NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence

When building a house, contractors and architects rely on a blueprint to help determine what features and structures are needed to support the house and provide those features sought after by potential buyers. If a potential error occurs in the construction of a support beam, for example, it is likely that the house will sustain damage and, possibly, crumble.

In much the same way, the features and structures of your brain provide a blueprint that help to support your body and provide the mechanisms with which to sustain your well-being. Individuals who suffer from mental illness, according to the fundamental premise of psychiatric neuroscience, are a result of abnormal brain function. Yet, as advancements in neuroimaging and genetics emerge, a whole new understanding of how to address mental illness remains for the psychiatric nurse practitioner (PNP). Neuroimaging and genetic techniques help provide insights, such as a blueprint of the brain, for detailing how the brain’s structure and wiring is functioning.

By determining what functions and structures of the brain or central nervous system are implicated in psychopathologies observed PNPs are able to synthesize biological explanations into treatment protocols for sustained, positive patient outcomes. A solid foundation and understanding of the functions and structures of the central nervous system is the first pillar of solidifying your understanding of psychopharmacology. NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence

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What’s Happening This Module?

This course is composed of three separate modules covering 11 weeks of content. Each module consists of an overarching topic in which each week within the module includes specific subtopics for learning. Module 1, Introduction to Neuroanatomy and Adherence, is a 3-week module. During Week 1, you will review foundational aspects of neuroanatomy as they relate to psychopharmacology. You will examine your knowledge of these foundational aspects of neuroanatomy by completing a Short Answer Assessment. During Week 2, you will explore neurotransmitters and receptor theory as they apply to psychopharmacology. You will engage in a Discussion with your colleagues on foundational neuroscience. In Week 3, you will examine medication adherence and strategies to mitigate non-adherence as it applies to specific treatment plans for patients. You will then complete a Quiz to test your knowledge of the entire module.

What do I have to do?	When do I have to do it?
Review your Learning Resources.	Days 1–7, Weeks 1, 2, and 3
Assignment: Short Answer Assessment	Submit your Assignment by Day 7 of Week 1.
Discussion: Foundational Neuroscience	Post by Day 3 of Week 2 and respond to your colleagues by Day 6 of Week 2.
Quiz: Neurobiology and Medication Adherence Concepts	Complete Quiz by Day 7 of Week 3.

Go to the Weekly Content

Week 1: Introduction to Neuroanatomy

The human brain is organized into the cerebral cortex, brainstem, subcortical structures, and the cerebellum. These anatomical structures are made of inter-connected elements that create distributed and highly inter-connected circuits. It is in these circuits where cognition, behavior, and affect are processed.

—Camprodon, J. A., & Roffman, J. L. (2016, p. 6)

By using a combination of psychotherapy and medication therapy, psychiatric nurse practitioners (PNP) are positioned to provide a very unique type of care to patients with psychiatric disorders. To be successful in this role, you must have a strong theoretical foundation in pathophysiology, psychopharmacology, and neuroscience. This foundation will help you assess, diagnose, and treat patients as you relate presenting symptoms to theoretical neuronal functioning.

This week, as you begin to study psychopharmacology, you will explore the basic functional unit of the nervous system, the neuron. You will review the structure of the neuron and you will examine the anatomy of the central nervous system and consider the functionality of the different structure and outward (phenotypic) expression of their activities. You will analyze these concepts as you complete your short answer assessment for this week. NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence

_Reference:_{Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier.}

Learning Objectives

Students will:

Describe the functions and structures of the central nervous system
Describe the different structures that make up the neuron
Explain the function of neurons in intracellular communication

Learning Resources

Required Readings

Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier.

Required Media

Psychopharmacologic Approaches to Treatment of Psychopathology (3m)

Optional Resources

Pathopharmacology: Disorders of the Nervous System: Exploring the Human Brain

Dr. Norbert Myslinski reviews the structure and function of the human brain. Using human brains, he examines and illustrates the development of the brain and areas impacted by disorders associated with the brain. (15m)

Introduction to Advanced Pharmacology

In this media presentation, Dr. Terry Buttaro, associate professor of practice at Simmons School of Nursing and Health Sciences, discusses the importance of pharmacology for the advanced practice nurse. (6m)

Assignment

Practicum Manual Acknowledgment

The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.

Field Experience: MSN Nurse Practitioner Practicum Manual

Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.

Optional Discussion Forum: PMHNP Study Support Lounge

The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge, where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts.

As a peer, you are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like these is a statistically significant predictor of success.

To Participate in this Optional Discussion:

PMHNP Study Support Lounge

Assignment: Short Answer Assessment

As a psychiatric 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.

Photo Credit: Getty Images/Science Photo Libra

To complete:

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

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.
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?
In 3 or 4 sentences, explain how glia cells function in the central nervous system. Be specific and provide examples.
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.
In 3–5 sentences, explain the concept of “neuroplasticity.” Be specific and provide examples.

By Day 7

Submit your 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 “WK1Assgn+last name+first initial.(extension)” as the name.
Click the Week 1 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 1 Assignment 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 “WK1Assgn+last name+first initial.(extension)” and click Open.
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 1 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 1 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 1

To participate in this Assignment:

Week 1 Assignment

Practicum – Upcoming Deadline

In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .

