Tag: Homework Solution

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    – ## TipsforStudyingMath.pdf – 20250924_102413.jpg **## TipsforStudyingMath.pdf** Tips for Studying Math 1) Math is not a spectator sport. You need to work out problems yourself to learn and understand the material. 2) Have a Math notebook. As you read the textbook, work out the example problems yo…

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    – ## TipsforStudyingMath.pdf

    – 20250924_102413.jpg

    **## TipsforStudyingMath.pdf**

    Tips for Studying Math

    1) Math is not a spectator sport. You need to work out problems yourself to learn

    and understand the material.

    2) Have a Math notebook. As you read the textbook, work out the example

    problems yourself.

    3) Do your homework right after reading/studying the textbook, while it’s still fresh in

    your mind.

    4) Practice, practice, practice. Mathematics is a skill, it takes exercise and time to

    learn, so practice as often as you can (every day or every other day). Don’t

    expect to cram right before taking the exam/quiz.

    5) Mistakes make your brain grow! That’s just part of the process. Keep trying.

    6) Math is sequential, the concepts build on one another. So don’t gloss-over

    concepts you don’t understand. Take the time to figure it out or ask a classmate

    or your professor.

    7) Take breaks. For every 50 minutes of studying, take a 10-minute break.

    8) Avoid distractions. Find a quiet place to work, and don’t try to multi-task. Math

    requires your full attention.

    9) Mix it up. Study an hour of math, then an hour for another class (if you’re taking

    more than one), rather than long sessions on one topic.

    10) Focus on understanding. Memorizing a solution won’t help you solve the next

    problem.

    11) Create a “cheat sheet” of all the important formulas and concepts before taking a

    quiz or exam. Maybe include an example or two of worked problems. The act of

    writing it down, and deciding what’s important to write down, will help you learn

    the material. And it will be a great resource while you’re taking the quiz/exam.

    **20250924_102413.jpg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20250924-102413-jpg)

    **20250924_102413.jpg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20250924-102413-jpg)

    **## TipsforStudyingMath.pdf**

    Tips for Studying Math

    1) Math is not a spectator sport. You need to work out problems yourself to learn

    and understand the material.

    2) Have a Math notebook. As you read the textbook, work out the example

    problems yourself.

    3) Do your homework right after reading/studying the textbook, while it’s still fresh in

    your mind.

    4) Practice, practice, practice. Mathematics is a skill, it takes exercise and time to

    learn, so practice as often as you can (every day or every other day). Don’t

    expect to cram right before taking the exam/quiz.

    5) Mistakes make your brain grow! That’s just part of the process. Keep trying.

    6) Math is sequential, the concepts build on one another. So don’t gloss-over

    concepts you don’t understand. Take the time to figure it out or ask a classmate

    or your professor.

    7) Take breaks. For every 50 minutes of studying, take a 10-minute break.

    8) Avoid distractions. Find a quiet place to work, and don’t try to multi-task. Math

    requires your full attention.

    9) Mix it up. Study an hour of math, then an hour for another class (if you’re taking

    more than one), rather than long sessions on one topic.

    10) Focus on understanding. Memorizing a solution won’t help you solve the next

    problem.

    11) Create a “cheat sheet” of all the important formulas and concepts before taking a

    quiz or exam. Maybe include an example or two of worked problems. The act of

    writing it down, and deciding what’s important to write down, will help you learn

    the material. And it will be a great resource while you’re taking the quiz/exam.

    **20250924_102413.jpg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20250924-102413-jpg)

    **## TipsforStudyingMath.pdf**

    Tips for Studying Math

    1) Math is not a spectator sport. You need to work out problems yourself to learn

    and understand the material.

    2) Have a Math notebook. As you read the textbook, work out the example

    problems yourself.

    3) Do your homework right after reading/studying the textbook, while it’s still fresh in

    your mind.

    4) Practice, practice, practice. Mathematics is a skill, it takes exercise and time to

    learn, so practice as often as you can (every day or every other day). Don’t

    expect to cram right before taking the exam/quiz.

    5) Mistakes make your brain grow! That’s just part of the process. Keep trying.

    6) Math is sequential, the concepts build on one another. So don’t gloss-over

    concepts you don’t understand. Take the time to figure it out or ask a classmate

    or your professor.

    7) Take breaks. For every 50 minutes of studying, take a 10-minute break.

    8) Avoid distractions. Find a quiet place to work, and don’t try to multi-task. Math

    requires your full attention.

    9) Mix it up. Study an hour of math, then an hour for another class (if you’re taking

    more than one), rather than long sessions on one topic.

    10) Focus on understanding. Memorizing a solution won’t help you solve the next

    problem.

