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NURS 6630 Assignment 1 Short Answer Assessment

NURS 6630 Assignment 1 Short Answer Assessment

NURS 6630 Assignment 1 Short Answer Assessment

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see the resolution of symptoms?

According to Wenstrup et al. (2020), SSRIs like fluoxetine or SNRIs like venlafaxine are often used as first-line treatments for major depressive disorder in patients with a history of alcohol misuse. Because of their propensity for addiction and the way they interact with alcohol, benzodiazepines are contraindicated for use among these patients (Benz et al., 2023). The timing for the resolution of symptoms might vary, but most patients should show some relief between two to four weeks, with the complete impact often lasting between six and eight weeks.

  1. List four predictors of late-onset generalized anxiety disorder.

According to Kyriacou et al. (2023), the main factors that predicted the occurrence of late-onset incident GAD over 12 years were:

  1. Being a woman
  2. Having experienced recent adverse life events
  • Having long-term physical (like cognitive impairment, heart failure, and respiratory disorders)
  1. Mental health disorders (like phobia, depression, and previous GAD).

Incident GAD is also independently and strongly linked with a parental history of mental illness, limited emotional support as a kid and poverty. Generalized Anxiety illness is a complex emotional illness caused by a combination of immediate and long-term risk factors, some of which may be changed by medical intervention.

  1. List four potential neurobiology causes of psychotic major depression.
  1. An elevated susceptibility to stress: An elevated susceptibility to stress has often been associated with the onset of psychosis and the exacerbation of its beneficial symptoms. Ongoing research is investigating the impact of psychosocial stress on the emergence of psychotic episodes in individuals who are clinically identified as having a high risk for experiencing psychosis (Zhang et al., 2021).
  2. Serotonin deficiency: Studies have shown a correlation between symptoms of depression and reduced levels of serotonin, which may also be associated with several other medical disorders (Zhang et al., 2021). Selective serotonin reuptake inhibitors (SSRIs) and other pharmacological agents that enhance serotonin levels or modulate its activity have shown promise in the management of depressive disorders, anxiety, migraines, and several other medical problems.
  • Tendency for Major Depressive Disorder: MDD is a psychiatric disorder that may potentially result in psychotic episodes, especially when patients do not get enough professional care and therapy. While mood disorders and psychotic illnesses can occur together, it is crucial to recognize that depression and schizophrenia need distinct therapies (Zhang et al., 2021).
  1. Increased dopamine levels: Researchers generally agree that dopamine plays a crucial role in the onset of psychosis (Zhang et al., 2021). Neuron transmission is facilitated by a chemical known as a neurotransmitter in the brain. Dopamine is a constituent in this category. It pertains to individuals’ subjective assessments of different objects’ value, importance, or attractiveness.
  1. An episode of major depression is defined as a period lasting at least two weeks. List at least five symptoms required for the episode to occur. Be specific.

A major depressive episode refers to a duration of at least two weeks during which an individual exhibits specific symptoms associated with major depression, such as profound sadness and despair, extreme fatigue, noticeable changes in body weight, alterations in sleep patterns, diminished interest in previously enjoyed activities, or contemplation of suicide (Benasi et al., 2021). These symptoms are enduring and resistant to modification, regardless of their inconsistency with an individual’s circumstances. Individuals diagnosed with severe depression have recurrent depressive episodes at regular intervals.

  1. List three classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 
  1. Selective serotonin reuptake inhibitor (SSRI): Fluoxetine is known to be very stimulating and has been linked to more frequent awakenings and disrupted sleep patterns. Sertraline decreases the overall duration of sleep and prolongs the time it takes to fall asleep. On the other hand, paroxetine, which is the most sedating SSRI and is commonly prescribed to help anxious patients sleep, leads to significant reductions in the total duration of sleep, the effectiveness of sleep, and the amount of rapid eye movement (REM) sleep. Additionally, paroxetine increases the number of awakenings during sleep and the time it takes. Similarly, citalopram, a more recent SSRI, reduces the overall amount of rapid eye movement sleep and prolongs the time it takes to enter REM sleep. Additionally, citalopram impacts sleep structure significantly more than escitalopram (Fietze et al., 2021).
  2. Dopamine agonists: Three randomized controlled trials investigating the impact of prolonged-release ropinirole and pramipexole, either in combination with levodopa or as a standalone treatment in early Parkinson’s disease, found that insomnia was a frequently reported side effect among participants receiving the intervention (Fietze et al., 2021). Levodopa and other drugs that affect dopamine may interfere with sleep at night either by directly affecting the regulation of sleep and wakefulness or due to symptoms that occur after the medication wears off.
  • Tricyclic Antidepressants (TCAs): Sedating TCAs are often used due to their ability to induce sleep. They may be used as substitutes for benzodiazepine receptor agonists at lower dosages than those used for antidepressants. TCAs do not have the same effect as benzodiazepines in terms of suppressing deep sleep. The number is 27. The primary cause of the sedating effects is the blocking of histamine-1 (H1) receptors. Nevertheless, it is recommended that not all TCAs have sedative properties. According to Fietze et al. (2021), the use of imipramine and desipramine is linked to insomnia and increased sleep disruption.

