NRNP 6675 WEEK 9 DISCUSSION POST : Prescribing for Older Adults and Pregnant Women
Walden University Discussion: Prescribing for Older Adults and Pregnant Women-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University Discussion: Prescribing for Older Adults and Pregnant Women assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for Discussion: Prescribing for Older Adults and Pregnant Women
Whether one passes or fails an academic assignment such as the Walden University Discussion: Prescribing for Older Adults and Pregnant Women depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for Discussion: Prescribing for Older Adults and Pregnant Women
The introduction for the Walden University Discussion: Prescribing for Older Adults and Pregnant Women is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for Discussion: Prescribing for Older Adults and Pregnant Women
After the introduction, move into the main part of the Discussion: Prescribing for Older Adults and Pregnant Women assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for Discussion: Prescribing for Older Adults and Pregnant Women
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for Discussion: Prescribing for Older Adults and Pregnant Women
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for Discussion: Prescribing for Older Adults and Pregnant Women
Patients affected by or at risk of mental health disorders have unique health needs that should be addressed in the care process. Psychiatric mental health nurses are responsible for adopting evidence-based interventions that optimize treatment outcomes such as safety, quality, and efficiency in the care process. They weigh the benefits and risks of the different treatment approaches based on patient characteristics. Therefore, the purpose of this paper is to explore pharmacotherapy for major depression during pregnancy.
Depression in pregnancy or perinatal depression is one of the major risks that affect the pregnant mother, unborn child, and the family as a whole. Perinatal depression affects up to 12.9% of pregnant women and may progress to the postpartum period. It has high comorbidity with disorders such as generalized anxiety disorder and obsessive-compulsive disorder (Miller et al., 2018). Pharmacotherapy is largely considered in treating perinatal depression. Currently, there is no FDA-approved drug for use in treating patients that develop depression during pregnancy. However, it is recommended that patients with a history of depression before pregnancy continue with the FDA-approved drugs during pregnancy. The drugs include escitalopram (Lexapro) and fluoxetine (Prozac). Fluoxetine and Lexapro produce their effect by i
nhibiting serotonin reuptake into the presynaptic neurons, hence, increasing its concentration and mood (Mitchell & Goodman, 2018). The non-FDA drugs for major depression that patients can continue using during pregnancy include other antidepressants such as Sertraline and paroxetine.
Risk assessments should be performed before initiating a pregnant patient on antidepressants. Accordingly, healthcare providers should determine whether the prescribed drug is associated with an increased risk of teratogenicity. The drug should not predispose the fetus to birth defects over baseline (LUSSKIN et al., 2018). The other risk assessment needed in the prescription of antidepressants is the determination of whether the drug predisposes the pregnant mother to pregnancy complications. Psychiatric mental health nurse practitioners should ensure that the selected medications do not cause complications such as premature birth, miscarriage, stillbirth, or intrauterine growth restriction. The risks of neurodevelopment and neonatal complications such as neurobehavioral teratogenicity should also be assessed before the administration of the medication (Komorowski, 2022). Therefore, the healthcare provider should strive to achieve a balance between the potential risks that each drug has and the known risks of major depression to help pregnant mothers and their families to make informed decisions.
FDA-approved medications used in treating depression have considerable benefits. First, they have minimal harm and optimal benefits to the patients. The drugs have been evaluated for clinical efficacy in improving depressive symptoms. The drugs also have a high level of tolerability, which enhances outcomes such as treatment adherence by the patients. The risks of FDA-approved drugs include the fact that they may not be effective for all patients. Patients have different characteristics that affect the pharmacokinetics and pharmacotherapeutics of FDA-approved drugs. Therefore, non-FDA-approved drugs prove beneficial in such cases, as they act as alternatives for improving patient outcomes in the treatment process. However, non-FDA-approved drugs have minimal evidence-based data supporting their use, hence, the increased risk of patient harm due to side and adverse effects associated with them. Clinical practice guidelines do not exist for the treatment of perinatal depression (Molenaar et al., 2018). Therefore, some of the factors to consider in treatment include safety and risks of the available treatment and patient factors that may affect the treatment outcomes.
Overall, perinatal depression is a serious mental health problem that should be managed effectively during pregnancy. Risk assessment should be performed to determine the suitability of antidepressants. A focus should be on ensuring minimal harm and optimal benefits to the mother and fetus. Since clinical practice guidelines for depression management in pregnancy do not exist, providers should consider other alternatives such as psychotherapy if symptoms are less severe.
