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    – 2 years ago **files (4)** – ## WK3DISCDATA-LevelsofMeasurement.docx – ## WK3DATAMediatranscript.txt – NURS_8211_WK3_DescriptiveStatistics.pptx – UrinaryTractInfection.pdf **## WK3DISCDATA-LevelsofMeasurement.docx** Levels of Measurement: Categorical vs. Continuous Data; Descriptive Statistics a…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (4)**

    – ## WK3DISCDATA-LevelsofMeasurement.docx

    – ## WK3DATAMediatranscript.txt

    – NURS_8211_WK3_DescriptiveStatistics.pptx
    – UrinaryTractInfection.pdf

    **## WK3DISCDATA-LevelsofMeasurement.docx**

    Levels of Measurement: Categorical vs. Continuous Data; Descriptive Statistics and Probability Theory Basics

    _What is the incidence of blood clots from COVID-19 in females over the age of 35?_

    The above question is an example of a research question. A research question consists of three parts and guides the methods and approaches in which you will study the question to find answers. The research question includes the question, the topic, and the population or variables. In the example provided above, the question examines the prevalence of blood clots from severe COVID-19 in a selected population. From this question, the variables can be assessed, considerations can be analyzed, and populations can be sampled in order to guide the research.

    For this Discussion, you will analyze a selected work to identify and analyze the variables, comparisons, and sample sizes. You will explore the potential levels of measurement for your variables and the rationale for the labels, as well as consider the advantages and challenges that you might experience in the statistical analysis.

    **Reference:** Gray, J. R., & Grove, S. K. (2020).
    _Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence_ (9th ed.). Elsevier.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373659)

    Learning Resources

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Bullen, P. (n.d.).
    [_How to choose a sample size (for the statistically challenged)_ Links to an external site.](https://tools4dev.org/resources/how-to-choose-a-sample-size/). tools4dev. https://tools4dev.org/resources/how-to-choose-a-sample-size/

    · Centers for Disease Control and Prevention. (2024, March).
    [_The NHSN standard infection ratio (SIR)_ Links to an external site.](https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf). https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf

    · “Overview of the Standard Infection Ratio (SIR)” (pp. 4–5)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
    _Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 147–157)

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 3, “Computing and Understanding Averages: Means to an End” (pp. 65–68)

    · Chapter 5, “Creating Graphs: A Picture Really Is Worth a Thousand Words” (pp. 88–118)

    · Chapter 8, “Hypotheticals and You: Testing Your Questions” (pp. 167–180)

    · Chapter 9, “Probability and Why It Counts: Fun With a Bell-Shaped Curve” (pp. 181–200)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Niedz, B. (2024).
    _Descriptive statistics_ [Video]. Walden University Canvas. https://waldenu.instructure.com

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Document:
    [Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906?wrap=1) [Download Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906/download?download_frd=1)

    [Required Resources for Topic: Infections](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Beydoun, A. S., Koss, K., Nielsen, T., Holcomb, A. J., Pichardo, P., Purdy, N., Zebolsky, A. L., Heaton, C. M., McMullen, C. P., Yesensky, J. A., Moore, M. G., Goyal, N., Kohan, J., Sajisevi, M., Tan, K., Petrisor, D., Wax, M. K., Kejner, A. E., Hassan, Z., … Zenga, J. (2022).
    [Perioperative topical antisepsis and surgical site infection in patients undergoing upper aerodigestive tract reconstructionLinks to an external site.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/).
    _JAMA Otolaryngology-Head & Neck Surgery, 148_(6), 547–554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/

    · Sood, N., Lee, R. E., To, J. K., Cervellione, K. L., Smilios, M. D., Chun, H., & Ngai, I. M. (2022).
    [Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundleLinks to an external site.](https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586). B
    _irth: Issues in Perinatal Care, 49_(1), 141–146. https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586

    · Sauer, K. (2023).
    [_Testing for the treatment of urinary tract infections in symptomatic adult patients residing in long-term care facility: An evidence-based quality improvement project_ Links to an external site.](https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872) (Publication No. 30569808) [Doctoral dissertation, Phoenix University]. ProQuest Dissertations and Theses Global. https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872

    **To prepare:**

    · View the required media.

    · It is recommended you complete the quiz prior to constructing your initial response.

    By Day 3 of Week 3

    **Post** a response including the following:

    · Choose a research study, QI article, or EBP DNP project and interpret at least one continuous demographic variable and one categorical variable.

    · Differentiate between comparisons made using descriptive statistics (e.g., the mean and standard deviation) and comparisons based on inferential statistics (e.g., a
    _t_ test).

    · Compare and contrast the sample sizes used in the research study, the QI project, and the DNP project in terms of type 1 and type 2 errors.

    · Explain the SIR rate, how it is developed, and how organizations use it.

    · Using the same articles, pick one and differentiate between one descriptive and one inferential statistic used in any one of the three studies/projects.

    By Day 6 of Week 3

    **Read** a selection of your colleagues’ posts and
    **respond** to
    **at least two** of your colleagues on
    **two different days** by expanding upon their reflections, making connections to your perceptions, and offering additional insights.

    **Reply**

    **## WK3DATAMediatranscript.txt**

    BARBARA NIEDZ: Hi, all. Dr. Niedz here
    again and moving on to a brief discussion
    about descriptive statistics. So we'll talk a bit about
    measures of central tendency and measures of
    dispersion, and you'll see how they work for
    continuous variables. We'll also talk about
    frequencies and percentages and how they fit for
    categorical data. We'll use, revisit a
    little research lingo, and talk about null directional
    and non-directional hypotheses. We'll also visit the
    standardized infection rate, the standardized
    infection ratio measure, and how that's used in research,
    quality improvement, and DNP. And we're also going to
    spend a little time talking about the differences
    between type one and type two measurement errors and how they
    figure into research projects. Four levels of measurement, two
    categorical and two continuous– very important concepts
    and very important aspects of measurement. Categorical data is
    usually displayed by counts and percentages. So for example, nominal
    level data might be gender. Male, female, and
    transgender people might fall into
    those three buckets. And there's no value placed. Men are not better than women. Women are not better than men. Transgender are not
    better than men or women, and the data is equal
    in terms of the value of those contributions
    to the data set. Whereas ordinal data is ranked. So, for example, if you
    collected a demographic data on educational level
    for some reason, whether you were talking
    about health literacy or staff educational backgrounds,
    those data are ranked. People who only
    completed fifth grade and never completed grade
    school have less education than those people who
    completed high school who have less education
    than those people who have some college as
    opposed to those people who have advanced degrees. So categorical data
    come in two forms– nominal and ordinal. Ordinal is ranked,
    nominal is not. Continuous data is actually
    from the type of data that you can do an average
    with that makes sense. So for example,
    interval level data, where you have some scale
    that measures something– let's say perceived stress– from a number that
    is as low as zero with no perceived
    stress to as high as 21, where this is the most stress
    you can possibly imagine. The differences
    between the divisions, even though there
    might be zero, is very soft because a lot of
    stress compared to some stress is not exactly something that
    you can multiply or divide by, whereas ratio level data is. So suppose ratio level
    data– for example, income, annual income, zero– is very different from annual
    income of $50,000 a year, which is half the amount
    of $100,000 a year. So ratio data has equal
    divisions, has an absolute zero. But they're all
    useful and you're going to see some
    examples of that. Measures of central tendency–
    the mean, as I mentioned, is the arithmetic average. The mode is the most frequently
    occurring value in a data set. And the median is
    that point at which you have an equal
    number of observations above and below that point. You see them represented in, in
    published work and in projects. They're all very useful. The mean is subject to extremes,
    and if there are outliers present in the data, the median
    is a much more useful tool. Standard deviation tells you
    about that variation away from the mean. The variance is simply the
    standard deviation squared. And the range is the
    lowest point to the highest point in the data set. So measures of central tendency
    and measures of dispersion are very useful tools. The chapters that
    I've selected out for every week in Salkind and
    Frey are really useful tools, and understanding these concepts
    takes more than a 15 minute video, and I hope you'll
    consult with Salkind and Frey in order to be able to
    complete assignments, in order to be able to
    address the discussion questions in the classroom,
    and certainly the ability to answer the knowledge
    check questions. So, means and standard
    deviations, very, very useful for continuous data. Counts and percentages,
    also important. Percentile rankings allow
    you to do some comparisons. And confidence intervals
    are not exactly prediction, but it tells you something
    about that spread of data and what you might
    expect in terms of the relationship between
    the sample and the population. So, just a little
    bit of information on those four types of
    concepts can be very helpful. So a picture is worth
    a thousand words, and you can see the differences
    between categorical data on the left with a bar
    graph and continuous data on the right with a histogram. And in the histogram, you can
    see that that is essentially continuous data– no spaces,
    no gaps between the bars– whereas the categorical
    data on the left is summarized in a bar chart. And you can see that there
    are no gaps between the bars, and they are, in fact,
    separate and apart. Now, this is only a portion
    of the table in Sood et al that is presented on
    page 144 and is actually a way to present
    demographic variables and other important variables,
    independent and dependent variables, in a study all
    efficiently in one small table. And you can see that there are
    both categorical variables– for example, ethnicity,
    with 1,086 participants, broken down into the counts
    by different groupings– Asians, Hispanic, Black,
    Hispanic, white, and others– and also the percentages
    of the sample. You could easily
    do this manually to just figure out
    those percentages, but it's awfully nice
    when they're presented like this in a published piece. You can also see that the
    age and gestational age in this study are
    presented as the mean and the standard deviation plus
    or minus 1 standard deviation. So you get an idea of what the
    spread of data might look like. Median BMI and the range– again, it's an ordinal
    level of measurement. And so the mean
    might make good sense for the way that is
    presented and time in minutes also
    presented in the average with the standard deviation. So, can be a very efficient and
    useful way of summarizing data. There are three
    types of hypotheses that are actually
    usually implicit and not stated unless
    you were reading a PhD dissertation from Proquest. The null hypothesis
    states that there is no relationship,
    no association, between the variables,
    between the dependent and the independent variables. The alternate hypothesis states
    that there is a relationship or association between those
    independent and dependent variables, and hypothesis
    can go in one direction or not, depending on the
    nature of that comparison. And that can also be
    an important concept. So here's an example. Take a look at the study
    that's in the resources for this week by Bedouin
    and others from 2022. It's a study about perioperative
    prophylaxis practices and surgical site infections. And the null hypothesis
    would essentially say there is no association. There is no
    relationship, and there's no differences in
    perioperative prophylaxis practices and the SSI rate. However, an alternate
    hypothesis would posit a relationship between
    those two types of variables in a specific type
    of surgical procedure and would perhaps even be
    more specific in electing a certain type of
    prophylaxis over another. So, null, alternative,
    directional, or non-directional hypotheses. So the standardized
    infection rate or the standardized
    infection ratio, the SIR, is a very useful tool that's
    been developed by the NHSN that allows us to take a
    look at infections and make some comparisons on
    the basis of risk adjustment. So how sick are the
    patients, and what is the predicted rate of
    infection for a particular type of surgical procedure? It compares the actual
    rate to the prediction. So a SIR of greater
    than 1 indicates more hospital acquired
    infections than predicted, and an SIR error
    rate of less than 1 indicates fewer hospital
    acquired infections than predicted. So I played around with the
    literature and the SIR rate as I was preparing
    these slides and videos, and I live in New Jersey. And so I just said,
    well, let me see what I can find about this
    that's publicly available. And there is, in New Jersey,
    the State Department of Health publishes by hospital
    comparisons for different types of surgeries across
    the state and provides hospital-specific SIR rates
    for these different surgical procedures. So I challenge you to
    look in your own state and see what you can find out
    in terms of published SIR rates. And if you can't find anything,
    look up New Jersey Department of Health, and you'll be able
    to see a variety of hospitals in New Jersey. So we typically use probability
    theory and the normal curve in order to be able to
    understand prediction, and our statistics, our
    statistical analysis that we'll move into
    starting next week, will allow us to define
    a critical value, the point at which we can make
    a decision about rejecting the null hypothesis,
    that there is no difference or no
    association, in favor of the alternate hypothesis that
    says essentially, if you were to repeat the test with
    a different sample, you'd likely get a similar
    result 95% of the time or 99% of the time, depending
    on what that p value is, or whether it is in this
    part of the curve, where 95% of the values are, that allows you to see that
    difference between rejecting and not rejecting the
    hypothesis, the null hypothesis. There is actually excellent
    information in Salkind and Frey on pages 215 to 217
    on this concept. Now, one characteristic that
    you can see in the SOOD et al article is about whether
    or not there's a P value. If there's a P
    value, you can infer from that there is an
    inferential test of significance that is being used. And you can see this in
    table two in Sood et al. The last key point I want
    to make in this video is about measurement error. A type one error is
    the type of error that is made when statistical
    significance is found, but it's not really there. And your protection against this
    is the all important p value. Type two error is
    the type of error that you make when you
    don't find significance, but it's really there. And sample size is the biggest
    protection that we have. Key points in this
    video on this slide. Don't forget the
    value of the reading.