    11) Create a “cheat sheet” of all the important formulas and concepts before taking a

    quiz or exam. Maybe include an example or two of worked problems. The act of

    writing it down, and deciding what’s important to write down, will help you learn

    the material. And it will be a great resource while you’re taking the quiz/exam.

    **20250924_102413.jpg**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/20250924-102413-jpg)

    – 1
    – 2

  • [Solved] CM

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    Executive Solution Overview

    \ 20250924_103441.jpg](https://www.sweetstudy.com/files/20250924-103441-jpg "20250924_103441.jpg") \ 20250924_103521.jpg](https://www.sweetstudy.com/files/20250924-103521-jpg "20250924_103521.jpg") \ 20250924_103807.jpg](https://www.sweetstudy.com/files/20250924-103807-jpg "20250924_103807.jpg…

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    Assignment Prompt & Instructions

    \
    20250924_103441.jpg](https://www.sweetstudy.com/files/20250924-103441-jpg "20250924_103441.jpg")
    \
    20250924_103521.jpg](https://www.sweetstudy.com/files/20250924-103521-jpg "20250924_103521.jpg")
    \
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  • [Solved] NUR 620

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    – ## NUR620WK5disresponse.pdf – NUR620DISCUSSION17.pdf **## NUR620WK5disresponse.pdf** Reply from Daniela Barbeito Bipolar Case Discussion Clinical Case Summary Jill is a 24-year-old Hispanic woman that appeared in the emergency department due to radical change in behavioral orientation on her part …

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    – ## NUR620WK5disresponse.pdf

    – NUR620DISCUSSION17.pdf

    **## NUR620WK5disresponse.pdf**

    Reply from Daniela Barbeito
    Bipolar Case Discussion

    Clinical Case Summary

    Jill is a 24-year-old Hispanic woman that appeared in the emergency department due to
    radical change in behavioral orientation on her part as described by her parents. She has been
    giving everything away and insists that she is going to South Pole to rescue the world which is an
    indication of delusional and grandiose thought. According to the parents, she has been hardly
    sleeping in the past 7 days, she is very energetic. During the clinical interview, she seems to be
    pressured and talkative, uncontrollable laugher, and difficulties in sitting down and are reflective
    of psychomotor agitation. It is extremely difficult to make her stop and even she does not seem
    to have the ability to stay long enough to pay attention to provide answers to questions
    accordingly. These findings are consistent with a manic episode that constitutes mood and
    psychotic symptoms which necessitate an urgent intervention (Wiebe et al., 2022).
    Primary and Differential Diagnoses

    Bipolar I Disorder, Current Episode Manic, With Psychotic Features (DSM-5 296.44;
    ICD-10 F31.2) is the initial diagnosis of Jill. This is supported by her symptoms of decreased
    sleep drive, bombast, abundant energy, impulsiveness and delusional beliefs (Nierenberg et al.,
    2023). Among various diagnoses to consider is the Schizoaffective Disorder, Bipolar Type
    (DSM-5 295.70; ICD-10 F25.0) which can be characterized with psychotic symptoms and at the
    same time mood swings, but in her case, her symptoms appear as a mood episode and not as a
    persistent problem. The next similar diagnosis is the case of Substance/Medication-Induced
    Bipolar and Related Disorder (DSM-5 292.84; ICD-10 F06.33) because mania may appear when
    stimulants and drugs are used, and the diagnosis is to be excluded with the help of toxicology test
    (Nierenberg et al., 2023). However, the history of her mother and father shows that there is no
    substance consumption, but it is endogenous mood disorder. This is an essential requirement
    because it would be necessary to offer the appropriate diagnosis and specialized therapy.

    Pharmacological Treatment

    Pharmacological therapy using a mood stabilizer as prescribed by the APA and
    CANMAT guidelines should be the first-line treatment of Jill and in this instance, lithium
    carbonate is the first-line drug. Lithium has been historically proved to be useful in the treatment
    of acute manic episode and prevention of relapse as well as minimization of the chances of
    suicide (Wiebe et al., 2022). The symptoms that Jill had are severe, and the symptoms observed
    are a result of psychotic in nature and thus it is appropriate to prescribe atypical antipsychotic
    medicine, such as risperidone or olanzapine. These antipsychotics have a quicker response
    compared to the lithium in the alleviation of the agitation, delusions and disorganized behavior.
    The combination therapy is also widely prescribed in case of acute mania with psychosis as not
    only the mood is treated but the symptoms as well are cured quickly. The lithium level, kidney

    and thyroid activity would also be under strict monitoring to enable her to have good care of her
    condition.

