NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders

Sample Answer for NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders Included After Question

NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders

 

When pediatric patients present with mood disorders, the process of assessing, diagnosing, and treating them can be quite complex. Children not only present with different signs and symptoms than adult patients with the same disorders, they also metabolize medications much differently. Yet, there may be times when the same psychopharmacologic treatments may be used in both pediatric and adult cases with major depressive disorders. As a result, psychiatric nurse practitioners must exercise caution when prescribing psychotropic medications to these patients. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat pediatric patients presenting with mood disorders.

To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of pediatric patients requiring antidepressant therapy.The Assignment: 5 pages
    For this assignment, you will write a 5–6-page paper on the topic of bipolar and bipolar and
    related disorders. You will create this guide as an assignment; therefore, a title page,
    introduction, conclusion, and reference page are required. You must include a minimum of 3
    scholarly supporting resources outside of your course provided resources.
    In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic
    Disorder, Substance/Medication-Induced Bipolar and Related Disorder, Bipolar and Related
    Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen
    diagnosis of bipolar and related disorder on the following:
     Prevalence and Neurobiology of your chosen disorder
     Discuss the differences between your chosen disorder and one other bipolar and related
    disorders in relation to the diagnostic criteria including presentation of symptoms
    according to DSM 5 TR criteria Discuss special populations and considerations (children, adolescents, pregnancy/post-
    partum, older adult, emergency care) for your chosen bipolar and related disorder;
    demonstrating critical thinking beyond basics of HIPPA and informed consent with
    discussion of at least one for EACH category:  legal considerations, ethical
    considerations, cultural considerations, social determinants of health

    NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders
    NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders

     Discuss FDA and/or clinical practice guidelines approved pharmacological treatment
    options in relation to acute and mixed episodes vs maintenance pharmacological
    treatment for your chosen bipolar and related disorder
     Of the medication treatment options for your chosen disorder discuss side effects, FDA
    approvals and warnings.  What is important to monitor in terms of labs, comorbid
    medical issues with why important for monitoring
     Provide 3 examples of how to write a proper prescription that you would provide to the
    patient or transmit to the pharmacy.
    Note: Support your rationale with a minimum of five academic resources. While you may use the
    course text to support your rationale, it will not count toward the resource requirement. You
    should be utilizing the primary and secondary literature.
    Reminder: The College of Nursing requires that all papers submitted include a title page,
    introduction, summary, and references. The Sample Paper provided at the Walden Writing
    Center
    Links to an external site. provides an example of those required elements (available at
    https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All
    papers submitted must use this formatting.
    By Day 7
    Submit your Assignment.
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    your draft, access the Turnitin Drafts from the Start Here area.
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    WK5Assgn_LastName_Firstinitial
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The Assignment: 5 pages

Examine Case Study: An African American Child Suffering From Depression. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632).All papers submitted must use this formatting.

 

By Day 7

Submit your Assignment.

Submission and Grading Information

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  • Please save your Assignment using the naming convention “WK4Assgn+last name+first initial.(extension)” as the name.
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  • Click on the Submit button to complete your submission.

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What’s Coming Up in Week 5?

Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

Next week, you will build on your assessment and treatment skills as you examine patients presenting with bipolar disorders.

Next Week

To go to the next week:

Week 5

NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders Rubric Detail

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A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders

Title: NURS 6630 Assessing and Treating Pediatric Patients With Mood Disorders

Assessing and Treating Patients With Bipolar Disorder  

Bipolar disorder is one of the most common mental illnesses characterized by drastic shifts in the patient’s mood, activity, and energy levels, affecting their ability to conduct daily tasks (Marzani, & Neff, 2021). Such drastic changes in the patient’s energy levels and mood are more severe, unlike the normal ups and downs experienced by most people. The National Institute of Mental Health (NIH) reported that approximately 2.8% of adults in the United States were diagnosed with bipolar disorder last year (Citrome, 2020). Bipolar disorders are associated with severe morbidity and mortality rates. However, through evidence-based practice, several treatment options have been proposed with proven effectiveness in the management of patients with bipolar disorder. In this discussion, the choices of medication used to manage a young Asian adult diagnosed with bipolar type 1 have been discussed in addition to the reasons behind the choice of psychotropic agent and the expected outcome and legal and ethical considerations encountered by the PMHNP. The choices of medications used are based on both pharmacodynamic and pharmacokinetic factors.  