    **NURS_8211_WK3_DescriptiveStatistics.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nurs-8211-wk3-descriptivestatistics-pptx)

    **UrinaryTractInfection.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/urinarytractinfection-pdf-10222459)

    **UrinaryTractInfection.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/urinarytractinfection-pdf-10222459)

    **## WK3DISCDATA-LevelsofMeasurement.docx**

    Levels of Measurement: Categorical vs. Continuous Data; Descriptive Statistics and Probability Theory Basics

    _What is the incidence of blood clots from COVID-19 in females over the age of 35?_

    The above question is an example of a research question. A research question consists of three parts and guides the methods and approaches in which you will study the question to find answers. The research question includes the question, the topic, and the population or variables. In the example provided above, the question examines the prevalence of blood clots from severe COVID-19 in a selected population. From this question, the variables can be assessed, considerations can be analyzed, and populations can be sampled in order to guide the research.

    For this Discussion, you will analyze a selected work to identify and analyze the variables, comparisons, and sample sizes. You will explore the potential levels of measurement for your variables and the rationale for the labels, as well as consider the advantages and challenges that you might experience in the statistical analysis.

    **Reference:** Gray, J. R., & Grove, S. K. (2020).
    _Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence_ (9th ed.). Elsevier.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373659)

    Learning Resources

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Bullen, P. (n.d.).
    [_How to choose a sample size (for the statistically challenged)_ Links to an external site.](https://tools4dev.org/resources/how-to-choose-a-sample-size/). tools4dev. https://tools4dev.org/resources/how-to-choose-a-sample-size/

    · Centers for Disease Control and Prevention. (2024, March).
    [_The NHSN standard infection ratio (SIR)_ Links to an external site.](https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf). https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf

    · “Overview of the Standard Infection Ratio (SIR)” (pp. 4–5)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
    _Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 147–157)

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 3, “Computing and Understanding Averages: Means to an End” (pp. 65–68)

    · Chapter 5, “Creating Graphs: A Picture Really Is Worth a Thousand Words” (pp. 88–118)

    · Chapter 8, “Hypotheticals and You: Testing Your Questions” (pp. 167–180)

    · Chapter 9, “Probability and Why It Counts: Fun With a Bell-Shaped Curve” (pp. 181–200)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Niedz, B. (2024).
    _Descriptive statistics_ [Video]. Walden University Canvas. https://waldenu.instructure.com

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Document:
    [Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906?wrap=1) [Download Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906/download?download_frd=1)

    [Required Resources for Topic: Infections](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Beydoun, A. S., Koss, K., Nielsen, T., Holcomb, A. J., Pichardo, P., Purdy, N., Zebolsky, A. L., Heaton, C. M., McMullen, C. P., Yesensky, J. A., Moore, M. G., Goyal, N., Kohan, J., Sajisevi, M., Tan, K., Petrisor, D., Wax, M. K., Kejner, A. E., Hassan, Z., … Zenga, J. (2022).
    [Perioperative topical antisepsis and surgical site infection in patients undergoing upper aerodigestive tract reconstructionLinks to an external site.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/).
    _JAMA Otolaryngology-Head & Neck Surgery, 148_(6), 547–554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/

    · Sood, N., Lee, R. E., To, J. K., Cervellione, K. L., Smilios, M. D., Chun, H., & Ngai, I. M. (2022).
    [Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundleLinks to an external site.](https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586). B
    _irth: Issues in Perinatal Care, 49_(1), 141–146. https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586

    · Sauer, K. (2023).
    [_Testing for the treatment of urinary tract infections in symptomatic adult patients residing in long-term care facility: An evidence-based quality improvement project_ Links to an external site.](https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872) (Publication No. 30569808) [Doctoral dissertation, Phoenix University]. ProQuest Dissertations and Theses Global. https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872

    **To prepare:**

    · View the required media.

    · It is recommended you complete the quiz prior to constructing your initial response.

    By Day 3 of Week 3

    **Post** a response including the following:

    · Choose a research study, QI article, or EBP DNP project and interpret at least one continuous demographic variable and one categorical variable.

    · Differentiate between comparisons made using descriptive statistics (e.g., the mean and standard deviation) and comparisons based on inferential statistics (e.g., a
    _t_ test).

    · Compare and contrast the sample sizes used in the research study, the QI project, and the DNP project in terms of type 1 and type 2 errors.

    · Explain the SIR rate, how it is developed, and how organizations use it.

    · Using the same articles, pick one and differentiate between one descriptive and one inferential statistic used in any one of the three studies/projects.

    By Day 6 of Week 3

    **Read** a selection of your colleagues’ posts and
    **respond** to
    **at least two** of your colleagues on
    **two different days** by expanding upon their reflections, making connections to your perceptions, and offering additional insights.