    Non-Pharmacological Treatment

    To the recovery and relapses prevention of Jill, non-pharmacological interventions play
    an important role. Psychoeducation should be undertaken with Jill and her family to enable them
    to be better informed about the bipolar disorder and the necessity of taking medication regularly
    and to be more conscious about the onset of relapse. Cognitive Behavioral Therapy (CBT) would
    help her in doubting the distorted beliefs, have a higher level of insight and develop coping
    mechanisms that will help her overcome stressors that might cause future incidences (Wiebe et
    al., 2022). The Family-Focused Therapy (FFT) reveals much evidence of family communication,
    relapse prevention, and treatment compliance which would prove very helpful based on the role
    played by her parents in her treatment process. The initially secure hospitalization could be
    inpatient to ensure her safety and provide the intensive stabilization since she is giving away the
    possessions and has poor judgment. There would be a need to follow up with outpatient therapy
    after the stabilization in order to maintain the development. Such psychosocial interventions
    present the best chance to stabilize in the event of their combination with medication.

    Health Promotion Intervention

    The best health promotion that could be offered to Jill is the provision of lifestyle and
    wellness program well-structured, which would focus on sleep hygiene and routine building,
    stress management. The bipolar disorder is highly sensitive to sleep disturbances, but the risk of
    a relapse can be minimized significantly by setting the normal sleep and wake patterns. One
    should also adopt healthy lifestyle, physical exercises and shunning of other substances like
    alcohol and caffeine to make sure that the body is stable (Nierenberg et al., 2023). The other area
    that Jill needs to be associated with is the community support groups and culturally sensitive
    learning resources that can enable her to gain more knowledge about the illness and overcome
    the stigma. The PHC should be reinforced through the follow-up treatment of psychiatric
    treatment and adherence to pharmacologic as well as non-pharmacologic treatment as a long-
    term measure. These are the measures of health promotion that can empower Jill to take a
    significant part in her rehabilitation and reduce the possibilities of reoccurring episodes.

    Reply from William Joseph Sierra
    Discussion: Bipolar Case

    1. Summarize the clinical case including the significant subjective and objective data.
    Subjective Data:

    The patient, Jill, is a 24-year-old Hispanic female. Her parents are taking her to the clinic,
    so an evaluation is conducted. The patient has either had manic or depressive episodes in the last
    week. She also wants to save the world by traveling to the South Pole, but this suggests that she
    would be confined to a room. She is distributing and getting rid of her belongings in the
    meantime. Although she still seems to be quite active, the surveyed person's parents speculate
    that she had severe insomnia a week prior to the survey. They also say that she laughs
    hysterically, talks without pausing, and appears preoccupied. The interview also revealed Jill's
    annoyance and restlessness.

    Objective Data:

    The patient reports the presence of multiple symptoms including inflated self-esteem, lack
    of sleep, excessive talkativeness, flight of ideas, lack of concentration, and over-engagement in
    activities prone to painful outcomes. In addition to dysfunction of a specific period of
    abnormally and persistently elevated, expansive, or irritable mood lasting at least one
    week (American Psychiatric Association, 2022).

    2. Generate a primary and two differential diagnoses. Use the DSM5 to support the
    assessment. Include the DSM5 and ICD 10 codes.

    The patient's primary diagnosis is bipolar disorder, specifically Most Recent Episode
    Manic with Psychotic Features (DSM-5 Code 296.89 and ICD-10 Code F31.81). A patient must
    experience a week-long manic episode in order to be eligible for a bipolar disorder diagnosis
    based on the Most Recent Episode Manic with Psychotic Features (American Psychiatric
    Association, 2022). At least three of the following symptoms had to be present: a need for less
    sleep, a high but irregular speech rate, egocentric delusions of exaggerated self-worth,
    accelerated goal-directed behavior, attention deficit, and a high level of risk-taking.

    Secondly, the patient must present with at least one psychotic symptom, such as delusions
    or psychosis. Jill has been displaying signs of sleep deprivation, high goal-directed behavior
    such as trying to sell everything she owns, pressure and hurry in speech, and distractibility over
    the past week. She also believes she wants to save the world and has delusional fits in
    psychiatric disorders. As a result, the patient is diagnosed with DSM-5 Bipolar Disorder, Most
    Recent Episode Manic with Psychotic Features (American Psychiatric Association, 2022).

    Differential diagnoses:

    Schizophrenia, With Catatonia (ICD-10: (F20.2): This includes traits like pressure,
    emotional tension, and a rapid-fire stream of words; it also includes the presence of delusions
    and potential manic episodes.

    Substance-induced Bipolar and Related Disorder (ICD-10: F10.14): The severity and
    remission involve substance abuse or withdrawal, which mimics a manic episode (American
    Psychiatric Association, 2022).