The case study provided described a 26 years old Asian woman who presented to the clinic with a primary diagnosis of bipolar type 1. The patient was previously hospitalized for 21 days as a result of the onset of acute mania. The patient is in good health with a stable mood at the moment but claims to hate sleeping. She is however underweight with a BMI of 18.3. Genetic testing reveals that the patient is positive for the CYP2D6*10 allele. She has been taking lithium to manage her mental condition during the hospitalization period, which she stopped talking when she was discharged.  Mental examination results reveal that the patient is oddly groomed, but displays perfect orientation in person, time, and place. She is however rapid and pressured. Upon administration of the Young Mania Rating Scale (YMRS), the patient revealed a score of 22, which indicated mild mania. She however denies suicidal ideation and auditory or visual hallucination.  

Decision #1 

Begin Seroquel XR 100 mg orally at HS 

Reason Behind Decision 1:  

Seroquel (Quetiapine) is recommended by most study guidelines for the management of bipolar disorder as monotherapy. The mood-stabilizing effects of Seroquel are associated with its antagonistic effect at the 5-HT2A and D2 receptors (Citrome, 2020). Studies have revealed great effectiveness of the drug and long-term adherence among patients on extended-release (XR) quetiapine which is administered once daily. The drug also exhibits a desirable safety profile with mild side effects which can be managed non-pharmacologically such as changes in weight. The drug is metabolized in the liver by cytochrome P450 (CYP) 3A4, which is low among patients with CYP2D6*10 allele such as Asians. This promotes slow metabolism, hence prolonged duration of action. 

The use of lithium is not appropriate given that the patient stopped taking the drug immediately, which is discouraged as a result of increased risks of relapse and non-compliance. Lithium is also associated with undesirable side effects such as weight gain and GI disturbances especially when administered in higher doses like 300mg (Lin et al., 2020).  

Risperdal is also not a good alternative for the patient as monotherapy. The drug displays great effectiveness when administered in combination with lithium (Marzani, & Neff, 2021). Consequently, the recommended starting dose with Risperdal is 2 to 3mg once daily, which makes the 1mg dose undesirable.  

 

Expected Outcome 

Within the next 4 weeks, the patient is expected to exhibit at least 50% remission of manic symptoms (Citrome, 2020). Her compliance level is also expected to improve, with good sleeping patterns. Her agitation is also expected to reduce. Upon administration of the Young Mania Rating Scale (YMRS), the patient should record a score of less than 12.  

Ethical Considerations Impact on Treatment Plan 

According to the legal and ethical guidelines, the PMHNP must take into account the patient’s race and ethnicity in formulating the most effective treatment plan (Lin et al., 2020). Consequently, given that the patient is an adult, the nurse needs to involve the patient in making decisions concerning the medication choice to promote satisfaction.  

Decision 2: 

Discontinue using Seroquel and Start 40mg Geodon 40 mg orally BID. 

Reason Behind Decision 2: 

The initial intervention revealed minimal effectiveness in controlling the patient’s manic episodes. Consequently, undesired side effects were exhibited by the patient such as constipation, weight gain, and dry mouth which made the patient uncomfortable with the drug. As such it is necessary to discontinue the drug and initiate Geodon which is FDA approved for the management of manic episodes among patients diagnosed with bipolar 1 disorder (Marzani, & Neff, 2021). The drug exhibits a desirable safety profile, unlike Seroquel. Consequently, studies show that Geodon has great bioavailability, and hence must be administered with a 500 calorie intake. The patient also disliked the weight gain side effect associated with the initial drug which will not be the case with Geodon.  

Increasing the dose of Seroquel is not appropriate as this will only worsen the side effects already exhibited by the patient (Rhee et al., 2020). The patient also suggested the drug changes, and ignoring her request would only promote non-compliance and affects their therapeutic relationship with the nurse.   

