birth,

and decide on the number of children they get. Society and economic aspects should therefore

not dictate the decision a woman makes regarding the same.

2.How does she believe access to birth control will change women’s lives?

She believes that birth control will create convenience for women as the same will allow

them to decide when to have kids and how many kids to bear. As such, it will promote economic

independence and reduce the economic hardships that stem from giving birth to many children

that one is unable to fully sustain. It will also help to manage women's health as the act of

bearing many children drains a woman and leads to other health complications. Good health

translates to increased productivity and as such a woman will be in a position to work for longer

hours and increase household income to sustain her family. The use of birth control will facilitate

women empowerment as it is a way of navigating feminine spirit which is essential in changing

the existing societal notions about women's role. Sanger foresaw if women would be capable of

Sign up t
https://bit.ly/3Hf8eOU

BUILDING AN ETHICS WORKPLACE CULTUREThe Chief Ethics OfficerAssignment OverviewIn this assignment you will be asked to consider the role of organizational leaders with respect to ensuring companies work to create an ethical workplace culture. It is important for all upper level leaders to 'walk the talk' so to speak. In addition, many larger companies have a Chief Ethics and Compliance Officer who provides leadership and oversight to the company's business ethics related endeavors. In this assignment you will be asked to discuss the contributions of executive leaders and of the Ethics Officer with respect to building an organization that values workplace ethics.

- What do you believe are the most important characteristics of ethical leadership? 2. Describe the relationship between the ethical leader and the follower. 3. Why is this relationship important for organizations that are attempting to do the right thing? 4. Based on your readings (both the articles provided and Terris' text), what is the role of the Chief Ethics Officer and how does the role of this person relate to the success of the ethics related endeavors within large organizations?SLP Assignment ExpectationsYour paper should be 2-3 pages, double-spaced and in 12-point type size.Your paper should have a separate cover page and a separate reference page. Make sure you cite your sources. Use APA style, and proofread your paper. Upload your paper by the end of the module.
https://bit.ly/3MLERoP

Prescribing for Children and Adolescents

Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.

—Agency for Healthcare Research and Quality

Photo Credit: Getty Images/Ingram Publishing

Psychotropic drugs are commonly used for children and adolescents to treat mental health disorders, yet many of these drugs are not FDA approved for use in these populations. Thus, their use is considered “off-label,” and it is often up to the best judgment of the prescribing clinician. As a PMHNP, you will need to apply the best available information and research on pharmacological treatments for children in order to safely and effectively treat child and adolescent patients. Sometimes this will come in the form of formal studies and approvals for drugs in children. Other times you may need to extrapolate from research or treatment guidelines on drugs in adults. Each individual patient case will need to be considered independently and each treatment considered from a risk assessment standpoint. What psychotherapeutic approach might be indicated as an initial treatment? What are the potential side effects of a particular drug?

For this Assignment, you consider these questions and others as you explore FDA-approved (“on label”) pharmacological treatments, non-FDA-approved (“off-label”) pharmacological treatments, and nonpharmacological treatments for disorders in children and adolescents.

Reference:

Agency for Healthcare Research and Quality. (2015). Off-label drugs: What you need to know. https://www.ahrq.gov/patients-consumers/patient-involvement/off-label-drug-usage.html

To Prepare

- Your Instructor will assign a specific disorder for you to research for this Assignment.
- Use the Walden library to research evidence-based treatments for your assigned disorder in children and adolescents. You will need to recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating this disorder in children and adolescents.

The Assignment (1–2 pages)

- Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.
- 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 scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Attach the PDFs of your sources.