    3. Discuss a pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    Bipolar disorder is characterized by mood swings, and mood stabilizers will be necessary
    to treat it. They are only given to patients in order to prevent manic and maniacal episodes.
    According to Nath & Gupta (2024), Lithium is a drug that the Food and Drug Administration has
    approved to treat bipolar disorder, which includes both acute manic phases and a maintenance
    phase (Nath & Gupta, 2024). To alleviate Jill's manic symptoms and to promote a stable and
    optimal mood for the remainder of the week, lithium would be a suitable recommendation.

    4. 4. Discuss non-pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    One effective non-pharmacological treatment for bipolar disorder is cognitive behavioral
    therapy (CBT). It is crucial to remember that CBT aims to counteract undesirable behaviours and
    thought patterns (Özdel et al., 2021). In addition to identifying the factors that trigger bipolar
    episodes, cognitive behavioral therapy (CBT) helps people learn healthy coping mechanisms for
    stressful situations (Özdel et al., 2021).

    5. Describe a health promotion intervention that would be appropriate for this patient.
    Health promotion interventions help to meet the need for psychoeducation. Additionally,

    the intervention increases opportunities for medication compliance (Deng et al., 2022). In Jill's
    case, psychoeducation would be necessary for both her and her family since it would enable
    them to recognize the signs that her moods were shifting and seek professional help as soon as
    possible. To assess and precondition treatment plans, the intervention would also be necessary to
    improve follow-up appointments in accordance with the schedule.

    **NUR620DISCUSSION17.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nur620discussion17-pdf-10408551)

    **NUR620DISCUSSION17.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nur620discussion17-pdf-10408551)

    **## NUR620WK5disresponse.pdf**

    Reply from Daniela Barbeito
    Bipolar Case Discussion

    Clinical Case Summary

    Jill is a 24-year-old Hispanic woman that appeared in the emergency department due to
    radical change in behavioral orientation on her part as described by her parents. She has been
    giving everything away and insists that she is going to South Pole to rescue the world which is an
    indication of delusional and grandiose thought. According to the parents, she has been hardly
    sleeping in the past 7 days, she is very energetic. During the clinical interview, she seems to be
    pressured and talkative, uncontrollable laugher, and difficulties in sitting down and are reflective
    of psychomotor agitation. It is extremely difficult to make her stop and even she does not seem
    to have the ability to stay long enough to pay attention to provide answers to questions
    accordingly. These findings are consistent with a manic episode that constitutes mood and
    psychotic symptoms which necessitate an urgent intervention (Wiebe et al., 2022).
    Primary and Differential Diagnoses

    Bipolar I Disorder, Current Episode Manic, With Psychotic Features (DSM-5 296.44;
    ICD-10 F31.2) is the initial diagnosis of Jill. This is supported by her symptoms of decreased
    sleep drive, bombast, abundant energy, impulsiveness and delusional beliefs (Nierenberg et al.,
    2023). Among various diagnoses to consider is the Schizoaffective Disorder, Bipolar Type
    (DSM-5 295.70; ICD-10 F25.0) which can be characterized with psychotic symptoms and at the
    same time mood swings, but in her case, her symptoms appear as a mood episode and not as a
    persistent problem. The next similar diagnosis is the case of Substance/Medication-Induced
    Bipolar and Related Disorder (DSM-5 292.84; ICD-10 F06.33) because mania may appear when
    stimulants and drugs are used, and the diagnosis is to be excluded with the help of toxicology test
    (Nierenberg et al., 2023). However, the history of her mother and father shows that there is no
    substance consumption, but it is endogenous mood disorder. This is an essential requirement
    because it would be necessary to offer the appropriate diagnosis and specialized therapy.

    Pharmacological Treatment

    Pharmacological therapy using a mood stabilizer as prescribed by the APA and
    CANMAT guidelines should be the first-line treatment of Jill and in this instance, lithium
    carbonate is the first-line drug. Lithium has been historically proved to be useful in the treatment
    of acute manic episode and prevention of relapse as well as minimization of the chances of
    suicide (Wiebe et al., 2022). The symptoms that Jill had are severe, and the symptoms observed
    are a result of psychotic in nature and thus it is appropriate to prescribe atypical antipsychotic
    medicine, such as risperidone or olanzapine. These antipsychotics have a quicker response
    compared to the lithium in the alleviation of the agitation, delusions and disorganized behavior.
    The combination therapy is also widely prescribed in case of acute mania with psychosis as not
    only the mood is treated but the symptoms as well are cured quickly. The lithium level, kidney

    and thyroid activity would also be under strict monitoring to enable her to have good care of her
    condition.