 

References

Benasi, G., Fava, G. A., & Guidi, J. (2021). Prodromal Symptoms in Depression: A Systematic review. Psychotherapy and Psychosomatics, 90(6), 365–372. https://doi.org/10.1159/000517953

Benz, M. B., Epstein‐Lubow, G., Weinstock, L. M., & Gaudiano, B. A. (2023). Polypharmacy among patients with major depressive disorder and co-occurring substance use disorders in a psychiatric hospital setting. Journal of Clinical Psychopharmacology, 43(3), 273–277. https://doi.org/10.1097/jcp.0000000000001681

Fietze, I., Laharnar, N., Koellner, V., & Penzel, T. (2021). The different faces of insomnia. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.683943

Kyriacou, T., Hodges, J. R., & Gould, R. L. (2023). Predictors and moderators of treatment outcome in late-life anxiety: A systematic review. Journal of Affective Disorders, pp. 339, 454–470. https://doi.org/10.1016/j.jad.2023.07.057

‌Wenstrup, T., Dorton, S., & Zeng, A. (2020). Is the combination of naltrexone and sertraline effective in treating comorbid depression and alcohol use disorder? Evidence-Based Practice, 23(7), 18–19. https://doi.org/10.1097/ebp.0000000000000709

Zhang, L., Verwer, R., Zhao, J., Huitinga, I., Lucassen, P. J., & Swaab, D. (2021). Changes in glial gene expression in the prefrontal cortex about major depressive disorder, suicide, and psychotic features. Journal of Affective Disorders, 295, 893–903. https://doi.org/10.1016/j.jad.2021.08.098

In 4 or 5 sentences, describe the anatomy of the basic unit of the nervous system, the neuron. Include each part of the neuron and a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse. Be specific and provide examples.

The nervous system, or neuron has two manor parts including peripheral nervous system and central nervous system. The peripheral nervous system is composed of nerves that are attached to the spinal cord and spread to the entire body. On the other hand, the central nervous system is made up of spinal cord and the brain. The nervous system transmit electric impulses between the brain and other parts of the body through the nerve cells consisting of dendrites and axons (Ernsberger & Rohrer, 2018). Dendrites and axons allow neurons to communicate across long distances through electric transmission. In the neuron system, electrical transmission takes place through the intercellular channels that provides alleyway of low resistance for the movement of currents between cells called “gap junction.” There are currents underlying the presynaptic action potential that generates a coupling potential within the postsynaptic cell.

Answer the following (listing is acceptable for these questions):
What are the major components that make up the subcortical structures?

The subcortical structures refers to the group of different neural formation that are found deep within the brain. The major components of the subcortical structures include:

  • Diencephalon
  • Limbic structures
  • Pituitary glands
  • Basal ganglia

These structures are involved in various complex activities such as emotion, memory, pleasure, as well as hormone production.

Which component plays a role in learning, memory, and addiction?

  • Limbic structures

What are the two key neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control?

 

  • pars reticulata(SNpr)
  • pars compacta(SNpc)

In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples.

Glial cells in the central nervous system function by responding to and manipulating neurotransmission in different ways. They also impact both the consolidation and preservation of memories. Glia cells enhances the maintenance of homeostasis by forming myelin within the peripheral nervous system through the provision of support and protection for the neurons. Also, through the formation of myelin, they are able to surround neurons and maintain or hold them in place, insulate them and provide oxygen and nutrients (Gershon & Nakamura, 2019).

In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific.