    **Reply**

    **## WK3DATAMediatranscript.txt**

    BARBARA NIEDZ: Hi, all. Dr. Niedz here
    again and moving on to a brief discussion
    about descriptive statistics. So we'll talk a bit about
    measures of central tendency and measures of
    dispersion, and you'll see how they work for
    continuous variables. We'll also talk about
    frequencies and percentages and how they fit for
    categorical data. We'll use, revisit a
    little research lingo, and talk about null directional
    and non-directional hypotheses. We'll also visit the
    standardized infection rate, the standardized
    infection ratio measure, and how that's used in research,
    quality improvement, and DNP. And we're also going to
    spend a little time talking about the differences
    between type one and type two measurement errors and how they
    figure into research projects. Four levels of measurement, two
    categorical and two continuous– very important concepts
    and very important aspects of measurement. Categorical data is
    usually displayed by counts and percentages. So for example, nominal
    level data might be gender. Male, female, and
    transgender people might fall into
    those three buckets. And there's no value placed. Men are not better than women. Women are not better than men. Transgender are not
    better than men or women, and the data is equal
    in terms of the value of those contributions
    to the data set. Whereas ordinal data is ranked. So, for example, if you
    collected a demographic data on educational level
    for some reason, whether you were talking
    about health literacy or staff educational backgrounds,
    those data are ranked. People who only
    completed fifth grade and never completed grade
    school have less education than those people who
    completed high school who have less education
    than those people who have some college as
    opposed to those people who have advanced degrees. So categorical data
    come in two forms– nominal and ordinal. Ordinal is ranked,
    nominal is not. Continuous data is actually
    from the type of data that you can do an average
    with that makes sense. So for example,
    interval level data, where you have some scale
    that measures something– let's say perceived stress– from a number that
    is as low as zero with no perceived
    stress to as high as 21, where this is the most stress
    you can possibly imagine. The differences
    between the divisions, even though there
    might be zero, is very soft because a lot of
    stress compared to some stress is not exactly something that
    you can multiply or divide by, whereas ratio level data is. So suppose ratio level
    data– for example, income, annual income, zero– is very different from annual
    income of $50,000 a year, which is half the amount
    of $100,000 a year. So ratio data has equal
    divisions, has an absolute zero. But they're all
    useful and you're going to see some
    examples of that. Measures of central tendency–
    the mean, as I mentioned, is the arithmetic average. The mode is the most frequently
    occurring value in a data set. And the median is
    that point at which you have an equal
    number of observations above and below that point. You see them represented in, in
    published work and in projects. They're all very useful. The mean is subject to extremes,
    and if there are outliers present in the data, the median
    is a much more useful tool. Standard deviation tells you
    about that variation away from the mean. The variance is simply the
    standard deviation squared. And the range is the
    lowest point to the highest point in the data set. So measures of central tendency
    and measures of dispersion are very useful tools. The chapters that
    I've selected out for every week in Salkind and
    Frey are really useful tools, and understanding these concepts
    takes more than a 15 minute video, and I hope you'll
    consult with Salkind and Frey in order to be able to
    complete assignments, in order to be able to
    address the discussion questions in the classroom,
    and certainly the ability to answer the knowledge
    check questions. So, means and standard
    deviations, very, very useful for continuous data. Counts and percentages,
    also important. Percentile rankings allow
    you to do some comparisons. And confidence intervals
    are not exactly prediction, but it tells you something
    about that spread of data and what you might
    expect in terms of the relationship between
    the sample and the population. So, just a little
    bit of information on those four types of
    concepts can be very helpful. So a picture is worth
    a thousand words, and you can see the differences
    between categorical data on the left with a bar
    graph and continuous data on the right with a histogram. And in the histogram, you can
    see that that is essentially continuous data– no spaces,
    no gaps between the bars– whereas the categorical
    data on the left is summarized in a bar chart. And you can see that there
    are no gaps between the bars, and they are, in fact,
    separate and apart. Now, this is only a portion
    of the table in Sood et al that is presented on
    page 144 and is actually a way to present
    demographic variables and other important variables,
    independent and dependent variables, in a study all
    efficiently in one small table. And you can see that there are
    both categorical variables– for example, ethnicity,
    with 1,086 participants, broken down into the counts
    by different groupings– Asians, Hispanic, Black,
    Hispanic, white, and others– and also the percentages
    of the sample. You could easily
    do this manually to just figure out
    those percentages, but it's awfully nice
    when they're presented like this in a published piece. You can also see that the
    age and gestational age in this study are
    presented as the mean and the standard deviation plus
    or minus 1 standard deviation. So you get an idea of what the
    spread of data might look like. Median BMI and the range– again, it's an ordinal
    level of measurement. And so the mean
    might make good sense for the way that is
    presented and time in minutes also
    presented in the average with the standard deviation. So, can be a very efficient and
    useful way of summarizing data. There are three
    types of hypotheses that are actually
    usually implicit and not stated unless
    you were reading a PhD dissertation from Proquest. The null hypothesis
    states that there is no relationship,
    no association, between the variables,
    between the dependent and the independent variables. The alternate hypothesis states
    that there is a relationship or association between those
    independent and dependent variables, and hypothesis
    can go in one direction or not, depending on the
    nature of that comparison. And that can also be
    an important concept. So here's an example. Take a look at the study
    that's in the resources for this week by Bedouin
    and others from 2022. It's a study about perioperative
    prophylaxis practices and surgical site infections. And the null hypothesis
    would essentially say there is no association. There is no
    relationship, and there's no differences in
    perioperative prophylaxis practices and the SSI rate. However, an alternate
    hypothesis would posit a relationship between
    those two types of variables in a specific type
    of surgical procedure and would perhaps even be
    more specific in electing a certain type of
    prophylaxis over another. So, null, alternative,
    directional, or non-directional hypotheses. So the standardized
    infection rate or the standardized
    infection ratio, the SIR, is a very useful tool that's
    been developed by the NHSN that allows us to take a
    look at infections and make some comparisons on
    the basis of risk adjustment. So how sick are the
    patients, and what is the predicted rate of
    infection for a particular type of surgical procedure? It compares the actual
    rate to the prediction. So a SIR of greater
    than 1 indicates more hospital acquired
    infections than predicted, and an SIR error
    rate of less than 1 indicates fewer hospital
    acquired infections than predicted. So I played around with the
    literature and the SIR rate as I was preparing
    these slides and videos, and I live in New Jersey. And so I just said,
    well, let me see what I can find about this
    that's publicly available. And there is, in New Jersey,
    the State Department of Health publishes by hospital
    comparisons for different types of surgeries across
    the state and provides hospital-specific SIR rates
    for these different surgical procedures. So I challenge you to
    look in your own state and see what you can find out
    in terms of published SIR rates. And if you can't find anything,
    look up New Jersey Department of Health, and you'll be able
    to see a variety of hospitals in New Jersey. So we typically use probability
    theory and the normal curve in order to be able to
    understand prediction, and our statistics, our
    statistical analysis that we'll move into
    starting next week, will allow us to define
    a critical value, the point at which we can make
    a decision about rejecting the null hypothesis,
    that there is no difference or no
    association, in favor of the alternate hypothesis that
    says essentially, if you were to repeat the test with
    a different sample, you'd likely get a similar
    result 95% of the time or 99% of the time, depending
    on what that p value is, or whether it is in this
    part of the curve, where 95% of the values are, that allows you to see that
    difference between rejecting and not rejecting the
    hypothesis, the null hypothesis. There is actually excellent
    information in Salkind and Frey on pages 215 to 217
    on this concept. Now, one characteristic that
    you can see in the SOOD et al article is about whether
    or not there's a P value. If there's a P
    value, you can infer from that there is an
    inferential test of significance that is being used. And you can see this in
    table two in Sood et al. The last key point I want
    to make in this video is about measurement error. A type one error is
    the type of error that is made when statistical
    significance is found, but it's not really there. And your protection against this
    is the all important p value. Type two error is
    the type of error that you make when you
    don't find significance, but it's really there. And sample size is the biggest
    protection that we have. Key points in this
    video on this slide. Don't forget the
    value of the reading.

    **NURS_8211_WK3_DescriptiveStatistics.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nurs-8211-wk3-descriptivestatistics-pptx)

    **UrinaryTractInfection.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/urinarytractinfection-pdf-10222459)

    **## WK3DISCDATA-LevelsofMeasurement.docx**

    Levels of Measurement: Categorical vs. Continuous Data; Descriptive Statistics and Probability Theory Basics

    _What is the incidence of blood clots from COVID-19 in females over the age of 35?_

    The above question is an example of a research question. A research question consists of three parts and guides the methods and approaches in which you will study the question to find answers. The research question includes the question, the topic, and the population or variables. In the example provided above, the question examines the prevalence of blood clots from severe COVID-19 in a selected population. From this question, the variables can be assessed, considerations can be analyzed, and populations can be sampled in order to guide the research.

    For this Discussion, you will analyze a selected work to identify and analyze the variables, comparisons, and sample sizes. You will explore the potential levels of measurement for your variables and the rationale for the labels, as well as consider the advantages and challenges that you might experience in the statistical analysis.

    **Reference:** Gray, J. R., & Grove, S. K. (2020).
    _Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence_ (9th ed.). Elsevier.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373659)

    Learning Resources

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Bullen, P. (n.d.).
    [_How to choose a sample size (for the statistically challenged)_ Links to an external site.](https://tools4dev.org/resources/how-to-choose-a-sample-size/). tools4dev. https://tools4dev.org/resources/how-to-choose-a-sample-size/

    · Centers for Disease Control and Prevention. (2024, March).
    [_The NHSN standard infection ratio (SIR)_ Links to an external site.](https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf). https://www.cdc.gov/nhsn/pdfs/ps-analysis-resources/nhsn-sir-guide.pdf

    · “Overview of the Standard Infection Ratio (SIR)” (pp. 4–5)

    · Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021).
    _Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model & guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    · Chapter 6, “Evidence of Appraisal: Research” (pp. 147–157)

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 3, “Computing and Understanding Averages: Means to an End” (pp. 65–68)

    · Chapter 5, “Creating Graphs: A Picture Really Is Worth a Thousand Words” (pp. 88–118)

    · Chapter 8, “Hypotheticals and You: Testing Your Questions” (pp. 167–180)

    · Chapter 9, “Probability and Why It Counts: Fun With a Bell-Shaped Curve” (pp. 181–200)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Niedz, B. (2024).
    _Descriptive statistics_ [Video]. Walden University Canvas. https://waldenu.instructure.com

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Document:
    [Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906?wrap=1) [Download Descriptive Statistics (PowerPoint presentation)](https://waldenu.instructure.com/courses/157739/files/12465906/download?download_frd=1)

    [Required Resources for Topic: Infections](https://waldenu.instructure.com/courses/157739/pages/week-3-learning-resources?module_item_id=6373659)

    · Beydoun, A. S., Koss, K., Nielsen, T., Holcomb, A. J., Pichardo, P., Purdy, N., Zebolsky, A. L., Heaton, C. M., McMullen, C. P., Yesensky, J. A., Moore, M. G., Goyal, N., Kohan, J., Sajisevi, M., Tan, K., Petrisor, D., Wax, M. K., Kejner, A. E., Hassan, Z., … Zenga, J. (2022).
    [Perioperative topical antisepsis and surgical site infection in patients undergoing upper aerodigestive tract reconstructionLinks to an external site.](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/).
    _JAMA Otolaryngology-Head & Neck Surgery, 148_(6), 547–554. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9047735/

    · Sood, N., Lee, R. E., To, J. K., Cervellione, K. L., Smilios, M. D., Chun, H., & Ngai, I. M. (2022).
    [Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundleLinks to an external site.](https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586). B
    _irth: Issues in Perinatal Care, 49_(1), 141–146. https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12586

    · Sauer, K. (2023).
    [_Testing for the treatment of urinary tract infections in symptomatic adult patients residing in long-term care facility: An evidence-based quality improvement project_ Links to an external site.](https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872) (Publication No. 30569808) [Doctoral dissertation, Phoenix University]. ProQuest Dissertations and Theses Global. https://www.proquest.com/dissertations-theses/point-care-testing-treatment-urinary-tract/docview/2875242069/se-2?accountid=14872

    **To prepare:**

    · View the required media.