    Non-Pharmacological Treatment

    To the recovery and relapses prevention of Jill, non-pharmacological interventions play
    an important role. Psychoeducation should be undertaken with Jill and her family to enable them
    to be better informed about the bipolar disorder and the necessity of taking medication regularly
    and to be more conscious about the onset of relapse. Cognitive Behavioral Therapy (CBT) would
    help her in doubting the distorted beliefs, have a higher level of insight and develop coping
    mechanisms that will help her overcome stressors that might cause future incidences (Wiebe et
    al., 2022). The Family-Focused Therapy (FFT) reveals much evidence of family communication,
    relapse prevention, and treatment compliance which would prove very helpful based on the role
    played by her parents in her treatment process. The initially secure hospitalization could be
    inpatient to ensure her safety and provide the intensive stabilization since she is giving away the
    possessions and has poor judgment. There would be a need to follow up with outpatient therapy
    after the stabilization in order to maintain the development. Such psychosocial interventions
    present the best chance to stabilize in the event of their combination with medication.

    Health Promotion Intervention

    The best health promotion that could be offered to Jill is the provision of lifestyle and
    wellness program well-structured, which would focus on sleep hygiene and routine building,
    stress management. The bipolar disorder is highly sensitive to sleep disturbances, but the risk of
    a relapse can be minimized significantly by setting the normal sleep and wake patterns. One
    should also adopt healthy lifestyle, physical exercises and shunning of other substances like
    alcohol and caffeine to make sure that the body is stable (Nierenberg et al., 2023). The other area
    that Jill needs to be associated with is the community support groups and culturally sensitive
    learning resources that can enable her to gain more knowledge about the illness and overcome
    the stigma. The PHC should be reinforced through the follow-up treatment of psychiatric
    treatment and adherence to pharmacologic as well as non-pharmacologic treatment as a long-
    term measure. These are the measures of health promotion that can empower Jill to take a
    significant part in her rehabilitation and reduce the possibilities of reoccurring episodes.

    Reply from William Joseph Sierra
    Discussion: Bipolar Case

    1. Summarize the clinical case including the significant subjective and objective data.
    Subjective Data:

    The patient, Jill, is a 24-year-old Hispanic female. Her parents are taking her to the clinic,
    so an evaluation is conducted. The patient has either had manic or depressive episodes in the last
    week. She also wants to save the world by traveling to the South Pole, but this suggests that she
    would be confined to a room. She is distributing and getting rid of her belongings in the
    meantime. Although she still seems to be quite active, the surveyed person's parents speculate
    that she had severe insomnia a week prior to the survey. They also say that she laughs
    hysterically, talks without pausing, and appears preoccupied. The interview also revealed Jill's
    annoyance and restlessness.

    Objective Data:

    The patient reports the presence of multiple symptoms including inflated self-esteem, lack
    of sleep, excessive talkativeness, flight of ideas, lack of concentration, and over-engagement in
    activities prone to painful outcomes. In addition to dysfunction of a specific period of
    abnormally and persistently elevated, expansive, or irritable mood lasting at least one
    week (American Psychiatric Association, 2022).

    2. Generate a primary and two differential diagnoses. Use the DSM5 to support the
    assessment. Include the DSM5 and ICD 10 codes.

    The patient's primary diagnosis is bipolar disorder, specifically Most Recent Episode
    Manic with Psychotic Features (DSM-5 Code 296.89 and ICD-10 Code F31.81). A patient must
    experience a week-long manic episode in order to be eligible for a bipolar disorder diagnosis
    based on the Most Recent Episode Manic with Psychotic Features (American Psychiatric
    Association, 2022). At least three of the following symptoms had to be present: a need for less
    sleep, a high but irregular speech rate, egocentric delusions of exaggerated self-worth,
    accelerated goal-directed behavior, attention deficit, and a high level of risk-taking.

    Secondly, the patient must present with at least one psychotic symptom, such as delusions
    or psychosis. Jill has been displaying signs of sleep deprivation, high goal-directed behavior
    such as trying to sell everything she owns, pressure and hurry in speech, and distractibility over
    the past week. She also believes she wants to save the world and has delusional fits in
    psychiatric disorders. As a result, the patient is diagnosed with DSM-5 Bipolar Disorder, Most
    Recent Episode Manic with Psychotic Features (American Psychiatric Association, 2022).

    Differential diagnoses:

    Schizophrenia, With Catatonia (ICD-10: (F20.2): This includes traits like pressure,
    emotional tension, and a rapid-fire stream of words; it also includes the presence of delusions
    and potential manic episodes.

    Substance-induced Bipolar and Related Disorder (ICD-10: F10.14): The severity and
    remission involve substance abuse or withdrawal, which mimics a manic episode (American
    Psychiatric Association, 2022).

