Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree

Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree
Assignment 1: Practicum: Decision Tree
For this Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting symptoms of a mental health disorder.
Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives
Students will:
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Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree:
Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.
At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

 
BACKGROUND
Tyrel is an 8-year-old black male who is brought in by his mother for a variety of psychiatric complaints. Shaquana, Tyrel’s mother, reports that Tyrel has been exhibiting a lot of worry and “nervousness” over the past 2 months. She states that she notices that he has been quite “keyed up” and spends a great deal of time worrying about “germs.” She states that he is constantly washing his hands because he feels as though he is going to get sick like he did a few weeks ago, which kept him both out of school and off the playground. He was also not able to see his father for two weekends because of being sick. Shaquana explains that although she and her ex-husband Desmond divorced about 2 years ago, their divorce was amicable and they both endeavor to see that Tyrel is well cared for.
Shaquana reports that Tyrel is irritable at times and has also had some sleep disturbances (which she reports as “trouble staying asleep”). She reports that he has been more and more difficult to get to school as he has become nervous around his classmates. He has missed about 8 days over the course of the last 3 weeks. He has also stopped playing with his best friend from across the street. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.
His mother reports that she feels “responsible” for his current symptoms. She explains that after he was sick with strep throat a few weeks ago, she encouraged him to be more careful about washing his hands after playing with other children, handling things that did not belong to him, and especially before eating. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She continues by saying “maybe if I didn’t make such a big deal about it, he would not be obsessed with germs.”
Per Shaquana, her pregnancy with Tyrel was uncomplicated, and Tyrel has met all developmental milestones on time. He has had an uneventful medical history and is current on all immunizations.
OBJECTIVE
During your assessment of Tyrel, he seems cautious being around you. He warms a bit as you discuss school, his friends at school, and what he likes to do. He admits that he has been feeling “nervous” lately, but when you question him as to why, he simply shrugs his shoulders.
When you discuss his handwashing with him, he tells you that “handwashing is the best way to keep from getting sick.” When you question him how many times a day he washes his hands, he again shrugs his shoulders. You can see that his bilateral hands are dry. Throughout your assessment, Tyrel reveals that he has been thinking of how dirty his hands are; and no matter how hard he tries to stop thinking about his “dirty” hands, he is unable to do so. He reports that he gets “really nervous” and “scared” that he will get sick, and that the only way to make himself feel better is to wash his hands. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. He reports that it does work for a while and that he feels “better” after he washes his hands, but then a little while later, he will begin thinking “did I wash my hands well enough? What if I missed an area?” He reports that he can feel himself getting more and more “scared” until he washes his hands again.
MENTAL STATUS EXAM
Tyrel is alert and oriented to all spheres. Eye contact varies throughout the clinical interview. He reports his mood as “good,” admits to anxiety. Affect consistent to self-reported mood. He denies visual/auditory hallucinations. No overt delusional or paranoid thought processes were apparent. He denies suicidal ideation.
Lab studies obtained from Tyrel’s pediatric nurse practitioner were all within normal parameters. An antistreptolysin O antibody titer was obtained for reasons you are unclear of, and this titer was shown to be above normal parameters.

Decision Point One
BASED ON THE INFORMATION PROVIDED IN THE SCENARIO ABOVE, WHICH OF THE FOLLOWING DIAGNOSES WOULD THE PMHNP GIVE TO TYREL?
In your write-up of this case, be certain to link specific symptoms presented in the case to DSM–5 criteria to support your diagnosis.

Generalized Anxiety Disorder (GAD)
Obsessive Compulsive Disorder
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

Decision Point One

 Generalized Anxiety Disorder (GAD)

Decision Point Two
Begin Paxil 10 mg orally daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks
 Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved.

