)
The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing. |
|
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. |
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
|
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors. |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
|
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors. |
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA format errors. |
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors. |
|
| Total Points: 100 | |||||
Name: NURS_6630_Week10_Assignment1_Rubric