    3. Discuss a pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    Bipolar disorder is characterized by mood swings, and mood stabilizers will be necessary
    to treat it. They are only given to patients in order to prevent manic and maniacal episodes.
    According to Nath & Gupta (2024), Lithium is a drug that the Food and Drug Administration has
    approved to treat bipolar disorder, which includes both acute manic phases and a maintenance
    phase (Nath & Gupta, 2024). To alleviate Jill's manic symptoms and to promote a stable and
    optimal mood for the remainder of the week, lithium would be a suitable recommendation.

    4. 4. Discuss non-pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    One effective non-pharmacological treatment for bipolar disorder is cognitive behavioral
    therapy (CBT). It is crucial to remember that CBT aims to counteract undesirable behaviours and
    thought patterns (Özdel et al., 2021). In addition to identifying the factors that trigger bipolar
    episodes, cognitive behavioral therapy (CBT) helps people learn healthy coping mechanisms for
    stressful situations (Özdel et al., 2021).

    5. Describe a health promotion intervention that would be appropriate for this patient.
    Health promotion interventions help to meet the need for psychoeducation. Additionally,

    the intervention increases opportunities for medication compliance (Deng et al., 2022). In Jill's
    case, psychoeducation would be necessary for both her and her family since it would enable
    them to recognize the signs that her moods were shifting and seek professional help as soon as
    possible. To assess and precondition treatment plans, the intervention would also be necessary to
    improve follow-up appointments in accordance with the schedule.

    **NUR620DISCUSSION17.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nur620discussion17-pdf-10408551)

    **## NUR620WK5disresponse.pdf**

    Reply from Daniela Barbeito
    Bipolar Case Discussion

    Clinical Case Summary

    Jill is a 24-year-old Hispanic woman that appeared in the emergency department due to
    radical change in behavioral orientation on her part as described by her parents. She has been
    giving everything away and insists that she is going to South Pole to rescue the world which is an
    indication of delusional and grandiose thought. According to the parents, she has been hardly
    sleeping in the past 7 days, she is very energetic. During the clinical interview, she seems to be
    pressured and talkative, uncontrollable laugher, and difficulties in sitting down and are reflective
    of psychomotor agitation. It is extremely difficult to make her stop and even she does not seem
    to have the ability to stay long enough to pay attention to provide answers to questions
    accordingly. These findings are consistent with a manic episode that constitutes mood and
    psychotic symptoms which necessitate an urgent intervention (Wiebe et al., 2022).
    Primary and Differential Diagnoses

    Bipolar I Disorder, Current Episode Manic, With Psychotic Features (DSM-5 296.44;
    ICD-10 F31.2) is the initial diagnosis of Jill. This is supported by her symptoms of decreased
    sleep drive, bombast, abundant energy, impulsiveness and delusional beliefs (Nierenberg et al.,
    2023). Among various diagnoses to consider is the Schizoaffective Disorder, Bipolar Type
    (DSM-5 295.70; ICD-10 F25.0) which can be characterized with psychotic symptoms and at the
    same time mood swings, but in her case, her symptoms appear as a mood episode and not as a
    persistent problem. The next similar diagnosis is the case of Substance/Medication-Induced
    Bipolar and Related Disorder (DSM-5 292.84; ICD-10 F06.33) because mania may appear when
    stimulants and drugs are used, and the diagnosis is to be excluded with the help of toxicology test
    (Nierenberg et al., 2023). However, the history of her mother and father shows that there is no
    substance consumption, but it is endogenous mood disorder. This is an essential requirement
    because it would be necessary to offer the appropriate diagnosis and specialized therapy.

    Pharmacological Treatment

    Pharmacological therapy using a mood stabilizer as prescribed by the APA and
    CANMAT guidelines should be the first-line treatment of Jill and in this instance, lithium
    carbonate is the first-line drug. Lithium has been historically proved to be useful in the treatment
    of acute manic episode and prevention of relapse as well as minimization of the chances of
    suicide (Wiebe et al., 2022). The symptoms that Jill had are severe, and the symptoms observed
    are a result of psychotic in nature and thus it is appropriate to prescribe atypical antipsychotic
    medicine, such as risperidone or olanzapine. These antipsychotics have a quicker response
    compared to the lithium in the alleviation of the agitation, delusions and disorganized behavior.
    The combination therapy is also widely prescribed in case of acute mania with psychosis as not
    only the mood is treated but the symptoms as well are cured quickly. The lithium level, kidney

    and thyroid activity would also be under strict monitoring to enable her to have good care of her
    condition.