Decision Point Three
Increase Paxil to 20 mg orally daily

Guidance to Student
While GAD was not the actual diagnosis in this case, the child’s OCD symptoms did decrease with Paxil. Although Paxil is not FDA-approved for treatment of OCD in children, it is an SSRI like Sertraline and Fluvoxamine, which are FDA-approved for the treatment of OCD. So if there are no objectionable side effects and the symptoms appear to be decreasing, there may be no need to change drugs, but optimizing the dose may be a better choice. Augmentation with psychotherapy may also be useful, but the current dose of Paxil is still somewhat low, so augmenting with psychotherapy would be a good idea, but in and of itself would not be sufficient to meet this child’s needs.
Finally, while the PMHNP could consider changing to Fluvoxamine, the “controlled release” preparation is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s Prescriber’s Guide for further details). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation.

Decision Point Two
 
Begin Zoloft 50 mg orally daily

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks
 Upon return to the clinic, Tyrel’s mother reported that he has had some decrease in his symptoms. She notices that he is still handwashing frequently, but thinks that the frequency has decreased “a bit.” Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. She also reports that Tyrel has not fully embraced returning to school, but that his attendance has improved. Tyrel’s mom is concerned about the decrease in Tyrel’s appetite. She reports that he has been having some decreased appetite and has complained of feeling “sick to his stomach.”

Decision Point Three
Change to Fluvoxamine controlled release 100 mg orally every morning

Guidance to Student
In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Notice that nothing in the scenario tells us that the PMHNP has assessed this.
Although the child had OCD and not GAD, Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. Starting at too high a dose can result in unfavorable side effects (gastrointestinal side effects are notable in this drug), and we can see that Tyrel is experiencing nausea and decreased appetite. In this case, it is recommended to wait to see if the side effects dissipate. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Decreasing the dose to 12.5 mg orally daily for about 3 or 4 days, then going back to 25 mg orally daily may help to overcome the unfavorable side effects. If side effects persist, the PMHNP may need to consider switching to a different medication.
Fluvoxamine controlled release is not FDA-approved for use in children with OCD (see “Special Populations: Children and Adolescents” in the Fluvoxamine monograph of Stahl’s Prescribers Guide for further details). Fluvoxamine 100 mg orally daily may not be tolerated in the morning secondary to the drug’s sigma-1 antagonist properties, which can cause sedation. Dosing of Fluvoxamine should be such that the larger dose is given in the evening to minimize daytime sedation. It is also worth noting that nothing in the scenario tells us that the Zoloft will not be effective.
Cognitive behavioral therapy is the psychotherapy of choice for treating OCD. However, in this case, the PMHNP assumed he/she was working with GAD, which may have delayed some of the work of CBT—that is, the focus of the sessions would have focused on the obsessive thoughts/compulsive behaviors versus a generalized anxiety. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. However, in this case, the diagnostic challenge made it difficult.

Decision Point One

 Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (“PANDAS”)

Decision Point Two
Refer client to a pediatric neurologist

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks
 You learn that the pediatric neurologist completed a comprehensive assessment on Tyrel, and although symptoms of OCD seem to have occurred after he was sick, and although antistreptolysin O titers were elevated, there is insufficient evidence for the diagnosis of PANDAS.