Name: NRNP_6665_Week3_Assignment1_Rubric

- Grid View
- List View

 ExcellentGoodFairPoorIn 1–2 pages, address the following: • Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your assigned disorder in children and adolescents.23 (23%) - 25 (25%)The response accurately and concisely explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.20 (20%) - 22 (22%)The response accurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.18 (18%) - 19 (19%)The response somewhat vaguely or inaccurately explains one FDA-approved drug, one off-label drug, and one nonpharmacological intervention that would be appropriate for treating the assigned disorder in children and adolescents.0 (0%) - 17 (17%)The response vaguely or inaccurately explains interventions that would be appropriate for treating the assigned disorder in children and adolescents. Interventions may not represent the three types of interventions required, or response may be missing.• 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?23 (23%) - 25 (25%)The response accurately and concisely explains the risk assessment you would use to inform your treatment decision making. A concise and accurate explanation of the risks and benefits of each pharmacological intervention is provided.20 (20%) - 22 (22%)The response accurately explains the risk assessment you would use to inform your treatment decision making. An adequate explanation of the risks and benefits of each pharmacological intervention is provided.18 (18%) - 19 (19%)The response somewhat vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The explanation of the risks and benefits of each pharmacological intervention is somewhat vague or inaccurate.0 (0%) - 17 (17%)The response vaguely or inaccurately explains the risk assessment you would use to inform your treatment decision making. The risks and benefits of each pharmacological intervention is vague or inaccurate. Or, the response is missing.• 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.23 (23%) - 25 (25%)The response accurately and concisely uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.20 (20%) - 22 (22%)The response accurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.18 (18%) - 19 (19%)The response somewhat vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations.0 (0%) - 17 (17%)The response vaguely or inaccurately uses either clinical guidelines (if available) or other information from the literature to justify intervention recommendations. Or, the response is missing.• Support your reasoning with at least three scholarly resources, one each on the FDA-approved drug, the off-label, and a non-medication intervention for the disorder. Be sure they are current (no more than 5 years old). Attach the PDFs of your sources.9 (9%) - 10 (10%)The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations. The resources reflect the latest clinical guidelines and provide strong justification for decision making.8 (8%) - 8 (8%)The response provides at least three current, evidence-based resources from the literature to support the intervention recommendations.7 (7%) - 7 (7%)Three evidence-based resources are provided to support the intervention recommendations, but they may only provide vague or weak justification.0 (0%) - 6 (6%)Two or fewer resources are provided to support the intervention recommendations. The resources may not be current or evidence based.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.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.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 are brief and not descriptive.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 are vague or off topic.0 (0%) - 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity
https://bit.ly/3xT5gwN

-

To Prepare

- Reflect on the study plan you created in NRNP 6665. Did you accomplish your SMART goals? What areas of focus still present opportunities for growth?

The Assignment

- Revise your study plan summarizing your current strengths and opportunities for improvement.
- Develop 3–4 new SMART goals for this quarter and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
- Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.
https://bit.ly/3MBFQb0

For this Assignment, you will consider the areas you aim to focus on to gain practical experience as an advanced practice nurse. Then, you will develop a Practicum Experience Plan (PEP) containing the objectives you will fulfill in order to achieve your aims. For this practicum experience, be sure to develop goals and objectives that allow you to synthesize knowledge and skills related to assessment, diagnosis, and treatment planning. 

To Prepare

- Review your Clinical Skills Self-Assessment Form you submitted last week and think about areas for which you would like to gain application-level experience and/or continued growth as an advanced practice nurse. How can your experiences in the practicum help you achieve these aims?  
- Review the information related to developing objectives provided in this week’s Learning Resources. Your practicum learning objectives that you want to achieve during your practicum experience must be: - Specific  
- Measurable  
- Attainable  
- Results-focused  
- Time-bound 
- Reflective of the higher-order domains of Bloom’s taxonomy (i.e., application level and above)  
- Discuss your professional aims and your proposed practicum objectives with your Preceptor to ascertain if the necessary resources are available at your practicum site.  
- Select one nursing theory and one counseling/psychotherapy theory to best guide your clinical practice. Explain why you selected these theories. Support your approach with evidence-based literature.
- Create a timeline of practicum activities that demonstrates how you plan to meet these goals and objectives based on your practicum requirements.

The Assignment

Record the required information in each area of the Practicum Experience Plan template, including 3–4 measurable practicum learning objectives you will use to facilitate your learning during the practicum experience.  
https://bit.ly/3H5uJFY

Assignment 1: Evaluation and Management (E/M)Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.

For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5-TR to ICD-10.

Photo Credit: Getty Images/Tetra images RF

To PrepareReview this week’s Learning Resources on coding, billing, reimbursement.Review the E/M patient case scenario provided.The AssignmentAssign DSM-5-TR and ICD-10 codes to services based upon the patient case scenario.Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.

Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding.Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.   