    Non-Pharmacological Treatment

    To the recovery and relapses prevention of Jill, non-pharmacological interventions play
    an important role. Psychoeducation should be undertaken with Jill and her family to enable them
    to be better informed about the bipolar disorder and the necessity of taking medication regularly
    and to be more conscious about the onset of relapse. Cognitive Behavioral Therapy (CBT) would
    help her in doubting the distorted beliefs, have a higher level of insight and develop coping
    mechanisms that will help her overcome stressors that might cause future incidences (Wiebe et
    al., 2022). The Family-Focused Therapy (FFT) reveals much evidence of family communication,
    relapse prevention, and treatment compliance which would prove very helpful based on the role
    played by her parents in her treatment process. The initially secure hospitalization could be
    inpatient to ensure her safety and provide the intensive stabilization since she is giving away the
    possessions and has poor judgment. There would be a need to follow up with outpatient therapy
    after the stabilization in order to maintain the development. Such psychosocial interventions
    present the best chance to stabilize in the event of their combination with medication.

    Health Promotion Intervention

    The best health promotion that could be offered to Jill is the provision of lifestyle and
    wellness program well-structured, which would focus on sleep hygiene and routine building,
    stress management. The bipolar disorder is highly sensitive to sleep disturbances, but the risk of
    a relapse can be minimized significantly by setting the normal sleep and wake patterns. One
    should also adopt healthy lifestyle, physical exercises and shunning of other substances like
    alcohol and caffeine to make sure that the body is stable (Nierenberg et al., 2023). The other area
    that Jill needs to be associated with is the community support groups and culturally sensitive
    learning resources that can enable her to gain more knowledge about the illness and overcome
    the stigma. The PHC should be reinforced through the follow-up treatment of psychiatric
    treatment and adherence to pharmacologic as well as non-pharmacologic treatment as a long-
    term measure. These are the measures of health promotion that can empower Jill to take a
    significant part in her rehabilitation and reduce the possibilities of reoccurring episodes.

    Reply from William Joseph Sierra
    Discussion: Bipolar Case

    1. Summarize the clinical case including the significant subjective and objective data.
    Subjective Data:

    The patient, Jill, is a 24-year-old Hispanic female. Her parents are taking her to the clinic,
    so an evaluation is conducted. The patient has either had manic or depressive episodes in the last
    week. She also wants to save the world by traveling to the South Pole, but this suggests that she
    would be confined to a room. She is distributing and getting rid of her belongings in the
    meantime. Although she still seems to be quite active, the surveyed person's parents speculate
    that she had severe insomnia a week prior to the survey. They also say that she laughs
    hysterically, talks without pausing, and appears preoccupied. The interview also revealed Jill's
    annoyance and restlessness.

    Objective Data:

    The patient reports the presence of multiple symptoms including inflated self-esteem, lack
    of sleep, excessive talkativeness, flight of ideas, lack of concentration, and over-engagement in
    activities prone to painful outcomes. In addition to dysfunction of a specific period of
    abnormally and persistently elevated, expansive, or irritable mood lasting at least one
    week (American Psychiatric Association, 2022).

    2. Generate a primary and two differential diagnoses. Use the DSM5 to support the
    assessment. Include the DSM5 and ICD 10 codes.

    The patient's primary diagnosis is bipolar disorder, specifically Most Recent Episode
    Manic with Psychotic Features (DSM-5 Code 296.89 and ICD-10 Code F31.81). A patient must
    experience a week-long manic episode in order to be eligible for a bipolar disorder diagnosis
    based on the Most Recent Episode Manic with Psychotic Features (American Psychiatric
    Association, 2022). At least three of the following symptoms had to be present: a need for less
    sleep, a high but irregular speech rate, egocentric delusions of exaggerated self-worth,
    accelerated goal-directed behavior, attention deficit, and a high level of risk-taking.

    Secondly, the patient must present with at least one psychotic symptom, such as delusions
    or psychosis. Jill has been displaying signs of sleep deprivation, high goal-directed behavior
    such as trying to sell everything she owns, pressure and hurry in speech, and distractibility over
    the past week. She also believes she wants to save the world and has delusional fits in
    psychiatric disorders. As a result, the patient is diagnosed with DSM-5 Bipolar Disorder, Most
    Recent Episode Manic with Psychotic Features (American Psychiatric Association, 2022).

    Differential diagnoses:

    Schizophrenia, With Catatonia (ICD-10: (F20.2): This includes traits like pressure,
    emotional tension, and a rapid-fire stream of words; it also includes the presence of delusions
    and potential manic episodes.

    Substance-induced Bipolar and Related Disorder (ICD-10: F10.14): The severity and
    remission involve substance abuse or withdrawal, which mimics a manic episode (American
    Psychiatric Association, 2022).

    3. Discuss a pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    Bipolar disorder is characterized by mood swings, and mood stabilizers will be necessary
    to treat it. They are only given to patients in order to prevent manic and maniacal episodes.
    According to Nath & Gupta (2024), Lithium is a drug that the Food and Drug Administration has
    approved to treat bipolar disorder, which includes both acute manic phases and a maintenance
    phase (Nath & Gupta, 2024). To alleviate Jill's manic symptoms and to promote a stable and
    optimal mood for the remainder of the week, lithium would be a suitable recommendation.