Decision Point Three
Begin Risperdal 0.5 mg orally twice a day

Guidance to Student
If the PMHNP believes that PANDAS is the most likely diagnosis, he or she should consider the nature of the disorder and the extent of the management, which may include high doses of steroids, the potential for plasma exchange therapy, and possibly monoclonal antibody therapy. A scope of practice considerations should be undertaken—that is, does the PMHNP have the necessary knowledge, skills, and abilities to undertake the care of this client? The PMHNP should consider working in collaboration with the pediatric neurologist to optimize outcomes for this client and his family. Although antistreptolysin O and other titers indicate recent alpha streptococci infection, it should be noted that these titers can remain elevated for weeks after the infection and do not necessarily represent the development of negative sequelae such as PANDAS.
In terms of an actual diagnosis, the child’s main symptoms are most consistent with obsessive-compulsive disorder. There may also be an element of social phobia developing, but at this point, the PMHNP has not assessed the nature of the school avoidance—that is, why is the child avoiding school. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Notice that nothing in the scenario tells us that the PMHNP has assessed this.
Zoloft is FDA-approved to treat OCD in children. The starting dose is 25 mg orally daily. However, it is important to increase from the starting dose to an appropriate therapeutic dose to effectively manage symptoms. In this scenario, Fluvoxamine (immediate release) 25 mg orally daily would be the most appropriate agent.
Week 7: Learning and Motor Disorders in Childhood
“I had a substitute teacher today, so it was not a good day. She thought I was goofing off, but I could not help myself. As much as I tried to hold back, knowing she would freak out, I felt like a volcano. I erupted with a sound, kinda like a bullfrog that lasted for almost 10 minutes. She kept telling me to quiet down, but I could not help myself. Then the physical stretching and flexing of my neck started. She was really mad. Finally, my friend told her about me. It was embarrassing.”
Samuel, age 9
Learning disorders represent a diagnostic challenge in that many of the features of learning disorders overlap with ADHD. Appropriate diagnosis is essential to proper treatment. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Motor disorders can be a source of considerable distress for both the child and their parents. Appropriate diagnosis is required in order to initiate the most appropriate treatment to minimize the impact of these conditions on the child.
This week, you work with your group again to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examine the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.
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Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

Standard 9 “Evidence-Based Practice and Research” (pages 71-72)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 4, “Theories of Personality and Psychopathology” (pp. 151–191)
Chapter 31, “Child Psychiatry” (pp. 1181–1205)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

“Neurodevelopmental Disorders”

“Specific Learning Disorder”
“Motor Disorders”

Note: You will access this book from the Walden Library databases.
Murphy, T. K., Lewin, A. B., Storch, E. A., Stock, S. (2013). Practice parameter for the assessment and treatment of children and adolescents with tic disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 52(12), 1341–1359. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00695-3/pdf
McGarvey, E. L., Leon-Verdin, M., Wancheck, T. N., & Bonnie, R. J. (2013). Decisions to initiate involuntary commitment: The role of intensive community services and other factors. Psychiatric Services, 64(2), 120–126.
Note: You will access this article from the Walden Library databases.
Kaltiala-Heino, R. (2010). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree . Involuntary commitment and detainment in adolescent psychiatric inpatient care. Social Psychiatry and Psychiatric Epidemiology, 45(8),785–793. doi:10.1007/s00127-009-0116-3
Note: You will access this article from the Walden Library databases.
Lindsey, M. A., Joe, S., Muroff, J., & Ford, B. E. (2010). Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth. General Hospital Psychiatry, 32(3), 300–309. doi:10.1016/j.genhosppsych.2010.01.007
Note: You will access this article from the Walden Library databases.
Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.
 
Note: All Stahl resources can be accessed through the Walden Library using the link. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear.
 
To access information on the following medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.
Review the following medications:

Tourette syndrome
Pervasive developmental disorders

clonidine
haloperidol
pimozide
guanfacine

Note: Many of these medications are FDA approved for adults only. Some are FDA approved for disorders in children and adolescents. Many are used “off label” for the disorders examined in this week. As you read the Stahl drug monographs, focus your attention on FDA approvals for children/adolescents (including “ages” for which the medication is approved, if applicable) and further note which drugs are “off label.”
Optional Resources
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Hoboken, NJ: Wiley Blackwell.

Chapter 47, “Children With Specific Sensory Impairments” (pp. 612–622)

Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Discussion: Parent Guide
Learning disorders and motor disorders can be difficult for parents to understand. They often have many questions that go unanswered and can create considerable misunderstanding. This misunderstanding can damage the child/parent relationship. The PMHNP can answer questions and provide guidance for the family in order to help reduce the uncertainty of the disorders.
For the Discussion, you will work with your group again to develop a Parent Guide for your assigned disorder.
Learning Objectives
Students will:

Analyze signs and symptoms of learning and motor disorders in childhood
Analyze pathophysiology of learning and motor disorders in childhood
Analyze diagnosis and treatment methods for learning and motor disorders in childhood
Evaluate Parent Guides

To Prepare for this Discussion:

Your Instructor will assign you to a group and a disorder by Day 1 of Week 2.
Review the resources concerning your assigned disorder.
Use your group’s Discussion Board to design and develop the Parent Guide before posting to the group wiki. For further guidance, refer to the Accessing Group Discussions instructions below. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.