Neurons often communicate and pass information from each other through synapses. In the process of transmitting information, when an action potential reaches the presynaptic terminal, neurotransmitter is released from the neuron into the synaptic cleft which is a 30nm gap found between the presynaptic axon terminal and the postsynaptic dendrite (Khan et al., 2019). After electric impulses travels across the synaptic cleft, the transmitter will always attach to the neurotransmitter receptors within the postsynaptic side, and according to the neurotransmitter produced, e.g Na+, K+, Ca+ will move through the channels that span the membrane (Gershon & Nakamura, 2019).

In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples.

 

Neural plasticity or neuroplasticity refers to the ability of the neural networks within the brain to change through reorganization and growth. The above changes often range from a single/individual neuron pathways, making new connections, to the systematic adjustments such as cortical remapping. One of the main example of neuroplasticity involve network and circuit changes that results from learning a new ability, practice, environmental influences, as well as the psychological stress.

References

Ernsberger, U., & Rohrer, H. (2018). Sympathetic tales: subdivisons of the autonomic nervous system and the impact of developmental studies. Neural development13(1), 1-21. https://neuraldevelopment.biomedcentral.com/articles/10.1186/s13064-018-0117-6

Khan, A. A., Lip, G. Y., & Shantsila, A. (2019). Heart rate variability in atrial fibrillation: The balance between sympathetic and parasympathetic nervous system. European journal of clinical investigation49(11), e13174. https://onlinelibrary.wiley.com/doi/full/10.1111/eci.13174

Gershon, M. D., & Nakamura, H. (2019). Functional anatomy of the enteric nervous system. In Hirschsprung’s disease and allied disorders (pp. 31-76). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-15647-3_3

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Short Answer Assessment

As a psychiatric and mental health nurse practitioner, before you can recommend potential pharmacotherapeutics to address a patient’s condition or disorder, you must understand the basic function and structure of the neuron and central nervous system. For this Assignment, you will review and apply your understanding of neuroanatomy by addressing a set of short answer prompts.

To Prepare:

  • Review the Learning Resources for this week in preparation to complete this Assignment.
  • Reflect on the basic function and structure of the neuron in relation to the central nervous system.
  • Reflect on the inter-connectedness between neurons and the central nervous system, including the pathway and distribution of electrical impulses.
  • Reflect on how neurons communicate with each other and review the concept of neuroplasticity.

To complete:

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. In 4 or 5 sentences, describe the anatomy of the basic unit of the nervous system, the neuron. Include each part of the neuron and a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse. Be specific and provide examples.
  2. Answer the following (listing is acceptable for these questions):
    • What are the major components that make up the subcortical structures?
    • Which component plays a role in learning, memory, and addiction?
    • What are the two key neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control?
  3. In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples.
  4. The synapse is an area between two neurons that allows for chemical communication. In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific.
  5. In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples.

Resources

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

WEEKLY RESOURCES

By Day 7

Submit your Assignment.

submission information

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

  1. To submit your completed assignment, save your Assignment as WK1Assgn2_LastName_Firstinitial
  2. Then, click on Start Assignment near the top of the page.
  3. Next, click on Upload File and select Submit Assignment for review.

 

NURS 6630 Assignment 1 Short Answer Assessment
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NURS 6630 Assignment 1 Short Answer Assessment
NURS 6630 Assignment 1 Short Answer Assessment

 

Neurons are information messengers with three main parts namely the cell body, axon, and the dendrites (Kringelbach et al., 2020). The cell body is made up of a nucleus and cytoplasm and produces protein required to construct other parts of the neuron. The axon, on the other hand, extends from the cell body and carries signals away from the cell body while the dendrites carry signals toward the cell body and have numerous synapses to receive the signal from nearby neurons. Upon stimulation, neurons transmit an electrical impulse that passes through the dendrite, to the cell body, axon, axon terminal, and finally, the stimulus is passed (Kringelbach et al., 2020). At the axonal terminal, the axon releases neurotransmitters that depolarize neighboring cells through synapses and by binding to the membrane of the dendrite.

Subcortical Structures

Other structures within the brain are subcortical structures that act as information hubs for the nervous system. Their main role is to relay and modulate information circulating in different areas of the brain. They include the basal ganglia, limbic structures, pituitary gland, and the diencephalon (Malinowski, 2019).