    4. 4. Discuss non-pharmacological treatment would you prescribe? Use the clinical
    guidelines to support the rationale for this treatment.

    One effective non-pharmacological treatment for bipolar disorder is cognitive behavioral
    therapy (CBT). It is crucial to remember that CBT aims to counteract undesirable behaviours and
    thought patterns (Özdel et al., 2021). In addition to identifying the factors that trigger bipolar
    episodes, cognitive behavioral therapy (CBT) helps people learn healthy coping mechanisms for
    stressful situations (Özdel et al., 2021).

    5. Describe a health promotion intervention that would be appropriate for this patient.
    Health promotion interventions help to meet the need for psychoeducation. Additionally,

    the intervention increases opportunities for medication compliance (Deng et al., 2022). In Jill's
    case, psychoeducation would be necessary for both her and her family since it would enable
    them to recognize the signs that her moods were shifting and seek professional help as soon as
    possible. To assess and precondition treatment plans, the intervention would also be necessary to
    improve follow-up appointments in accordance with the schedule.

    **NUR620DISCUSSION17.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nur620discussion17-pdf-10408551)

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    **## StressAssignment.docx**

    Write an essay on stress and it has to be 1500 words.

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    Ex: exploring stress's physical and mental health impacts, such as its link to chronic diseases or anxiety

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    – ## MSW525MODULE4GuidelinesINSTRUCTIONS.docx

    **## MSW525MODULE4GuidelinesINSTRUCTIONS.docx**

    Case Analysis:
    **Skin Hunger in chapter 4** **and The Boy who was Raised as a Dog in chapter 6 of The Boy who was Raised as a Dog.**

    1.
    **Recognize and analyze effects of that early experiences with adversity can have on children’s behaviors and relationships.**

    2.
    **Recognize and examine the ways that trauma is often passed down from generation to generation.**

    3.
    **Identify and examine the intervention strategies that address developmental trauma.**

    **Readings:**

    Perry, B. D., & Szalavitz, M. (2017).
    _The boy who was raised as a dog: And other stories from a child psychiatrist's notebook: what traumatized children can teach us about loss, love, and healing_.

    | | | |
    | — | — | — |
    | **Criteria** | | **Description** |
    | **Recognize and analyze the effects that early experiences with adversity can have on children's behaviors and relationships.** | | The student provides an excellent analysis of the impact that early trauma can have on the development of children and <br>**identifies multiple examples from the cases of Virginia/Laura, Connor, and Justin.** |
    | **Recognize and examine the ways that trauma is often passed down from generation to generation.** | | The student provides an excellent analysis of <br>**the ways in which trauma is often passed down from Generation to Generation and identifies multiple examples of this from the cases of Virginia and Connor.** |
    | **Identify and examine the intervention strategies that address developmental trauma.** | | The student provides an excellent analysis of the <br>**strategies that are used to intervene to address developmental trauma and identifies multiple examples from the cases of Virginia and Connor**. |
    | | | |

    **## MSW525MODULE4GuidelinesINSTRUCTIONS.docx**

    Case Analysis:
    **Skin Hunger in chapter 4** **and The Boy who was Raised as a Dog in chapter 6 of The Boy who was Raised as a Dog.**

    1.
    **Recognize and analyze effects of that early experiences with adversity can have on children’s behaviors and relationships.**

    2.
    **Recognize and examine the ways that trauma is often passed down from generation to generation.**

    3.
    **Identify and examine the intervention strategies that address developmental trauma.**

    **Readings:**

    Perry, B. D., & Szalavitz, M. (2017).
    _The boy who was raised as a dog: And other stories from a child psychiatrist's notebook: what traumatized children can teach us about loss, love, and healing_.

    | | | |
    | — | — | — |
    | **Criteria** | | **Description** |
    | **Recognize and analyze the effects that early experiences with adversity can have on children's behaviors and relationships.** | | The student provides an excellent analysis of the impact that early trauma can have on the development of children and <br>**identifies multiple examples from the cases of Virginia/Laura, Connor, and Justin.** |
    | **Recognize and examine the ways that trauma is often passed down from generation to generation.** | | The student provides an excellent analysis of <br>**the ways in which trauma is often passed down from Generation to Generation and identifies multiple examples of this from the cases of Virginia and Connor.** |
    | **Identify and examine the intervention strategies that address developmental trauma.** | | The student provides an excellent analysis of the <br>**strategies that are used to intervene to address developmental trauma and identifies multiple examples from the cases of Virginia and Connor**. |
    | | | |