    · It is recommended you complete the quiz prior to constructing your initial response.

    By Day 3 of Week 3

    **Post** a response including the following:

    · Choose a research study, QI article, or EBP DNP project and interpret at least one continuous demographic variable and one categorical variable.

    · Differentiate between comparisons made using descriptive statistics (e.g., the mean and standard deviation) and comparisons based on inferential statistics (e.g., a
    _t_ test).

    · Compare and contrast the sample sizes used in the research study, the QI project, and the DNP project in terms of type 1 and type 2 errors.

    · Explain the SIR rate, how it is developed, and how organizations use it.

    · Using the same articles, pick one and differentiate between one descriptive and one inferential statistic used in any one of the three studies/projects.

    By Day 6 of Week 3

    **Read** a selection of your colleagues’ posts and
    **respond** to
    **at least two** of your colleagues on
    **two different days** by expanding upon their reflections, making connections to your perceptions, and offering additional insights.

    **Reply**

    **## WK3DATAMediatranscript.txt**

    BARBARA NIEDZ: Hi, all. Dr. Niedz here
    again and moving on to a brief discussion
    about descriptive statistics. So we'll talk a bit about
    measures of central tendency and measures of
    dispersion, and you'll see how they work for
    continuous variables. We'll also talk about
    frequencies and percentages and how they fit for
    categorical data. We'll use, revisit a
    little research lingo, and talk about null directional
    and non-directional hypotheses. We'll also visit the
    standardized infection rate, the standardized
    infection ratio measure, and how that's used in research,
    quality improvement, and DNP. And we're also going to
    spend a little time talking about the differences
    between type one and type two measurement errors and how they
    figure into research projects. Four levels of measurement, two
    categorical and two continuous– very important concepts
    and very important aspects of measurement. Categorical data is
    usually displayed by counts and percentages. So for example, nominal
    level data might be gender. Male, female, and
    transgender people might fall into
    those three buckets. And there's no value placed. Men are not better than women. Women are not better than men. Transgender are not
    better than men or women, and the data is equal
    in terms of the value of those contributions
    to the data set. Whereas ordinal data is ranked. So, for example, if you
    collected a demographic data on educational level
    for some reason, whether you were talking
    about health literacy or staff educational backgrounds,
    those data are ranked. People who only
    completed fifth grade and never completed grade
    school have less education than those people who
    completed high school who have less education
    than those people who have some college as
    opposed to those people who have advanced degrees. So categorical data
    come in two forms– nominal and ordinal. Ordinal is ranked,
    nominal is not. Continuous data is actually
    from the type of data that you can do an average
    with that makes sense. So for example,
    interval level data, where you have some scale
    that measures something– let's say perceived stress– from a number that
    is as low as zero with no perceived
    stress to as high as 21, where this is the most stress
    you can possibly imagine. The differences
    between the divisions, even though there
    might be zero, is very soft because a lot of
    stress compared to some stress is not exactly something that
    you can multiply or divide by, whereas ratio level data is. So suppose ratio level
    data– for example, income, annual income, zero– is very different from annual
    income of $50,000 a year, which is half the amount
    of $100,000 a year. So ratio data has equal
    divisions, has an absolute zero. But they're all
    useful and you're going to see some
    examples of that. Measures of central tendency–
    the mean, as I mentioned, is the arithmetic average. The mode is the most frequently
    occurring value in a data set. And the median is
    that point at which you have an equal
    number of observations above and below that point. You see them represented in, in
    published work and in projects. They're all very useful. The mean is subject to extremes,
    and if there are outliers present in the data, the median
    is a much more useful tool. Standard deviation tells you
    about that variation away from the mean. The variance is simply the
    standard deviation squared. And the range is the
    lowest point to the highest point in the data set. So measures of central tendency
    and measures of dispersion are very useful tools. The chapters that
    I've selected out for every week in Salkind and
    Frey are really useful tools, and understanding these concepts
    takes more than a 15 minute video, and I hope you'll
    consult with Salkind and Frey in order to be able to
    complete assignments, in order to be able to
    address the discussion questions in the classroom,
    and certainly the ability to answer the knowledge
    check questions. So, means and standard
    deviations, very, very useful for continuous data. Counts and percentages,
    also important. Percentile rankings allow
    you to do some comparisons. And confidence intervals
    are not exactly prediction, but it tells you something
    about that spread of data and what you might
    expect in terms of the relationship between
    the sample and the population. So, just a little
    bit of information on those four types of
    concepts can be very helpful. So a picture is worth
    a thousand words, and you can see the differences
    between categorical data on the left with a bar
    graph and continuous data on the right with a histogram. And in the histogram, you can
    see that that is essentially continuous data– no spaces,
    no gaps between the bars– whereas the categorical
    data on the left is summarized in a bar chart. And you can see that there
    are no gaps between the bars, and they are, in fact,
    separate and apart. Now, this is only a portion
    of the table in Sood et al that is presented on
    page 144 and is actually a way to present
    demographic variables and other important variables,
    independent and dependent variables, in a study all
    efficiently in one small table. And you can see that there are
    both categorical variables– for example, ethnicity,
    with 1,086 participants, broken down into the counts
    by different groupings– Asians, Hispanic, Black,
    Hispanic, white, and others– and also the percentages
    of the sample. You could easily
    do this manually to just figure out
    those percentages, but it's awfully nice
    when they're presented like this in a published piece. You can also see that the
    age and gestational age in this study are
    presented as the mean and the standard deviation plus
    or minus 1 standard deviation. So you get an idea of what the
    spread of data might look like. Median BMI and the range– again, it's an ordinal
    level of measurement. And so the mean
    might make good sense for the way that is
    presented and time in minutes also
    presented in the average with the standard deviation. So, can be a very efficient and
    useful way of summarizing data. There are three
    types of hypotheses that are actually
    usually implicit and not stated unless
    you were reading a PhD dissertation from Proquest. The null hypothesis
    states that there is no relationship,
    no association, between the variables,
    between the dependent and the independent variables. The alternate hypothesis states
    that there is a relationship or association between those
    independent and dependent variables, and hypothesis
    can go in one direction or not, depending on the
    nature of that comparison. And that can also be
    an important concept. So here's an example. Take a look at the study
    that's in the resources for this week by Bedouin
    and others from 2022. It's a study about perioperative
    prophylaxis practices and surgical site infections. And the null hypothesis
    would essentially say there is no association. There is no
    relationship, and there's no differences in
    perioperative prophylaxis practices and the SSI rate. However, an alternate
    hypothesis would posit a relationship between
    those two types of variables in a specific type
    of surgical procedure and would perhaps even be
    more specific in electing a certain type of
    prophylaxis over another. So, null, alternative,
    directional, or non-directional hypotheses. So the standardized
    infection rate or the standardized
    infection ratio, the SIR, is a very useful tool that's
    been developed by the NHSN that allows us to take a
    look at infections and make some comparisons on
    the basis of risk adjustment. So how sick are the
    patients, and what is the predicted rate of
    infection for a particular type of surgical procedure? It compares the actual
    rate to the prediction. So a SIR of greater
    than 1 indicates more hospital acquired
    infections than predicted, and an SIR error
    rate of less than 1 indicates fewer hospital
    acquired infections than predicted. So I played around with the
    literature and the SIR rate as I was preparing
    these slides and videos, and I live in New Jersey. And so I just said,
    well, let me see what I can find about this
    that's publicly available. And there is, in New Jersey,
    the State Department of Health publishes by hospital
    comparisons for different types of surgeries across
    the state and provides hospital-specific SIR rates
    for these different surgical procedures. So I challenge you to
    look in your own state and see what you can find out
    in terms of published SIR rates. And if you can't find anything,
    look up New Jersey Department of Health, and you'll be able
    to see a variety of hospitals in New Jersey. So we typically use probability
    theory and the normal curve in order to be able to
    understand prediction, and our statistics, our
    statistical analysis that we'll move into
    starting next week, will allow us to define
    a critical value, the point at which we can make
    a decision about rejecting the null hypothesis,
    that there is no difference or no
    association, in favor of the alternate hypothesis that
    says essentially, if you were to repeat the test with
    a different sample, you'd likely get a similar
    result 95% of the time or 99% of the time, depending
    on what that p value is, or whether it is in this
    part of the curve, where 95% of the values are, that allows you to see that
    difference between rejecting and not rejecting the
    hypothesis, the null hypothesis. There is actually excellent
    information in Salkind and Frey on pages 215 to 217
    on this concept. Now, one characteristic that
    you can see in the SOOD et al article is about whether
    or not there's a P value. If there's a P
    value, you can infer from that there is an
    inferential test of significance that is being used. And you can see this in
    table two in Sood et al. The last key point I want
    to make in this video is about measurement error. A type one error is
    the type of error that is made when statistical
    significance is found, but it's not really there. And your protection against this
    is the all important p value. Type two error is
    the type of error that you make when you
    don't find significance, but it's really there. And sample size is the biggest
    protection that we have. Key points in this
    video on this slide. Don't forget the
    value of the reading.

