Neurological and Musculoskeletal Disorders

Alzheimer’s Disease 76-year-old Iranian Male BACKGROUND Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation. SUBJECTIVE During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. MENTAL STATUS EXAM Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive) RESOURCES § Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Neurological and Musculoskeletal Disorders

Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Decision Point One Select what you should do: Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks : Begin Aricept (donepezil) 5 mg orally at BEDTIME Begin Razadyne (galantamine) 4 mg orally BID 1 Title of the Paper in Full Goes Here Student Name Here Walden University Course Number, Section, and Title (Example: NURS 0000 Section 01, Title of Course) Month, Day, Year (enter the date submitted to instructor) 2 Title of the Paper This is your introductory paragraph designed to inform the reader of what you will cover in the paper. (BSN Students – Carefully follow your course-specific Grading Rubric concerning the content that is required for your assignment and the Academic Writing Expectations [AWE] level of your course.) This template’s formatting—Times New Roman 12-point font, double spacing, 1” margins, 1/2” indentations beginning of each paragraph, page numbers, and page breaks—is set for you, and you do not need to change it. Do not add any extra spaces between the heading and the text (you may want to check Spacing under Paragraph, and make sure settings are all set to “0”).

The ideas in this paper should be in your own words and supported by credible outside evidence. Cite the author, year of publication, and page number, if necessary, per APA. The introductory paragraph should receive no specific heading because the first section functions as your paper’s introduction. Build this paragraph with the following elements: 1. Briefly detail what has been said or done regarding the topic. 2. Explain the problem with what has been said or done. 3. Create a purpose statement (also commonly referred to as a thesis statement) as the last sentence of this paragraph: “The purpose of this paper is to describe…”. Level 1 Heading (Name According to the Grading Rubric Required Content) This text will be the beginning of the body of the paper. Even though this section has a new heading, make sure to connect this section to the previous one so readers can follow along with the ideas and research presented. The first sentence, or topic sentence, in each paragraph should transition from the previous paragraph and summarize the main point in the paragraph. Make sure each paragraph addresses only one topic. When you see yourself drifting to another idea, make sure you break into a new paragraph. Avoid long paragraphs that are more than three- 3 fourths of a page. Per our program recommendations, each paragraph should be at least 3-4 sentences in length and contain a topic sentence, evidence, analysis, and a conclusion or lead out sentence. In your paragraphs, synthesize your resources/readings into your own words and avoid using direct quotations. In the rare instances you do use a direct quotation of a historical nature from a source, the page or paragraph numbers are also included in the citation. For example, Leplante and Nolin (2014) described burnout as “a negative affective response occurring as result of chronic work stress” (p. 2). When you transition to a new idea, you should begin a new paragraph. Another Level 1 Heading (Name According to the Grading Rubric Required Content) Here is another Level 1 heading. Again, the topic sentence of this section should explain how this paragraph is related to or a result of what you discussed in the previous section. Consider using transitions between sentences to help readers see the connections between ideas. Be sure to credit your source(s) in your paper using APA style. The APA Manual 6th edition and the Walden Writing Center are your best citation resources. Writing Center resources are available at https://academicguides.waldenu.edu/writingcenter/apa/citations. You must appropriately and correctly cite all works used in your document. The following paragraph provides examples of in-text citation examples. According to Leplante (2014), employers cause burnout when employees are stressed by too much work. Or you might write and cite in this manner: Employers cause burnout when employees are stressed by too much work (Leplante, 2014). When paraphrasing, the author name and year of publication in citations is required by APA to direct the reader to a specific source in the reference list. Personal communications are not listed in the reference page but are noted in text as (S. Wall, 4 personal communication, May 24, 2018). This should immediately follow the content of the interview. Another Level 1 Heading (Name According to the Grading Rubric Required Content) APA can seem difficult to master, but following the general rules becomes easier with use. Neurological and Musculoskeletal Disorders