The limbic systems play a great role in learning and memory addiction.  The systems provide the anatomical substrate for emotions and motivated behaviors, including the circulatory for reward-related events and stress responses. Specifically, the hippocampus is used to mediate a cognitive/spatial form of memory. It controls learning and declarative memory which covers the memory of facts and events (Malinowski, 2019).  The dorsal striatum also helps in memory by mediating the stimulus-response habit memory. Addiction on the other hand is linked to the limbic system through the orbitofrontal cortex and anterior cingulate gyrus (Malinowski, 2019).

In line with motor control, the nigra striatal region offers two anatomically and functionally distinct portions knowns as the substantia nigra pars compacta and the substantia nigra pars reticulata.

Glial Cells

Other essential components in the central nervous system are the glial cells. They include the astrocytes whose role is to maintain the environment for neuronal signaling by controlling the level of neurotransmitters surrounding the synapses (Hirbec et al., 2020). Equally, oligodendrocytes wrap around the axons forming a protective layer called myelin sheath which enhances neuron signaling. The cells also include microglia, ependymal cells, and radial glial whose roles are clearing dead cells or removing harmful toxins, maintaining homeostasis, and regenerating neurons and other glial cells like astrocytes and oligodendrocytes respectively.

Neuron Communication

Neurons communicate with each other through synaptic transmission. A chemical synapse is registered at the axon terminal of the presynaptic neuron and the dendrite of the postsynaptic neuron (Malinowski, 2019). The dendrite picks up signals and passes the signals down to the axon, into the axon terminals, and into the synapses. The role of the chemical synapse is to transform the electrical signal in the presynaptic cell’s axon into a chemical signal and back into an electrical signal in the postsynaptic cell.

Neuroplasticity

Brain plasticity denotes the ability of the brain to reorganize itself and form new neural connections in response to extrinsic or intrinsic stimuli.  Through axonal sprouting, the undamaged axons develop new nerve endings and reconnect neurons with severed or injured links (Mateos-Aparicio & Rodríguez-Moreno, 2019). For instance, undamaged brain sites of stroke patients rewire themselves to take over functions of the damaged brain sites. Similarly, the undamaged axons sprout nerve endings that connect with other undamaged nerve cells to form new neural pathways (Mateos-Aparicio & Rodríguez-Moreno, 2019).   For example, exposing the brain to specific grammatical rules helps it process and develop language.

References

Hirbec, H., Déglon, N., Foo, L. C., Goshen, I., Grutzendler, J., Hangen, E., … & Escartin, C. (2020). Emerging technologies to study glial cells. Glia, 68(9), 1692-1728. https://doi.org/10.1002/glia.23780

Kringelbach, M. L., Cruzat, J., Cabral, J., Knudsen, G. M., Carhart-Harris, R., Whybrow, P. C., … & Deco, G. (2020). Dynamic coupling of whole-brain neuronal and neurotransmitter systems. Proceedings of the National Academy of Sciences, 117(17), 9566-9576. https://doi.org/10.1073/pnas.1921475117

Malinowski, M. N. (2019). Anatomy of the brain and brain stem. In Deer’s Treatment of Pain (pp. 49-59). Springer, Cham.

Mateos-Aparicio, P., & Rodríguez-Moreno, A. (2019). The impact of studying brain plasticity. Frontiers in cellular neuroscience, 13, 66. https://doi.org/10.3389/fncel.2019.00066

NURS_6630_Week1_Assignment_Rubric

  Excellent

Point range: 90–100

Good

Point range: 80–89

Fair

Point range: 70–79

Poor

Point range: 0–69

In 4 or 5 sentences, describe the anatomy of the basic unit of the nervous sytem, the neuron. Include each part of the neuron and a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse. Be specific and provide examples. 12 (16%) – 13 (17.33%)

The response accurately and clearly describes in detail the anatomy of the neuron. The response accurately and clearly describes in detail each part of the neuron, and it includes a detailed explanation of the general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse.

Examples fully support the response provided.

11 (14.67%) – 11 (14.67%)

The response accurately describes the anatomy of the neuron. The response accurately describes each part of the neuron, and it includes a general overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse.

Examples support the response provided.

10 (13.33%) – 10 (13.33%)

The response provides an inaccurate or vague description of the anatomy of the neuron. The response inaccurately or vaguely describes each part of the neuron, and it includes an inaccurate or vague overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse.

Examples vaguely support the response provided.