    **NURS_8211_WK3_DescriptiveStatistics.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nurs-8211-wk3-descriptivestatistics-pptx)

    **UrinaryTractInfection.pdf**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/urinarytractinfection-pdf-10222459)

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    – 2 years ago **files (2)** – ## Unit10soap.doc – ## Unit9SOAPNotePost-TraumaticStressDisorderPTSD.docx **## Unit10soap.doc** Unit 10soap – Clinical SOAP Note on Oppositional defiant disorder. Use attached example ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889991) **## Unit9SO…

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    – 2 years ago

    **files (2)**

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    **## Unit10soap.doc**

    Unit 10soap – Clinical SOAP Note on Oppositional defiant disorder. Use attached example

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889991)

    **## Unit9SOAPNotePost-TraumaticStressDisorderPTSD.docx**

    2

    **Unit 9 SOAP Note Post-Traumatic Stress Disorder (PTSD)**

    **SOAP Note: Post-Traumatic Stress Disorder (PTSD)**

    **Subjective:**

    Chief complaint (in patient's own words): "I can't sleep at night. I keep having these terrible nightmares about the car accident, and I'm always on edge."

    History of present illness: The patient is a 35-year-old male who presents with symptoms of PTSD following a severe car accident 6 months ago. He has stated that he suffers from intrusive thoughts, flashbacks, and nightmares about the accident. The patient says she feels always nervous and always on the alert, especially when driving or being a passenger in a car. He does not drive anymore and has missed several days at work because of his symptoms. The patient states that they have problems falling asleep and maintaining it, and they get only 3-4 hours of sleep per night. He also refers to desensitization and social isolation from his family and friends. (American Psychiatric Association, 2013).

    **Current Medications:**

    · 50 mg of sertraline every day (begun three months ago)

    · 1 mg of prazosin taken before bed (begun 1 month ago)

    **Allergies:** No known drug allergies

    **Past Medical History:**

    – Mild traumatic brain injury from the car accident (resolved)

    – Hypertension (controlled with diet and exercise)

    **Past Psychiatric History**: No history of mental illness diagnosis or treatment

    **Family History:** father who has a history of alcoholism

    **Relevant personal and social history:** The patient has two children, ages eight and ten, and is married. He works as an accountant but has been struggling to maintain his performance due to concentration difficulties and missed workdays. He reports increased tension in his marriage due to emotional withdrawal and irritability. The patient denies any history of substance abuse but mentions having 2-3 alcoholic drinks per night to "help fall asleep." This level of alcohol consumption may interfere with PTSD treatment and exacerbate symptoms (Lancaster et al., 2016).

    **Objective:**

    **Vitals:** BP 138/88, HR 82, RR 18, Temp 98.4°F

    **ROS:** Positive for sleep disturbance, anxiety, and concentration difficulties as described above. Otherwise, negative.

    **Mental Status Exam:**

    – Appearance: Well-groomed, appropriate attire

    – Behavior: Tense, hypervigilant

    – Speech: Normal rate and volume

    – Mood: "Anxious and on edge"

    – Affect: Constricted, anxious

    – Thought Process: Linear and goal-directed

    – Thought Content: Preoccupation with accident, no current suicidal or homicidal ideation

    – Perceptions: No hallucinations

    – Cognition: Alert and oriented x4, intact attention and concentration

    – Insight: Good

    – Judgment: Fair

    **Psychiatric Screening Measures:**

    – PCL-5 (PTSD Checklist for DSM-5): Score 58 (indicating severe PTSD symptoms)

    – PHQ-9 (Patient Health Questionnaire-9): Score 14 (indicating moderate depression)

    – GAD-7 (Generalized Anxiety Disorder-7): Score 16 (indicating severe anxiety)

    These screening measures support the clinical presentation and aid in diagnosis and treatment planning (Watkins et al., 2018).

    **Assessment:**

    **Primary Diagnosis**: Post-Traumatic Stress Disorder (F43.10)

    **DSM-5 Criteria Met:**

    A. Exposure to actual death or threatened death in a motor vehicle accident

    B. Presence of intrusion symptoms (recurrent distressing memories, nightmares, flashbacks)

    C. Persistent avoidance of stimuli associated with the trauma (avoiding driving, thoughts about the accident)

    D. Negative alterations in cognitions and mood (feeling detached from others, persistent negative emotional state)

    E. Marked alterations in arousal and reactivity (hypervigilance, sleep disturbance, irritability)

    F. Duration of disturbance is more than 1 month

    G. The disturbance causes clinically significant distress and impairment in social and occupational functioning

    H. The disturbance is not attributable to the physiological effects of a substance or another medical condition

    (American Psychiatric Association, 2013)

    **Differential Diagnoses:**

    1. Adjustment Disorder with Mixed Anxiety and Depressed Mood

    2. Major Depressive Disorder

    3. Generalized Anxiety Disorder

    **Potential Obstacles to Treatment:**

    – Avoidance behaviors reinforcing symptoms

    – Alcohol use potentially interfering with treatment effectiveness

    – Work-related stress and potential job insecurity

    – Marital strain due to PTSD symptoms

    **Plan:**

    1.
    **Medication Management:**

    · Increase Sertraline to 100 mg daily for 4 weeks, then reassess. This adjustment is based on evidence supporting the efficacy of SSRIs in PTSD treatment (Friedman, 2019).

    · Continue Prazosin 1 mg at bedtime for nightmares

    · Discuss risks of alcohol use with current medications and recommend gradual reduction

    **2. Psychotherapy:**

    · Refer for Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) therapy, weekly sessions for 12 weeks. These evidence-based treatments have shown significant efficacy in reducing PTSD symptoms (Watkins et al., 2018).

    · Provide psychoeducation on PTSD and its treatment

    **3. Behavioral Interventions:**

    · Teach and practice grounding techniques for managing flashbacks and anxiety

    · Encourage gradual exposure to driving-related stimuli using a hierarchical approach

    · Implement sleep hygiene measures and stimulus control therapy for insomnia

    **4. Supportive Measures:**

    · Refer to a PTSD support group

    · Recommend family therapy to address marital strain and improve family support

    · Provide resources for workplace accommodations if needed

    **5. Substance Use:**

    · Educate on risks of alcohol use for PTSD symptoms and sleep

    · Recommend gradual reduction of alcohol intake

    · Consider referral to substance abuse counselor if unable to reduce independently

    · (Lancaster et al., 2016)

    **6. Follow-up and Monitoring:**

    · Schedule follow-up appointment in 2 weeks to assess medication response and side effects

    · Obtain baseline liver function tests and lipid panel

    · Reassess PCL-5, PHQ-9, and GAD-7 scores at each visit to track symptom improvement

    · Coordinate care with therapist and other providers

    **7. Safety Planning:**

    · Develop a crisis plan, including coping strategies and emergency contacts

    · Assess for suicidal ideation at each visit

    · Provide crisis hotline information

    **8. Patient Education:**

    · Provide written materials on PTSD, treatment options, and coping strategies

    · Discuss importance of medication adherence and potential side effects

    · Encourage lifestyle modifications: regular exercise, stress reduction techniques, and healthy sleep habits

    This comprehensive treatment plan addresses the multifaceted nature of PTSD and incorporates evidence-based interventions across pharmacological, psychological, and behavioral domains (Friedman, 2019; Watkins et al., 2018).

    **Prognosis**: With adherence to the treatment plan, including medication management and evidence-based psychotherapy, the prognosis for symptom reduction and improved functioning is generally good. However, the patient's alcohol use and avoidance behaviors may complicate treatment. Further and changes in the strategy of the treatment will be essential for the best outcomes.

    **References**

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Friedman, M. J. (2019). PTSD: Pharmacotherapeutic approaches. Current Psychiatry Reports, 21(12), 1-9.

    Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105.

    Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

    **## Unit9SOAPNotePost-TraumaticStressDisorderPTSD.docx**

    2

    **Unit 9 SOAP Note Post-Traumatic Stress Disorder (PTSD)**

    **SOAP Note: Post-Traumatic Stress Disorder (PTSD)**

    **Subjective:**

    Chief complaint (in patient's own words): "I can't sleep at night. I keep having these terrible nightmares about the car accident, and I'm always on edge."

    History of present illness: The patient is a 35-year-old male who presents with symptoms of PTSD following a severe car accident 6 months ago. He has stated that he suffers from intrusive thoughts, flashbacks, and nightmares about the accident. The patient says she feels always nervous and always on the alert, especially when driving or being a passenger in a car. He does not drive anymore and has missed several days at work because of his symptoms. The patient states that they have problems falling asleep and maintaining it, and they get only 3-4 hours of sleep per night. He also refers to desensitization and social isolation from his family and friends. (American Psychiatric Association, 2013).

    **Current Medications:**

    · 50 mg of sertraline every day (begun three months ago)

    · 1 mg of prazosin taken before bed (begun 1 month ago)

    **Allergies:** No known drug allergies

    **Past Medical History:**

    – Mild traumatic brain injury from the car accident (resolved)

    – Hypertension (controlled with diet and exercise)

    **Past Psychiatric History**: No history of mental illness diagnosis or treatment

    **Family History:** father who has a history of alcoholism

    **Relevant personal and social history:** The patient has two children, ages eight and ten, and is married. He works as an accountant but has been struggling to maintain his performance due to concentration difficulties and missed workdays. He reports increased tension in his marriage due to emotional withdrawal and irritability. The patient denies any history of substance abuse but mentions having 2-3 alcoholic drinks per night to "help fall asleep." This level of alcohol consumption may interfere with PTSD treatment and exacerbate symptoms (Lancaster et al., 2016).

    **Objective:**

    **Vitals:** BP 138/88, HR 82, RR 18, Temp 98.4°F

    **ROS:** Positive for sleep disturbance, anxiety, and concentration difficulties as described above. Otherwise, negative.