The Writing Center also offers numerous APA resources on its website and can answer your questions via email . Prior to submitting your paper for grading, submit your draft to SafeAssign Drafts found in the left column of your course. And so forth until the conclusion…. Conclusion The conclusion section should recap the major points of your paper. Do not introduce new ideas in this paragraph; the conclusion should interpret what you have written and what it means in the bigger picture. 5 References Please note that the following references are intended as examples only. List your own references in alphabetical order. Also, these illustrate different types of references; you are responsible for any citations not included in this list. In your paper, be sure every reference entry matches a citation, and every citation refers to an item in the reference list. Journal Article; One Author; DOI Leplante, J. P. (2014). Neurological and Musculoskeletal Disorders

Consultas and socially responsible investing in Guatemala: A case study examining Maya perspectives on the Indigenous right to free, prior, and informed consent. Society & Natural Resources, 27(4), 231–248. doi:10.1080/08941920.2013.861554 Journal Article, Two Authors; URL Eaton, T. V., & Akers, M. D. (2007). Whistleblowing and good governance. CPA Journal, 77(6), 66–71. Retrieved from http://www.cpajournal.com/ Journal Article, Three to Six Authors; URL Rasmussen, A., Hopkins, B., & Fitzpatrick, C. (2004). Systematic review. CPU Journal, 6(9), 44-51. Retrieved from http/www.cpujournal.com/ Journal Article, Seven Authors or more; DOI Kernis, M. H., Cornell, D. P., Sun, C. R., Berry, A., Harlow, T., Asgaard, G.,….Bach, J. S. (1993). There’s more to self-esteem than whether it is high or low: The importance of stability of self-esteem. Journal of Personality and Social Psychology, 65(9) 1190-1204. doi:10.1080/08941920.2013.861554 6 Book; One Author Weinstein, J. A. (2010). Social change (3rd ed.). Lanham, MD: Rowman & Littlefield. Book; Chapter in an Edited Book Christensen, L. (2001). For my people: Celebrating community through poetry. In B. Bigelow, B. Harvey, S. Karp, & L. Miller (Eds.), Rethinking our classrooms: Teaching for equity and justice (Vol. 2; pp. 16–17). Milwaukee, WI: Rethinking Schools. Professional Organization Article Centers for Disease Control and Prevention. (2010). Nutrition. Retrieved from http://www.cdc.gov/nutrition/ Professional Organization Web page Centers for Disease Control and Prevention. (2018). Back to school. Retrieved from https://www.cdc.gov/features/teens-back-to-school/index.html Professional Organization Book American Nurses Association. (2010). Nursing: Scope and standards of practice (2nd ed.). Silver Spring, MD: Author. Two or more works by same author in the same year Wall, S. (2018a). Effects of friendship on children’s behavior. Journal of Social Psychology, 4(1), 101-105. Wall, S. (2018b). Trials of parenting adolescents with deviant behaviors. Journal of Child Psychology, 4(12), 167-161. Government Article 7 National Institute of Mental Health. (1990). Neurological and Musculoskeletal Disorders

Clinical training in serious mental illness (DHHS Publication No. ADM 90-1679). Washington, DC: U.S. Government Printing Office. Lecture Notes Health effects of exposure to forest fires [Lecture notes]. (2005). Retrieved from https://class.waldenu.edu Personal Communication (Only Goes in Body of Paper and not in References) Video/DVD Laureate Education (Producer). (2009). Title of program here [DVD]. In Title of video here. Baltimore, MD: Author. Television (Audio) Important, I. M. (Producer). (1990, November 1). The nightly news hour [Television broadcast]. New York, NY: Central Broadcasting Service. APA Resources You have other several options to assist you in the formulation of your reference page. • Your American Psychological Association (APA) Manual is your best reference resource. Use the current edition with a copyright date of 2009. • The Walden Writing Center also a great place for referencing advice at https://academicguides.waldenu.edu/writingcenter/apa/references. • Citation and reference examples are provided in the ‘BSN TOP Ten References and Citations” handout found in the Writing Resources tab of the course. This document covers the 10 most commonly used reference and citation formats. You are responsible to look up any that are not included on this list. …Neurological and Musculoskeletal Disorders