Pathways Mental Health

Psychiatric Patient Evaluation

InstructionsUse the following case template to complete Week 2 Assignment 1. On page 5, assign DSM-5 and ICD-10 codes to the services documented. You will add your narrative answers to the assignment questions to the bottom of this template and submit altogether as one document.Identifying InformationIdentification was verified by stating of their name and date of birth. Time spent for evaluation: 0900am-0957amChief Complaint“My other provider retired. I don’t think I’m doing so well.”HPI25 yo Russian female evaluated for psychiatric evaluation referred from her retiring practitioner for PTSD, ADHD, Stimulant Use Disorder, in remission. She is currently prescribed fluoxetine 20mg po daily for PTSD, atomoxetine 80mg po daily for ADHD. Today, client denied symptoms of depression, denied anergia, anhedonia, amotivation, no anxiety, denied frequent worry, reports feeling restlessness, no reported panic symptoms, no reported obsessive/compulsive behaviors. Client denies active SI/HI ideations, plans or intent. There is no evidence of psychosis or delusional thinking. Client denied past episodes of hypomania, hyperactivity, erratic/excessive spending, involvement in dangerous activities, self-inflated ego, grandiosity, or promiscuity. Client reports increased irritability and easily frustrated, loses things easily, makes mistakes, hard time focusing and concentrating, affecting her job. Has low frustration tolerance, sleeping 5–6 hrs/24hrs reports nightmares of previous rape, isolates, fearful to go outside, has missed several days of work, appetite decreased. She has somatic concerns with GI upset and headaches. Client denied any current binging/purging behaviors, denied withholding food from self or engaging in anorexic behaviors. No self-mutilation behaviors.Diagnostic Screening ResultsScreen of symptoms in the past 2 weeks:  PHQ 9 = 0 with symptoms rated as no difficulty in functioning  Interpretation of Total Score  Total Score Depression Severity 1-4 Minimal depression 5-9 Mild depression 10-14 Moderate depression 15-19 Moderately severe depression 20-27 Severe depression  GAD 7 = 2 with symptoms rated as no difficulty in functioning  Interpreting the Total Score:  Total Score Interpretation ≥10 Possible diagnosis of GAD; confirm by further evaluation 5 Mild Anxiety 10 Moderate anxiety 15 Severe anxiety  MDQ screen negative PCL-5 Screen 32Past Psychiatric and Substance Use TreatmentEntered mental health system when she was age 19 after raped by a stranger during a house burglary. Previous Psychiatric Hospitalizations:  denied Previous Detox/Residential treatments: one for abuse of stimulants and cocaine in 2015 Previous psychotropic medication trials: sertraline (became suicidal), trazodone (worsened nightmares), bupropion (became suicidal), Adderall (began abusing) Previous mental health diagnosis per client/medical record: GAD, Unspecified Trauma, PTSD, Stimulant use disorder, ADHD confirmed by school recordsSubstance Use HistoryHave you used/abused any of the following (include frequency/amt/last use): Substance Y/N Frequency/Last Use Tobacco products Y ½ ETOH Y last drink 2 weeks ago, reports drinks 1-2 times monthly one drink socially  Cannabis N Cocaine Y last use 2015 Prescription stimulants Y last use 2015 Methamphetamine N Inhalants N Sedative/sleeping pills N Hallucinogens N Street Opioids N Prescription opioids N Other: specify (spice, K2, bath salts, etc.) Y reports one-time ecstasy use in 2015 Any history of substance related:  Blackouts: +  Tremors:   - DUI: -  D/T's: - Seizures: -  Longest sobriety reported since 2015—stayed sober maintaining sponsor, sober friends, and meetingsPsychosocial HistoryClient was raised by adoptive parents since age 6; from Russian orphanage. She has unknown siblings. She is single; has no children. Employed at local tanning bed salon Education: High School Diploma Denied current legal issues.Suicide / HOmicide Risk AssessmentRISK FACTORS FOR SUICIDE: Suicidal Ideas or plans - no Suicide gestures in past - no Psychiatric diagnosis - yes Physical Illness (chronic, medical) - no Childhood trauma - yes Cognition not intact - no Support system - yes Unemployment - no Stressful life events - yes Physical abuse - yes Sexual abuse - yes Family history of suicide - unknown Family history of mental illness - unknown Hopelessness - no Gender - female Marital status - single White race Access to means Substance abuse - in remission PROTECTIVE FACTORS FOR SUICIDE: Absence of psychosis - yes Access to adequate health care - yes Advice & help seeking - yes Resourcefulness/Survival skills - yes Children - no Sense of responsibility - yes Pregnancy - no; last menses one week ago, has Norplant Spirituality - yes Life satisfaction - “fair amount” Positive coping skills - yes Positive social support - yes Positive therapeutic relationship - yes Future oriented - yes Suicide Inquiry: Denies active suicidal ideations, intentions, or plans. Denies recent self-harm behavior. Talks futuristically. Denied history of suicidal/homicidal ideation/gestures; denied history of self-mutilation behaviors Global Suicide Risk Assessment: The client is found to be at low risk of suicide or violence, however, risk of lethality increased under context of drugs/alcohol. No required SAFETY PLAN related to low riskMental Status ExaminationShe is a 25 yo Russian female who looks her stated age. She is cooperative with examiner. She is neatly groomed and clean, dressed appropriately. There is mild psychomotor restlessness. Her speech is clear, coherent, normal in volume and tone, has strong cultural accent. Her thought process is ruminative. There is no evidence of looseness of association or flight of ideas. Her mood is anxious, mildly irritable, and her affect appropriate to her mood. She was smiling at times in an appropriate manner. She denies any auditory or visual hallucinations. There is no evidence of any delusional thinking. She denies any current suicidal or homicidal ideation. Cognitively, She is alert and oriented to all spheres. Her recent and remote memory is intact. Her concentration is fair. Her insight is good.Clinical ImpressionClient is a 25 yo Russian female who presents with history of treatment for PTSD, ADHD, Stimulant use Disorder, in remission. Moods are anxious and irritable. She has ongoing reported symptoms of re-experiencing, avoidance, and hyperarousal of her past trauma experiences; ongoing subsyndromal symptoms related to her past ADHD diagnosis and exacerbated by her PTSD diagnosis. She denied vegetative symptoms of depression, no evident mania/hypomania, no psychosis, denied anxiety symptoms. Denied current cravings for drugs/alcohol, exhibits no withdrawal symptoms, has somatic concerns of GI upset and headaches. At the time of disposition, the client adamantly denies SI/HI ideations, plans or intent and has the ability to determine right from wrong, and can anticipate the potential consequences of behaviors and actions. She is a low risk for self-harm based on her current clinical presentation and her risk and protective factors.Diagnostic Impression Double click inside this text box to add/edit text. Delete placeholder text when you add your answers.Treatment PlanMedication: Increase fluoxetine 40mg po daily for PTSD #30 1 RF Continue with atomoxetine 80mg po daily for ADHD. #30 1 RF Instructed to call and report any adverse reactions. Future Plan: monitor for decrease re-experiencing, hyperarousal, and avoidance symptoms; monitor for improved concentration, less mistakes, less forgetful Education: Risks and benefits of medications are discussed including non-treatment. Potential side effects of medications discussed. Verbal informed consent obtained. Not to drive or operate dangerous machinery if feeling sedated. Not to stop medication abruptly without discussing with providers. Discussed risks of mixing medications with OTC drugs, herbal, alcohol/illegal drugs. Instructed to avoid this practice. Praised and Encouraged ongoing abstinence. Maintain support system, sponsors, and meetings. Discussed how drugs/ETOH affects mental health, physical health, sleep architecture. Patient was educated about therapy and services of the MHC including emergent care. Referral was sent via email to therapy team for PET treatment. Patient has emergency numbers: Emergency Services 911, the national Crisis Line 800-273-TALK, the MHC Crisis Clinic. Patient was instructed to go to nearest ER or call 911 if they become actively suicidal and/or homicidal. Time allowed for questions and answers provided. Provided supportive listening. Patient appeared to understand discussion and appears to have capacity for decision making via verbal conversation. RTC in 30 days Follow up with PCP for GI upset and headaches, reviewed PCP history and physical dated one week ago and include lab results Patient is amenable with this plan and agrees to follow treatment regimen as discussed.