    **Mental Status Exam:**

    – Appearance: Well-groomed, appropriate attire

    – Behavior: Tense, hypervigilant

    – Speech: Normal rate and volume

    – Mood: "Anxious and on edge"

    – Affect: Constricted, anxious

    – Thought Process: Linear and goal-directed

    – Thought Content: Preoccupation with accident, no current suicidal or homicidal ideation

    – Perceptions: No hallucinations

    – Cognition: Alert and oriented x4, intact attention and concentration

    – Insight: Good

    – Judgment: Fair

    **Psychiatric Screening Measures:**

    – PCL-5 (PTSD Checklist for DSM-5): Score 58 (indicating severe PTSD symptoms)

    – PHQ-9 (Patient Health Questionnaire-9): Score 14 (indicating moderate depression)

    – GAD-7 (Generalized Anxiety Disorder-7): Score 16 (indicating severe anxiety)

    These screening measures support the clinical presentation and aid in diagnosis and treatment planning (Watkins et al., 2018).

    **Assessment:**

    **Primary Diagnosis**: Post-Traumatic Stress Disorder (F43.10)

    **DSM-5 Criteria Met:**

    A. Exposure to actual death or threatened death in a motor vehicle accident

    B. Presence of intrusion symptoms (recurrent distressing memories, nightmares, flashbacks)

    C. Persistent avoidance of stimuli associated with the trauma (avoiding driving, thoughts about the accident)

    D. Negative alterations in cognitions and mood (feeling detached from others, persistent negative emotional state)

    E. Marked alterations in arousal and reactivity (hypervigilance, sleep disturbance, irritability)

    F. Duration of disturbance is more than 1 month

    G. The disturbance causes clinically significant distress and impairment in social and occupational functioning

    H. The disturbance is not attributable to the physiological effects of a substance or another medical condition

    (American Psychiatric Association, 2013)

    **Differential Diagnoses:**

    1. Adjustment Disorder with Mixed Anxiety and Depressed Mood

    2. Major Depressive Disorder

    3. Generalized Anxiety Disorder

    **Potential Obstacles to Treatment:**

    – Avoidance behaviors reinforcing symptoms

    – Alcohol use potentially interfering with treatment effectiveness

    – Work-related stress and potential job insecurity

    – Marital strain due to PTSD symptoms

    **Plan:**

    1.
    **Medication Management:**

    · Increase Sertraline to 100 mg daily for 4 weeks, then reassess. This adjustment is based on evidence supporting the efficacy of SSRIs in PTSD treatment (Friedman, 2019).

    · Continue Prazosin 1 mg at bedtime for nightmares

    · Discuss risks of alcohol use with current medications and recommend gradual reduction

    **2. Psychotherapy:**

    · Refer for Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) therapy, weekly sessions for 12 weeks. These evidence-based treatments have shown significant efficacy in reducing PTSD symptoms (Watkins et al., 2018).

    · Provide psychoeducation on PTSD and its treatment

    **3. Behavioral Interventions:**

    · Teach and practice grounding techniques for managing flashbacks and anxiety

    · Encourage gradual exposure to driving-related stimuli using a hierarchical approach

    · Implement sleep hygiene measures and stimulus control therapy for insomnia

    **4. Supportive Measures:**

    · Refer to a PTSD support group

    · Recommend family therapy to address marital strain and improve family support

    · Provide resources for workplace accommodations if needed

    **5. Substance Use:**

    · Educate on risks of alcohol use for PTSD symptoms and sleep

    · Recommend gradual reduction of alcohol intake

    · Consider referral to substance abuse counselor if unable to reduce independently

    · (Lancaster et al., 2016)

    **6. Follow-up and Monitoring:**

    · Schedule follow-up appointment in 2 weeks to assess medication response and side effects

    · Obtain baseline liver function tests and lipid panel

    · Reassess PCL-5, PHQ-9, and GAD-7 scores at each visit to track symptom improvement

    · Coordinate care with therapist and other providers

    **7. Safety Planning:**

    · Develop a crisis plan, including coping strategies and emergency contacts

    · Assess for suicidal ideation at each visit

    · Provide crisis hotline information

    **8. Patient Education:**

    · Provide written materials on PTSD, treatment options, and coping strategies

    · Discuss importance of medication adherence and potential side effects

    · Encourage lifestyle modifications: regular exercise, stress reduction techniques, and healthy sleep habits

    This comprehensive treatment plan addresses the multifaceted nature of PTSD and incorporates evidence-based interventions across pharmacological, psychological, and behavioral domains (Friedman, 2019; Watkins et al., 2018).

    **Prognosis**: With adherence to the treatment plan, including medication management and evidence-based psychotherapy, the prognosis for symptom reduction and improved functioning is generally good. However, the patient's alcohol use and avoidance behaviors may complicate treatment. Further and changes in the strategy of the treatment will be essential for the best outcomes.

    **References**

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Friedman, M. J. (2019). PTSD: Pharmacotherapeutic approaches. Current Psychiatry Reports, 21(12), 1-9.

    Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105.

    Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

    **## Unit10soap.doc**

    Unit 10soap – Clinical SOAP Note on Oppositional defiant disorder. Use attached example

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889991)

    **## Unit9SOAPNotePost-TraumaticStressDisorderPTSD.docx**

    2

    **Unit 9 SOAP Note Post-Traumatic Stress Disorder (PTSD)**

    **SOAP Note: Post-Traumatic Stress Disorder (PTSD)**

    **Subjective:**

    Chief complaint (in patient's own words): "I can't sleep at night. I keep having these terrible nightmares about the car accident, and I'm always on edge."

    History of present illness: The patient is a 35-year-old male who presents with symptoms of PTSD following a severe car accident 6 months ago. He has stated that he suffers from intrusive thoughts, flashbacks, and nightmares about the accident. The patient says she feels always nervous and always on the alert, especially when driving or being a passenger in a car. He does not drive anymore and has missed several days at work because of his symptoms. The patient states that they have problems falling asleep and maintaining it, and they get only 3-4 hours of sleep per night. He also refers to desensitization and social isolation from his family and friends. (American Psychiatric Association, 2013).

    **Current Medications:**

    · 50 mg of sertraline every day (begun three months ago)

    · 1 mg of prazosin taken before bed (begun 1 month ago)

    **Allergies:** No known drug allergies

    **Past Medical History:**

    – Mild traumatic brain injury from the car accident (resolved)

    – Hypertension (controlled with diet and exercise)

    **Past Psychiatric History**: No history of mental illness diagnosis or treatment

    **Family History:** father who has a history of alcoholism

    **Relevant personal and social history:** The patient has two children, ages eight and ten, and is married. He works as an accountant but has been struggling to maintain his performance due to concentration difficulties and missed workdays. He reports increased tension in his marriage due to emotional withdrawal and irritability. The patient denies any history of substance abuse but mentions having 2-3 alcoholic drinks per night to "help fall asleep." This level of alcohol consumption may interfere with PTSD treatment and exacerbate symptoms (Lancaster et al., 2016).

    **Objective:**

    **Vitals:** BP 138/88, HR 82, RR 18, Temp 98.4°F

    **ROS:** Positive for sleep disturbance, anxiety, and concentration difficulties as described above. Otherwise, negative.

    **Mental Status Exam:**

    – Appearance: Well-groomed, appropriate attire

    – Behavior: Tense, hypervigilant

    – Speech: Normal rate and volume

    – Mood: "Anxious and on edge"

    – Affect: Constricted, anxious

    – Thought Process: Linear and goal-directed

    – Thought Content: Preoccupation with accident, no current suicidal or homicidal ideation

    – Perceptions: No hallucinations

    – Cognition: Alert and oriented x4, intact attention and concentration

    – Insight: Good

    – Judgment: Fair

    **Psychiatric Screening Measures:**

    – PCL-5 (PTSD Checklist for DSM-5): Score 58 (indicating severe PTSD symptoms)

    – PHQ-9 (Patient Health Questionnaire-9): Score 14 (indicating moderate depression)

    – GAD-7 (Generalized Anxiety Disorder-7): Score 16 (indicating severe anxiety)

    These screening measures support the clinical presentation and aid in diagnosis and treatment planning (Watkins et al., 2018).

    **Assessment:**

    **Primary Diagnosis**: Post-Traumatic Stress Disorder (F43.10)

    **DSM-5 Criteria Met:**

    A. Exposure to actual death or threatened death in a motor vehicle accident

    B. Presence of intrusion symptoms (recurrent distressing memories, nightmares, flashbacks)

    C. Persistent avoidance of stimuli associated with the trauma (avoiding driving, thoughts about the accident)

    D. Negative alterations in cognitions and mood (feeling detached from others, persistent negative emotional state)

    E. Marked alterations in arousal and reactivity (hypervigilance, sleep disturbance, irritability)

    F. Duration of disturbance is more than 1 month

    G. The disturbance causes clinically significant distress and impairment in social and occupational functioning

    H. The disturbance is not attributable to the physiological effects of a substance or another medical condition

    (American Psychiatric Association, 2013)

    **Differential Diagnoses:**

    1. Adjustment Disorder with Mixed Anxiety and Depressed Mood

    2. Major Depressive Disorder

    3. Generalized Anxiety Disorder

    **Potential Obstacles to Treatment:**

    – Avoidance behaviors reinforcing symptoms

    – Alcohol use potentially interfering with treatment effectiveness

    – Work-related stress and potential job insecurity

    – Marital strain due to PTSD symptoms

    **Plan:**

    1.
    **Medication Management:**

    · Increase Sertraline to 100 mg daily for 4 weeks, then reassess. This adjustment is based on evidence supporting the efficacy of SSRIs in PTSD treatment (Friedman, 2019).

    · Continue Prazosin 1 mg at bedtime for nightmares

    · Discuss risks of alcohol use with current medications and recommend gradual reduction

    **2. Psychotherapy:**

    · Refer for Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) therapy, weekly sessions for 12 weeks. These evidence-based treatments have shown significant efficacy in reducing PTSD symptoms (Watkins et al., 2018).

