State’s Nurse Practice Act.

In your response, identify the state (Texas) in which you practice and acknowledge that you have read your state’s Nurse Practice Act. Identify the professional codes and business practices regulated by the state for nurse practitioners and explain how invasive procedure privileges are granted within your state. Detail at least two standards for nurse practitioners within your state and discuss the regulations for ordering medications and devices within your state. How do national, state, and local regulations affect the AGACNP scope and practices? Support your answer with a minimum of two APRN peer-reviewed resources.

 

Sample Solution

I currently practice in the state of Texas, and I acknowledge that I have read the Texas Nurse Practice Act. The professional codes and business practices regulated by my state for nurse practitioners include prescribing medications, ordering diagnostic testing, delegating tasks to other healthcare professionals, and providing direct patient care. Additionally, my state mandates that nurse practitioners remain within their scope of practice when providing medical services to patients (Texas State Board Of Nursing [TSBON], 2019).

When it comes to invasive procedures such as suturing or administering injections, most states require additional privileges beyond what is outlined in a standard license. In Texas, those wishing to receive these advanced privileges must apply directly with the Texas Medical Board (TMB), who will consider factors such as current licensure status and clinical experience when making a decision (TMB & TSBON). Furthermore, applicants are required to document their past experience performing certain procedures before submitting an application for consideration (TSBON., 2019). Once approved for advanced privileges by the TMB, nurses can legally perform specific authorized activities related to invasive procedures without supervision from another healthcare provider.

In summary, while most states require nurses practicing within them to adhere to professional behavior codes and business practices mandated by legislation like the Texas Nurse Practice Act – including remaining within scope of practice when delivering patient care – gaining privileges associated with invasive procedures may necessitate extra steps on behalf of the applicant depending on where they live.

As humans, we continuously seek out things that can produce pleasurable feelings. One of the few ways to attain this feeling of euphoria or pleasure is by consumption of chemical substances. However, continuous consumption of these substances can lead to development of dependence towards them and this is more commonly known as addiction. Currently, the cost of social and economic impacts due to drugs of abuse addiction sums up to more than $740 billion annually (National Institute on Drug Abuse, 2017). Despite this, the clear neurophysiological mechanisms underlying development and progression of addiction is still unknown.

Addiction can be defined as repeated self-administration of alcohol or other drugs (AOD’s) despite knowledge of adverse medical and social consequences and attempts to abstain from AOD use (Robert & Koob, 1997). Initial intake of drug may be due influenced by genetic, psychosocial or environmental factors however, subsequent doses is most probably caused by action on drug on the brain to induce the drug-seeking behaviour. Addiction is comprised of three stages which are ‘binge/intoxication’, ‘withdrawal/negative affect’, and ‘preoccupation/anticipation’ as seen in Figure 1 (Koob &Volkow, 2010).

Figure 1. The Three stages of addiction and brain areas each stage associates with (Herman & Roberto, 2015)

‘Binge/intoxication’ refers to the consistent intake of drug after initial dose which may cause decrease in dopamine release after each intake due to sensitization. This will then lead to ‘withdrawal/negative affect’ stage where absence of drug will cause a decrease in dopamine causing anxious and restless feelings resulting in the craving or ‘preoccupation/anticipation’ stage. Two major factors known to modulate these behavioural changes are reinforcement where a stimulus increases the chance of response and neuroadaptation, the process by which neuronal structures change in response to drug exposure. Modulation of these factors motivates initial response to a drug and formation of long-term craving however, relapse is thought to be caused by permanent neuroadaptations that will cause discomfort during withdrawal (Robert & Koob, 1997)

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