0 (0%) – 9 (12%)

The response provides an inaccurate or incomplete description of the anatomy of the neuron, or is missing. The response inaccurately or incompletely describes each part of the neuron, and it includes an inaccurate or vague overview of electrical impulse conduction, the pathway it travels, and the net result at the termination of the impulse, or is missing.

Examples do not support the response provided, or is missing.

Answer the following (listing is acceptable for these questions):

a. What are the major components that make up the subcortical structures?
b. Which component plays a role in learning, memory, and addiction?
c. What are the two key neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control?

12 (16%) – 13 (17.33%)

The response accurately and clearly details the major components that make up the subcortical structures.

The response accurately and clearly details which component plays a role in learning, memory, and addiction.

The response accurately and clearly identifies the two neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control.

11 (14.67%) – 11 (14.67%)

The response accurately identifies the major components that make up the subcortical structures.

The response accurately identifies which component plays a role in learning, memory, and addiction.

The response accurately identifies the two neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control.

10 (13.33%) – 10 (13.33%)

The response inaccurately identifies the major components that make up the subcortical structures.

The response inaccurately identifies which component plays a role in learning, memory, and addiction.

The response inaccurately identifies two neurotransmitters located in the nigra striatal region of the brain that play a major role in motor control.

0 (0%) – 9 (12%)

The response inaccurately and incompletely identifies the major components that make up the subcortical structures, or is missing.

The response inaccurately and incompletely identifies which component plays a role in learning, memory, and addiction, or is missing.

The response inaccurately and incompletely identifies two neurotransmitters in the nigra striatal region of the brain that play a major role in motor control, or is missing.

In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples. 12 (16%) – 13 (17.33%)

The response accurately and clearly explains in detail how glia cells function in the central nervous system.

Examples fully support the response provided.

11 (14.67%) – 11 (14.67%)

The response accurately explains how glia cells function in the central nervous system.

Examples support the response provided.

10 (13.33%) – 10 (13.33%)

The response inaccurately or vaguely explains how glia cells function in the central nervous system.

Examples inaccurately or vaguely support the response provided.

0 (0%) – 9 (12%)

The response inaccurately and vaguely explains how glia cells function in the central nervous system, or is missing.

Examples do not support the response provided, or is missing.

The synapse is an area between two neurons that allows for chemical communication. In 3 or 4 sentences, explain what part of the neurons are communicating with each other and in which direction does this communication occur? Be specific. 12 (16%) – 13 (17.33%)

The response accurately and clearly explains in detail the part of the neurons that communicate with each other and the direction in which this communication occurs.

11 (14.67%) – 11 (14.67%)

The response accurately explains the part of the neurons that communicate with each other and the direction in which this communication occurs.

10 (13.33%) – 10 (13.33%)

The response inaccurately or vaguely explains the part of the neurons that communicate with each other and the direction in which this communication occurs.

0 (0%) – 9 (12%)

The response inaccurately and vaguely explains the part of the neurons that communicate with each other and the direction in which this communication occurs, or is missing.

In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples. 12 (16%) – 13 (17.33%)

The response accurately and clearly explains in detail the concept of neuroplasticity.

Examples provided fully support the response provided.

11 (14.67%) – 11 (14.67%)

The response accurately explains the concept of neuroplasticity.

Examples provided support the response provided.

10 (13.33%) – 10 (13.33%)

The response inaccurately or vaguely explains the concept of neuroplasticity.

Examples inaccurately or vaguely support the response provided.

0 (0%) – 9 (12%)

The response inaccurately and vaguely explains the concept of neuroplasticity, or is missing.

Examples do not support the response provided, or is missing.

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (6.67%) – 5 (6.67%)

Uses correct grammar, spelling, and punctuation with no errors.

4 (5.33%) – 4 (5.33%)

Contains a few (1 or 2) grammar, spelling, and punctuation errors.

3.5 (4.67%) – 3.5 (4.67%)

Contains several (3 or 4) grammar, spelling, and punctuation errors.

0 (0%) – 2 (2.67%)

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. 5 (6.67%) – 5 (6.67%)

Uses correct APA format with no errors.

4 (5.33%) – 4 (5.33%)

Contains a few (1 or 2) APA format errors.

3.5 (4.67%) – 3.5 (4.67%)

Contains several (3 or 4) APA format errors.

0 (0%) – 2 (2.67%)

Contains many (≥ 5) APA format errors.

Total Points: 75

Name: NURS_6630_Week1_Assignment_Rubric