Continuing the same dose of the medication is also against the patient’s will as this will lead to a further increase in the patient’s body weight (Lin et al., 2020). Consequently, the drug displayed minimal effectiveness which is below the desired therapeutic threshold in the management of bipolar.  

Expected Outcome 

The patient is expected to display at least 50% remission of symptoms within the next four weeks. Her sleeping pattern and agitation levels are expected to improve significantly (Rhee et al., 2020). Consequently, the initial side effects such as dry mouth, constipation, and weight gain are expected to resolve once Seroquel has been discontinued.  

Ethical Considerations Impact on Treatment Plan 

The legal and ethical requirements give the patient the right of making decisions concerning her health (Marzani, & Neff, 2021). As such, the PMHNP must respect the patient’s decision and make appropriate interventions as desired by the patient to promote satisfaction which intern builds on a positive therapeutic relationship with the patient.  

Decision 3: 

Continue the same dose and reassess in 4 weeks.  

Reason Behind Decision 1:  

The patient displayed great tolerance and adherence to the previous intervention with 50% remission of symptoms. Consequently, the undesired side effects were resolved within this time, promoting patient compliance. Studies show that despite the goal of attaining 100% remission of symptoms with psychotropic agents, a 50% management of symptoms is still desirable. Consequently, Geodon takes up to 8 to 12 weeks to completely managed maniac symptoms among patients with bipolar disorder (Mazza et al., 2020). As such, it is necessary to continue the same dose to promote further management of the patient’s symptoms, with no side effects. The treatment outcome must however be evaluated after four weeks, given that the treatment regimen was changed just after the first intervention failed. 

Increasing the dose of Geodon is not necessary given the great tolerance and effectiveness displayed by the patient (Mazza et al., 2020). Consequently, studies show that increased plasma concentrations of the drug are associated with severe side effects such as weight gain which resulted in to change of regimen in the first place. 

Augmenting Geodon with lithium is desirable, but at low doses to avoid side effects (Mazza et al., 2020). Consequently, this intervention could only be considered among patients who are not lithium defaulters as this will only compromise the patient’s compliance levels.  

Expected Outcome 

The patient is expected to display complete remission of symptoms within the next four weeks. She should be able to sleep well, with significantly reduced agitation levels (Rhee et al., 2020). Her scores upon administration of the Young Mania Rating Scale should also display a reading of less than 8.  

Ethical Considerations Impact on Treatment Plan 

According to the nursing code of ethics, it is the obligation of the PMHNP to promote the patient’s health and prevent harm. Consequently, holistic care requires the nurse to promote patient-centered care to attain positive treatment outcomes (Rhee et al., 2020). As such, listening to the patient and involving them in making decisions concerning which intervention is appropriate for their health is necessary.  

Conclusion 

Bipolar disorder is one of the most common mental illnesses across the world with increased morbidity and mortality rates. However, with early detection, studies show that patients can greatly benefit from the available treatment options with improved quality of life. Clinicians must also consider pharmacodynamic and pharmacokinetic factors when deciding on which medication to use for a given patient (Citrome, 2020). In the provided case study, the first intervention was to initiate the patient on Seroquel which is FDA approved for the management of bipolar among adults. However, the drug displayed undesired side effects such as weight gain, which made the patient uncomfortable with taking the medication (Lin et al., 2020). Consequently, the drug displayed minimal effectiveness, which led to changing the treatment regimen is the second decision. Geodon, is also FDA approved for the management of manic episodes among bipolar patients, hence considered as the best replacement for Seroquel (Mazza et al., 2020). The patient displayed great adherence and tolerance to this medication with 50% remission of symptoms. Consequently, the initial side effects were resolved. 

As a result, it was necessary to maintain the dose of this medication for the third intervention to avoid additional side effects and promote further remission of the patient’s symptoms. several legal and ethical considerations were encountered with the PMHNP in the management of this patient (Marzani, & Neff, 2021). For instance, the patient being an adult gives her the right of making decisions concerning her health. As such, the nurse needed to change the patient’s regimen when she was not comfortable with the weight to gain side effects as a result of Seroquel (Rhee et al., 2020). General, the nurse has the obligation of promoting the patient health and preventing harm.  