    · Provide psychoeducation on PTSD and its treatment

    **3. Behavioral Interventions:**

    · Teach and practice grounding techniques for managing flashbacks and anxiety

    · Encourage gradual exposure to driving-related stimuli using a hierarchical approach

    · Implement sleep hygiene measures and stimulus control therapy for insomnia

    **4. Supportive Measures:**

    · Refer to a PTSD support group

    · Recommend family therapy to address marital strain and improve family support

    · Provide resources for workplace accommodations if needed

    **5. Substance Use:**

    · Educate on risks of alcohol use for PTSD symptoms and sleep

    · Recommend gradual reduction of alcohol intake

    · Consider referral to substance abuse counselor if unable to reduce independently

    · (Lancaster et al., 2016)

    **6. Follow-up and Monitoring:**

    · Schedule follow-up appointment in 2 weeks to assess medication response and side effects

    · Obtain baseline liver function tests and lipid panel

    · Reassess PCL-5, PHQ-9, and GAD-7 scores at each visit to track symptom improvement

    · Coordinate care with therapist and other providers

    **7. Safety Planning:**

    · Develop a crisis plan, including coping strategies and emergency contacts

    · Assess for suicidal ideation at each visit

    · Provide crisis hotline information

    **8. Patient Education:**

    · Provide written materials on PTSD, treatment options, and coping strategies

    · Discuss importance of medication adherence and potential side effects

    · Encourage lifestyle modifications: regular exercise, stress reduction techniques, and healthy sleep habits

    This comprehensive treatment plan addresses the multifaceted nature of PTSD and incorporates evidence-based interventions across pharmacological, psychological, and behavioral domains (Friedman, 2019; Watkins et al., 2018).

    **Prognosis**: With adherence to the treatment plan, including medication management and evidence-based psychotherapy, the prognosis for symptom reduction and improved functioning is generally good. However, the patient's alcohol use and avoidance behaviors may complicate treatment. Further and changes in the strategy of the treatment will be essential for the best outcomes.

    **References**

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Friedman, M. J. (2019). PTSD: Pharmacotherapeutic approaches. Current Psychiatry Reports, 21(12), 1-9.

    Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105.

    Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

    **## Unit10soap.doc**

    Unit 10soap – Clinical SOAP Note on Oppositional defiant disorder. Use attached example

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889991)

    **## Unit9SOAPNotePost-TraumaticStressDisorderPTSD.docx**

    2

    **Unit 9 SOAP Note Post-Traumatic Stress Disorder (PTSD)**

    **SOAP Note: Post-Traumatic Stress Disorder (PTSD)**

    **Subjective:**

    Chief complaint (in patient's own words): "I can't sleep at night. I keep having these terrible nightmares about the car accident, and I'm always on edge."

    History of present illness: The patient is a 35-year-old male who presents with symptoms of PTSD following a severe car accident 6 months ago. He has stated that he suffers from intrusive thoughts, flashbacks, and nightmares about the accident. The patient says she feels always nervous and always on the alert, especially when driving or being a passenger in a car. He does not drive anymore and has missed several days at work because of his symptoms. The patient states that they have problems falling asleep and maintaining it, and they get only 3-4 hours of sleep per night. He also refers to desensitization and social isolation from his family and friends. (American Psychiatric Association, 2013).

    **Current Medications:**

    · 50 mg of sertraline every day (begun three months ago)

    · 1 mg of prazosin taken before bed (begun 1 month ago)

    **Allergies:** No known drug allergies

    **Past Medical History:**

    – Mild traumatic brain injury from the car accident (resolved)

    – Hypertension (controlled with diet and exercise)

    **Past Psychiatric History**: No history of mental illness diagnosis or treatment

    **Family History:** father who has a history of alcoholism

    **Relevant personal and social history:** The patient has two children, ages eight and ten, and is married. He works as an accountant but has been struggling to maintain his performance due to concentration difficulties and missed workdays. He reports increased tension in his marriage due to emotional withdrawal and irritability. The patient denies any history of substance abuse but mentions having 2-3 alcoholic drinks per night to "help fall asleep." This level of alcohol consumption may interfere with PTSD treatment and exacerbate symptoms (Lancaster et al., 2016).

    **Objective:**

    **Vitals:** BP 138/88, HR 82, RR 18, Temp 98.4°F

    **ROS:** Positive for sleep disturbance, anxiety, and concentration difficulties as described above. Otherwise, negative.

    **Mental Status Exam:**

    – Appearance: Well-groomed, appropriate attire

    – Behavior: Tense, hypervigilant

    – Speech: Normal rate and volume

    – Mood: "Anxious and on edge"

    – Affect: Constricted, anxious

    – Thought Process: Linear and goal-directed

    – Thought Content: Preoccupation with accident, no current suicidal or homicidal ideation

    – Perceptions: No hallucinations

    – Cognition: Alert and oriented x4, intact attention and concentration

    – Insight: Good

    – Judgment: Fair

    **Psychiatric Screening Measures:**

    – PCL-5 (PTSD Checklist for DSM-5): Score 58 (indicating severe PTSD symptoms)

    – PHQ-9 (Patient Health Questionnaire-9): Score 14 (indicating moderate depression)

    – GAD-7 (Generalized Anxiety Disorder-7): Score 16 (indicating severe anxiety)

    These screening measures support the clinical presentation and aid in diagnosis and treatment planning (Watkins et al., 2018).

    **Assessment:**

    **Primary Diagnosis**: Post-Traumatic Stress Disorder (F43.10)

    **DSM-5 Criteria Met:**

    A. Exposure to actual death or threatened death in a motor vehicle accident

    B. Presence of intrusion symptoms (recurrent distressing memories, nightmares, flashbacks)

    C. Persistent avoidance of stimuli associated with the trauma (avoiding driving, thoughts about the accident)

    D. Negative alterations in cognitions and mood (feeling detached from others, persistent negative emotional state)

    E. Marked alterations in arousal and reactivity (hypervigilance, sleep disturbance, irritability)

    F. Duration of disturbance is more than 1 month

    G. The disturbance causes clinically significant distress and impairment in social and occupational functioning

    H. The disturbance is not attributable to the physiological effects of a substance or another medical condition

    (American Psychiatric Association, 2013)

    **Differential Diagnoses:**

    1. Adjustment Disorder with Mixed Anxiety and Depressed Mood

    2. Major Depressive Disorder

    3. Generalized Anxiety Disorder

    **Potential Obstacles to Treatment:**

    – Avoidance behaviors reinforcing symptoms

    – Alcohol use potentially interfering with treatment effectiveness

    – Work-related stress and potential job insecurity

    – Marital strain due to PTSD symptoms

    **Plan:**

    1.
    **Medication Management:**

    · Increase Sertraline to 100 mg daily for 4 weeks, then reassess. This adjustment is based on evidence supporting the efficacy of SSRIs in PTSD treatment (Friedman, 2019).

    · Continue Prazosin 1 mg at bedtime for nightmares

    · Discuss risks of alcohol use with current medications and recommend gradual reduction

    **2. Psychotherapy:**

    · Refer for Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE) therapy, weekly sessions for 12 weeks. These evidence-based treatments have shown significant efficacy in reducing PTSD symptoms (Watkins et al., 2018).

    · Provide psychoeducation on PTSD and its treatment

    **3. Behavioral Interventions:**

    · Teach and practice grounding techniques for managing flashbacks and anxiety

    · Encourage gradual exposure to driving-related stimuli using a hierarchical approach

    · Implement sleep hygiene measures and stimulus control therapy for insomnia

    **4. Supportive Measures:**

    · Refer to a PTSD support group

    · Recommend family therapy to address marital strain and improve family support

    · Provide resources for workplace accommodations if needed

    **5. Substance Use:**

    · Educate on risks of alcohol use for PTSD symptoms and sleep

    · Recommend gradual reduction of alcohol intake

    · Consider referral to substance abuse counselor if unable to reduce independently

    · (Lancaster et al., 2016)

    **6. Follow-up and Monitoring:**

    · Schedule follow-up appointment in 2 weeks to assess medication response and side effects

    · Obtain baseline liver function tests and lipid panel

    · Reassess PCL-5, PHQ-9, and GAD-7 scores at each visit to track symptom improvement

    · Coordinate care with therapist and other providers

    **7. Safety Planning:**

    · Develop a crisis plan, including coping strategies and emergency contacts

    · Assess for suicidal ideation at each visit

    · Provide crisis hotline information

    **8. Patient Education:**

    · Provide written materials on PTSD, treatment options, and coping strategies

    · Discuss importance of medication adherence and potential side effects

    · Encourage lifestyle modifications: regular exercise, stress reduction techniques, and healthy sleep habits

    This comprehensive treatment plan addresses the multifaceted nature of PTSD and incorporates evidence-based interventions across pharmacological, psychological, and behavioral domains (Friedman, 2019; Watkins et al., 2018).

    **Prognosis**: With adherence to the treatment plan, including medication management and evidence-based psychotherapy, the prognosis for symptom reduction and improved functioning is generally good. However, the patient's alcohol use and avoidance behaviors may complicate treatment. Further and changes in the strategy of the treatment will be essential for the best outcomes.

    **References**

    American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

    Friedman, M. J. (2019). PTSD: Pharmacotherapeutic approaches. Current Psychiatry Reports, 21(12), 1-9.

    Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105.

    Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12, 258.

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    – 2 years ago **files (1)** – ## Unit10p.doc **## Unit10p.doc** Unit 10-Crisis Management Presentation. 1000 words 4 references. Include state regulation when indicated. Instructions You have been working as an outpatient psychiatric nurse practitioner in a busy office for about 6 months. You have a…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## Unit10p.doc

    **## Unit10p.doc**

    Unit 10-Crisis Management Presentation. 1000 words 4 references. Include state regulation when indicated.

    Instructions

    You have been working as an outpatient psychiatric nurse practitioner in a busy office for about 6 months. You have a few patients that you know quite well by this point and a few that you are getting to know.
    **Use bullet notes in a word document to complete presentation for each patient pay attention to sates of North Carolina rules and laws regarding each patient. Use grading rubric below.**

    Include a word document of references utilized in your video, in 7th edition APA formatting. Utilize resources for help with proper formatting.