Narrative Answers

Add your answers here. Delete instructions and placeholder text when you add your answers.

References
https://bit.ly/3xzkg2p

Directions: Refer to the DC Sniper Case at: (https://bja.ojp.gov/sites/g/files/xyckuh186/files/Publications/SniperRpt.pdf) to answer each of the following questions.

Discuss at least three things that complicated the investigation component of this case. Be specific using facts from the case itself, in addition to the laws that may have complicated the case. How were these complications minimized or overcome?Discuss two investigative lessons learned from this case and how they have helped the role of a criminal investigator and police departments in their entirety.Discuss the data bases that were used in the course of the investigation to garner information about the suspects and whether the importance of information sharing, and effective communication impacted this case positively or negatively and how. Be sure to give specific case information to support your thoughts.Discuss what evidence, upon finding the suspects, would be permissible to take without a warrant given the facts of the case that were known up until that time. Discuss the process you would go through to collect the evidence legally and to submit to the courts.

Format Requirements

Paper must be double spaced, 11 or 12 pt font and 1”margins all around, .doc or .docx format. Please do not submit a .pdf.All APA 7th edition format requirements must be followed (cover page, in text citations, reference page). Refer to APA/UMGC - learning resources found in the content page of this course.You must have resources to support your thoughts/opinions/information. These must be cited both in text as well as at the end of the document. Your paper should not contain direct quotes, sourced material must be paraphrased.
https://bit.ly/393Xpmc