For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.

Please take the time to review the Appropriate Preceptors and Field Sites for your courses.

Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.

Week 2: Neurotransmitters and Receptor Theory

Receptors and neurotransmitters are like a lock-and-key system. Just as it takes the right key to open a specific lock, it takes the right neurotransmitter to bind to a specific receptor. Not surprisingly, as it concerns psychopharmacology, the pharmacotherapeutics that are prescribed must trigger the release of certain neurotransmitters that bind to the correct receptors in order to elicit a favorable response for the patient. The mechanism of this binding and the response that follows reflects receptor theory and lies at the foundation of pharmacology. NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence

This week, you will continue your examination of neuroanatomy and neuroscience as you engage with you colleagues in a Discussion. You will also explore the potential impacts of foundational neuroscience on the prescription of pharmacotherapeutics.

Learning Objectives

Students will:

Analyze the agonist-to-antagonist spectrum of action of psychopharmacologic agents
Compare the actions of g couple proteins to ion gated channels
Analyze the role of epigenetics in pharmacologic action
Analyze the impact of foundational neuroscience on the prescription of medications

Learning Resources

Required Readings

Required Media

The University of British Columbia. (n. d.). Neuroanatomy videos. http://neuroanatomy.ca/videos.html

Note: Please review all of the media under the neuroanatomy series.

Optional Resources

Pathopharmacology: Disorders of the Nervous System: Exploring the Human Brain

Introduction to Advanced Pharmacology

Discussion: Foundational Neuroscience

As a psychiatric nurse practitioner, it is essential for you to have a strong background in foundational neuroscience. In order to diagnose and treat patients, you must not only understand the pathophysiology of psychiatric disorders but also how medications for these disorders impact the central nervous system. These concepts of foundational neuroscience can be challenging to understand. Therefore, this Discussion is designed to encourage you to think through these concepts, develop a rationale for your thinking, and deepen your understanding by interacting with your colleagues.

For this Discussion, review the Learning Resources and reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients.

By Day 3 of Week 2

Post a response to each of the following:

Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments.
Compare and contrast the actions of g couple proteins and ion gated channels.
Explain how the role of epigenetics may contribute to pharmacologic action.
Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action.

Read a selection of your colleagues’ responses.

By Day 6 of Week 2

Respond to at least two of your colleagues on two different days in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 2 Discussion Rubric

Post by Day 3 of Week 2 and Respond by Day 6 of Week 2

To Participate in this Discussion:

Week 2 Discussion

Week 3: Concepts in Assessing Medication Adherence and Strategies to Mitigate Non-Adherence

Poor adherence to psychiatric treatments is a widespread clinical problem that negatively impacts rates of treatment response and remission. While empirically-supported treatments are available for many psychiatric disorders, these treatments are not universally effective. Patients commonly face difficulties in taking prescribed psychotropic medications or attending psychotherapy sessions as recommended, and therefore may not achieve optimal outcomes.

—Traeger, L., Brennan, M. M., & Herman, J. B. (2016, p. 20)

This week, you will explore how medication adherence can impact a patient’s success with treatment. You will examine the epidemiology of adherence, the impact of non-adherence from a clinical and economic viewpoint, risk factors for non-adherence, assessing adherence, and integrating adherence into a treatment plan. You will also complete a Quiz to test your understanding of this module’s content.

_Reference:_{Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.}

Learning Objective

Students will:

Identify concepts related to neuroanatomy, receptor theory, and medication adherence in psychopharmacology

Learning Resources

Required Readings

Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.
Fialko, L., Garety, P. A., Kuipers, E., Dunn, G., Bebbington, P. E., Fowler, D., & Freeman, D. (2008). A large-scale validation study of the medication adherence rating scale (MARS). Schizophrenia Research, 100(1–3), 53–59. https://doi.org/10.1016/j.schres.2007.10.029
LaMorte, W. W. (2019). The transtheoretical model (stages of change). Boston University School of Public Health. https://sphweb.bumc.bu.edu/otlt/MPH-Modules/SB/BehavioralChangeTheories/BehavioralChangeTheories6.html
The transtheoretical model of health behavior change by Prochaska, J. O., & Velicer, W. F., in American Journal of Health Promotion, Vol. 12/ Issue 1. Copyright 1997 by Sage Publications, Inc.Reprinted by permission of Sage Publications, Inc. via the Copyright Clearance Center.

Required Media

Centers for Disease Control and Prevention. (2017). Overcoming barriers to medication adherence for chronic diseases [Video]. https://www.cdc.gov/grand-rounds/pp/2017/20170221-medication-adherence.html

Quiz: Neurobiology and Medication Adherence Concepts

Photo Credit: Getty Images

By Day 7

Complete the 20-question Quiz to gauge your understanding of this module’s content. NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence

Submission Information

Submit Your Quiz by Day 7

To submit your Quiz:

Week 3 Quiz

NURS 4430 Module 1: Introduction to Neuroanatomy and Adherence