Using evidence-based research, design and develop a Parent Guide for your assigned disorder including:

Signs and symptoms
Pathophysiology
How the disorder is diagnosed
Treatment options

Provide a minimum of three academic references.
By Day 5
One designated group member should post the completed Parent Guide to the Discussion.
By Day 7
Respond to at least two other groups’ wikis by providing at least two contributions for improving or including in their Parent Guide and at least two things that you like about their guide. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.
Submission and Grading Information
Accessing Group Discussions and Wikis
To access your group’s discussion, click on the Parent Guide Groups link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page. Select Group Discussion Board under the Group Tools menu to work on your participate in your group’s discussion.
To access your group’s wiki, click on the Parent Guide Groups link. Once you have clicked on the link, select your assigned team (e.g., Team A, Team B, Team C, etc.) to access your team’s home page.
Creating a Wiki Page
Create the first wiki topic page by entering the group’s wiki area and selecting Create Wiki Page. Use the group’s assigned disorder as the name of your wiki. Then add your Parent Guide in the Content text box. You can use the editor functions to format the text and include files, images, web links, multimedia, and mashups. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Select Submit when you have completed the wiki page.
Grading Criteria
To access your rubric:
Week 7 Parent Guide Discussion Rubric
To access your group discussion / wiki:
Parent Guide Groups
Post to Discussion by Day 5 and Respond by Day 7
To participate in this Discussion:
Parent Guide Groups – Week 7

Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment
PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.
In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.
Scenario for Week 7 Case:
You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?
Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Learning Objectives
Students will:

Evaluate clients for voluntary commitment
Evaluate clients for involuntary commitment based on state laws
Recommend actions for supporting parents of clients not eligible for involuntary commitment
Recommend actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

Review the Learning Resources concerning voluntary and involuntary commitment.
Read the Week 7 Scenario in your Learning Resources.
Research your state’s laws concerning voluntary and involuntary commitment.

The Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree (2–3 pages):

Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

By Day 7
Submit your Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn1+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn1+last name+first initial.(extension)” and click Open. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria
To access your rubric:
Week 7 Assignment 1 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 7 Assignment 1 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 7 Assignment 1

Assignment 2: Practicum: Week 5 Decision Tree
By Day 7
Submit your Assignment. Refer to Week 5 for additional guidance.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn2+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn2+last name+first initial.(extension)” and click Open. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.

Grading Criteria
To access your rubric:
Week 7 Assignment 2 Rubric
Check Your Assignment Draft for Authenticity
To check your Assignment draft for authenticity:
Submit your Week 7 Assignment 2 draft and review the originality report.
Submit Your Assignment by Day 7
To submit your Assignment:
Week 7 Assignment 2

Assignment 3: Board Vitals
This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.
These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.
You can access Board Vitals through the link sent to you in email or by following the link below:
https://www.boardvitals.com/
By Day 7
Complete the Board Vitals questions.

Practicum Reminder
Time Logs
You are required to keep a log of the time you spend related to your practicum experience and enter every patient you see each day. You can access your time log from the Welcome Page in your Meditrek account. You track time individually for each patient you work with. Please make sure to continuously input your hours throughout the term.

Making Connections
This week, you worked with your group to develop a Parent Guide for an assigned learning or motor disorder. For your practicum, you examined the practice of voluntary and involuntary commitment of children and adolescents with mental health disorders.
Anxiety disorder, OCD – Tyrel Essay Assignment Decision Tree Next week, you will debate the theory that bipolar depression can or cannot be diagnosed in children and adolescents.

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