    Patient 1

    A 45-year-old male who has been married for 15 years with 2 children. He has a history of MDD and pornography addiction which has been dealt with through therapy. This addiction had caused some trouble in the marriage but for the past 5 years, things have been going well in the marriage and patient denied looking at porn. MDD symptoms started in his 20s and have been well managed with citalopram (Celexa) 20mg daily. He comes in today visibly upset. He reports his wife has been cheating on him for 2 years and he found out when he came home from work to find his wife and kids gone, a note that detailed her infidelity and she took the children to live with the man she has been cheating with. Divorce proceedings are in effect. He states “I had no idea, I know I had my own problems but 2 years? I feel so stupid, I don’t know why I bothered improving myself, I don’t know how I can even go on. My work made me take some time off but I have continued to call in, I’m at risk of losing my job but I just can’t bring myself to go. The kids are my world and I haven’t even talked to them for a month”. You question him about suicidal or homicidal ideations and he replies that he has been suicidal since she left and has been drinking “at least a 6 pack” a night. He has had plans to shoot himself. When asked what is keeping him from acting on plans he said “My kids but I’m losing hope I’ll ever see or talk to them again”. What are your next steps?

    Patient 2

    A 19-year-old married female with a 2-month-old baby for her 4th visit. Her husband is present today. She presents today dressed more provocatively than you have seen her before. Her makeup is heavier than usual as well. The baby is in a carrier and is sleeping. She immediately starts discussing a video series on aliens she has been watching, her speech is rapid, loud, and tangential. She makes several looseness of associations between the video series and her baby. From her rambling, it sounds as if she believes the baby is an alien and she needs to take it to the desert and leave it on the mountain for the aliens to come and retrieve. She reports making plans to go camping with the baby and her husband this weekend. You question her about suicidal and homicidal ideations and she denies both. The husband states she has been acting “different” for a couple weeks, has never behaved like this before, and he is scared to leave her alone with the baby. She interjects that she knows the secret to world peace and giving their baby back to the aliens will accomplish it. What are your next steps?

    Complete this assignment and submit the Word documents and video links to this assignment dropbox by Sunday at 11:59 pm CT.

    Estimated time to complete: 4 hours

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889989)

    ![image2.png](https://www.sweetstudy.com/questions/see-attached-20889989)

    **## Unit10p.doc**

    Unit 10-Crisis Management Presentation. 1000 words 4 references. Include state regulation when indicated.

    Instructions

    You have been working as an outpatient psychiatric nurse practitioner in a busy office for about 6 months. You have a few patients that you know quite well by this point and a few that you are getting to know.
    **Use bullet notes in a word document to complete presentation for each patient pay attention to sates of North Carolina rules and laws regarding each patient. Use grading rubric below.**

    Include a word document of references utilized in your video, in 7th edition APA formatting. Utilize resources for help with proper formatting.

    Patient 1

    A 45-year-old male who has been married for 15 years with 2 children. He has a history of MDD and pornography addiction which has been dealt with through therapy. This addiction had caused some trouble in the marriage but for the past 5 years, things have been going well in the marriage and patient denied looking at porn. MDD symptoms started in his 20s and have been well managed with citalopram (Celexa) 20mg daily. He comes in today visibly upset. He reports his wife has been cheating on him for 2 years and he found out when he came home from work to find his wife and kids gone, a note that detailed her infidelity and she took the children to live with the man she has been cheating with. Divorce proceedings are in effect. He states “I had no idea, I know I had my own problems but 2 years? I feel so stupid, I don’t know why I bothered improving myself, I don’t know how I can even go on. My work made me take some time off but I have continued to call in, I’m at risk of losing my job but I just can’t bring myself to go. The kids are my world and I haven’t even talked to them for a month”. You question him about suicidal or homicidal ideations and he replies that he has been suicidal since she left and has been drinking “at least a 6 pack” a night. He has had plans to shoot himself. When asked what is keeping him from acting on plans he said “My kids but I’m losing hope I’ll ever see or talk to them again”. What are your next steps?

    Patient 2

    A 19-year-old married female with a 2-month-old baby for her 4th visit. Her husband is present today. She presents today dressed more provocatively than you have seen her before. Her makeup is heavier than usual as well. The baby is in a carrier and is sleeping. She immediately starts discussing a video series on aliens she has been watching, her speech is rapid, loud, and tangential. She makes several looseness of associations between the video series and her baby. From her rambling, it sounds as if she believes the baby is an alien and she needs to take it to the desert and leave it on the mountain for the aliens to come and retrieve. She reports making plans to go camping with the baby and her husband this weekend. You question her about suicidal and homicidal ideations and she denies both. The husband states she has been acting “different” for a couple weeks, has never behaved like this before, and he is scared to leave her alone with the baby. She interjects that she knows the secret to world peace and giving their baby back to the aliens will accomplish it. What are your next steps?

    Complete this assignment and submit the Word documents and video links to this assignment dropbox by Sunday at 11:59 pm CT.

    Estimated time to complete: 4 hours

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889989)

    ![image2.png](https://www.sweetstudy.com/questions/see-attached-20889989)

  • [Solved] see attached

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    due 3-10 – 2 years ago **files (1)** – ## Unit10.doc **## Unit10.doc** Unit 10- Clinical Journal Reflection. Due 3-10-25. 800-words. 4 scholarly references. Address the Following Items: 1. What are your outpatient facility and state policies regarding an inpatient hold in the state of North Carolin…

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    due 3-10

    – 2 years ago

    **files (1)**

    – ## Unit10.doc

    **## Unit10.doc**

    Unit 10- Clinical Journal Reflection. Due 3-10-25. 800-words. 4 scholarly references.

    Address the Following Items:

    1. What are your outpatient facility and state policies regarding an inpatient hold in the state of North Carolina/NC?

    · Does the patient have to be suicidal/homicidal or are there other criteria to place someone on a hold?

    · How long are these holds for your state of NC and to have them extended what is required?

    · Think about either your current place of employment or current clinical site.

    2. What are some potential biases you may have with a patient making suicidal statements?

    · If you have dealt with this, how did it go? If you have not yet, how do you think it will go?

    Use the appropriate APA formatting with a minimum of 4 references to support your work.

    All components must be discussed to receive full credit as complete.

    **Note**:
    _Grades of Incomplete on this assignment will result in a clinical failure._

    Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889981)

    **## Unit10.doc**

    Unit 10- Clinical Journal Reflection. Due 3-10-25. 800-words. 4 scholarly references.

    Address the Following Items:

    1. What are your outpatient facility and state policies regarding an inpatient hold in the state of North Carolina/NC?

    · Does the patient have to be suicidal/homicidal or are there other criteria to place someone on a hold?

    · How long are these holds for your state of NC and to have them extended what is required?

    · Think about either your current place of employment or current clinical site.

    2. What are some potential biases you may have with a patient making suicidal statements?

    · If you have dealt with this, how did it go? If you have not yet, how do you think it will go?

    Use the appropriate APA formatting with a minimum of 4 references to support your work.

    All components must be discussed to receive full credit as complete.

    **Note**:
    _Grades of Incomplete on this assignment will result in a clinical failure._

    Complete this assignment and submit it to this assignment dropbox by Sunday at 11:59 pm CT.

    ![image1.png](https://www.sweetstudy.com/questions/see-attached-20889981)

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    case study – 2 years ago **files (1)** – ## M92SoapnoteWeekAsa.docx **## M92SoapnoteWeekAsa.docx** M92 Soap note Week Asa Week 7: Vitamin D Deficiency · Due: Wednesday, 11:59 pm PT · Format: SOAP Note **## M92SoapnoteWeekAsa.docx** M92 Soap note Week Asa Week 7: Vitamin D Deficiency · Due: Wednesday…

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    **files (1)**

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    **## M92SoapnoteWeekAsa.docx**

    M92 Soap note Week Asa

    Week 7: Vitamin D Deficiency

    · Due: Wednesday, 11:59 pm PT

    · Format: SOAP Note

    **## M92SoapnoteWeekAsa.docx**

    M92 Soap note Week Asa

    Week 7: Vitamin D Deficiency

    · Due: Wednesday, 11:59 pm PT

    · Format: SOAP Note

  • [Solved] Lorem

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    Case study – 2 years ago **files (1)** – ## M92SoapNoteweekisi.docx **## M92SoapNoteweekisi.docx** M92 Soap Note week isi Week 6: Patient type: Asthma · Due: Wednesday, 11:59 pm PT · Format: SOAP Note **## M92SoapNoteweekisi.docx** M92 Soap Note week isi Week 6: Patient type: Asthma · Due: Wednesday…

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    **## M92SoapNoteweekisi.docx**

    M92 Soap Note week isi

    Week 6: Patient type: Asthma

    · Due: Wednesday, 11:59 pm PT

    · Format: SOAP Note

    **## M92SoapNoteweekisi.docx**

    M92 Soap Note week isi

    Week 6: Patient type: Asthma

    · Due: Wednesday, 11:59 pm PT

    · Format: SOAP Note

  • [Solved] bsn project 3

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    – 2 years ago **files (1)** – ## assessment3pdf.pages **## assessment3pdf.pages** ## preview.jpg **## assessment3pdf.pages** ## preview.jpg

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    **files (1)**

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    **## assessment3pdf.pages**

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    **## assessment3pdf.pages**

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  • [Solved] help with the response 2

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    Need help with response. – [\ \ Screenshot2025-03-08at6.23.00PM.png](https://www.sweetstudy.com/files/screenshot2025-03-08at6-23-00pm-png "Screenshot2025-03-08at6.23.00PM.png") – 2 years ago

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    Hello, need help with a response. Thank you! – [\ \ Screenshot2025-03-08at6.20.43PM.png](https://www.sweetstudy.com/files/screenshot2025-03-08at6-20-43pm-png "Screenshot2025-03-08at6.20.43PM.png") – 2 years ago

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