References
Komorowski, J. (2022). Chapter 17—Antidepressants in pregnancy. In D. Mattison & L.-A. Halbert (Eds.), Clinical Pharmacology During Pregnancy (Second Edition) (pp. 311–321). Academic Press. https://doi.org/10.1016/B978-0-12-818902-3.00014-2
LUSSKIN, S. I., KHAN, S. J., ERNST, C., HABIB, S., FERSH, M. E., & ALBERTINI, E. S. (2018). Pharmacotherapy for Perinatal Depression. Clinical Obstetrics and Gynecology, 61(3), 544–561. https://doi.org/10.1097/GRF.0000000000000365
Miller, E. S., Grobman, W. A., Culhane, J., Adam, E., Buss, C., Entringer, S., Miller, G., Wadhwa, P. D., Keenan-Devlin, L., & Borders, A. (2018). Antenatal depression, psychotropic medication use, and inflammation among pregnant women. Archives of Women’s Mental Health, 21(6), 785–790. https://doi.org/10.1007/s00737-018-0855-9
Mitchell, J., & Goodman, J. (2018). Comparative effects of antidepressant medications and untreated major depression on pregnancy outcomes: A systematic review. Archives of Women’s Mental Health, 21(5), 505–516. https://doi.org/10.1007/s00737-018-0844-z
Molenaar, N. M., Kamperman, A. M., Boyce, P., & Bergink, V. (2018). Guidelines on treatment of perinatal depression with antidepressants: An international review. Australian & New Zealand Journal of Psychiatry, 52(4), 320–327. https://doi.org/10.1177/0004867418762057
Sample Answer 2 for Discussion: Prescribing for Older Adults and Pregnant Women
As people grow older, they are likely to encounter physical and mental changes. They may experience diseases that are commonly seen in the older population such as diabetes, high blood pressure, and degenerative diseases. In addition to all these changes, they may also experience other changes such as children moving out of the house, causing them to be empty nesters, or loved ones getting ill and passing. These changes may precipitate mental health disorders such as depression. According to Csajbók, Kagstrom, and Cermakova, (2022) third of older adults experience a mental health disorder like depression. Mental health clinicians need to properly understand the variations in older adults, their comorbidities, lifestyle changes, order of medications being administered, and their pharmacodynamics in relation to any medications they prescribe for depression.
According to Chen et al., (2021) music, physical exercise, and massage have been shown to improve depressive symptoms in older adults. Depending on the severity of depressive symptoms, it will be beneficial to initiate nonpharmacological options. Patients should be educated on the goals of each treatment option. Patients who already have multiple medications should also attempt nonpharmacological options first to avoid potential side effects and interactions with other medications.
According to Glass, Hermida, Hershenberg, and Schwartz, (2020) many medications have been approved for the treatment of depression in the elderly. However, SSRI and SNRI are more preferred compared to tricyclics due to more favorable side effects. Citalopram is most frequently used due to its limited interaction in the liver
Before starting any antidepressant for an older adult, It is important to take into consideration the drug-drug interaction, family history, and other comorbidities since antidepressants may also treat other depressive-related disorders, start with the lowest possible dose and titrate while monitoring for any drug interaction or adverse effect (Glass, Hermida, Hershenberg, and Schwartz, 2020).
Reference
Csajbók, Z., Kagstrom, A., & Cermakova, P. (2022). Season of birth has no effect on symptoms of depression and anxiety in older adults. Scientific Reports, 12(1), 1–9. https://doi.org/10.1038/s41598-022-10892-8
Chen, Y.-J., Li, X.-X., Pan, B., Wang, B., Jing, G.-Z., Liu, Q.-Q., Li, Y.-F., Bing, Z.-T., Yang, K.-H., Han, X.-M., & Ge, L. (2021). Non-pharmacological interventions for older adults with depressive symptoms: A network meta-analysis of 35 randomized controlled trials. Aging & Mental Health, 25(5), 773–786. https://doi.org/10.1080/13607863.2019.1704219
Glass, O. M., Hermida, A. P., Hershenberg, R., & Schwartz, A. C. (2020). Considerations and Current Trends in the Management of the Geriatric Patient on a Consultation-Liaison Service. Current Psychiatry Reports, 22(5), 1–12. https://doi.org/10.1007/s11920-020-01147-2
Vijay, A., Becker, J. E., & Ross, J. S. (2018). Patterns and predictors of off-label prescription of psychiatric drugs. PloS One, 13(7), e0198363. https://doi.org/10.1371/journal.pone.0198363