 

 

References 

Citrome, L. (2020). Food and Drug Administration–Approved Treatments for Acute Bipolar Depression: What We Have and What We Need. Journal of Clinical Psychopharmacology, 40(4), 334-338. DOI: 10.1097/JCP.0000000000001227 

Lin, Y., Mojtabai, R., Goes, F. S., & Zandi, P. P. (2020). Trends in prescriptions of lithium and other medications for patients with bipolar disorder in office-based practices in the United States: 1996–2015. Journal of Affective Disorders, 276, 883-889. https://doi.org/10.1016/j.jad.2020.07.063 

Marzani, G., & Neff, A. P. (2021). Bipolar Disorders: Evaluation and Treatment. American Family Physician, 103(4), 227-239. PMID: 33587568. 

Mazza, M., Marano, G., Giuseppin, G., & Janiri, L. (2020). Ziprasidone in treating bipolar child and adolescent patients: More research is warranted. Bipolar disorders, 22(3), 311-312. https://doi.org/10.1111/bdi.12911 

Rhee, T. G., Olfson, M., Nierenberg, A. A., & Wilkinson, S. T. (2020). 20-year trends in the pharmacologic treatment of bipolar disorder by psychiatrists in outpatient care settings. American Journal of Psychiatry, 177(8), 706-715. https://doi.org/10.1176/appi.ajp.2020.19091000 

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Name: NURS_6630_Week4_Assignment_Rubric

  Excellent

Point range: 90–100

Good

Point range: 80–89

Fair

Point range: 70–79

Poor

Point range: 0–69

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Points Range: 9 (9%) – 10 (10%)

The response accurately, clearly, and fully summarizes in detail the case for the Assignment.

The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.

Points Range: 8 (8%) – 8 (8%)

The response accurately summarizes the case for the Assignment.

The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.

Points Range: 7 (7%) – 7 (7%)

The response inaccurately or vaguely summarizes the case for the Assignment.

The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.

Points Range: 0 (0%) – 6 (6%)

The response inaccurately and vaguely summarizes the case for the Assignment, or is missing.

The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.

Decision #1 (1–2 pages)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Points Range: 18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

Points Range: 16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

Points Range: 14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

Points Range: 0 (0%) – 13 (13%)

The response inaccurately and vaguely explains the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Decision #2 (1–2 pages)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Points Range: 18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

Points Range: 16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

Points Range: 14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

Points Range: 0 (0%) – 13 (13%)

The response inaccurately and vaguely explains in detail the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Decision #3 (1–2 pages)

• Which decision did you select?
• Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
• What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
• Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Points Range: 18 (18%) – 20 (20%)

The response accurately and clearly explains in detail the decision selected.

The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.

The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response.

The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.

Examples provided fully support the decisions and responses provided.

Points Range: 16 (16%) – 17 (17%)

The response accurately explains the decision selected.

The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.

The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.

The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.

The response accurately explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided support the decisions and responses provided.

Points Range: 14 (14%) – 15 (15%)

The response inaccurately or vaguely explains the decision selected.

The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.

The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.

The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.

Examples provided may support the decisions and responses provided.

Points Range: 0 (0%) – 13 (13%)

The response inaccurately and vaguely explains in detail the decision selected.

The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.

The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.

The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.

Examples provided do not support the decisions and responses provided, or is missing.

Conclusion (1 page)

• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Points Range: 14 (14%) – 15 (15%)

The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient.

The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.

Points Range: 12 (12%) – 13 (13%)

The response accurately summarizes the recommendations on the treatment options selected for this patient.

The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.

Points Range: 11 (11%) – 11 (11%)

The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient.

The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.

Points Range: 0 (0%) – 10 (10%)

The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing.

The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.

Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.
Points Range: 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.

Points Range: 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

Points Range: 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.

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

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

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

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

Points Range: 0 (0%) – 3 (3%)

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. Points Range: 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

Points Range: 4 (4%) – 4 (4%)

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

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Contains several (3 or 4) APA format errors.

Points Range: 0 (0%) – 3 (3%)

Contains many (≥ 5) APA format errors.

Total Points: 100