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i want a peer review for this discussion board Advanced nurse practitioners have been given the authority in many states to practice independently of their medical counterparts, thus the legal assumption of prescriptions and responsibilities that come with prescribing medications, patient considerations and contradictions. A methodical approach to advanced practice nursing includes maintaining a high-quality perceptive approach to the outcomes of the patients that are under their supervision. The advanced practice nurse must consider risk and benefits, current diagnosis and comorbities. Complex clinical perception should be at the forefront of each clinical encounter. Whether in outpatient clinical settings or hospitals. Advanced practice nurses are often in specialty areas. Family nurse practitioners and mental health practitioners may cross paths in efforts to manage women’s health. A group that requires special consideration when prescribing medications is pregnant women or women in child-bearing years with a mental illness. Referred to as “the last therapeutic orphans”(Betcher & Wisner, 2020) the need for microscopic pharmaceutical management in this population requires a collaborative effort during preterm, intra and postpartum. Practitioners may need to consider basic testing in certain age groups, like pregnancy testing, prior to prescribing medications. The use of medications and psychological assistance is evidence-based(Betcher & Wisner, 2020) in this group and a patient-centered approach must be fore-fronted when managing prescription services. Considering the trimester and the developing fetus are high priorities when managing current diagnoses such as depression, schizophrenia, bipolar and anxiety disorders. A standardized medication used for bipolar disorder, lithium, which also requires maintenance levels, has a direct effect on fetal cardiac malformations(Betcher & Wisner, 2020). The same study revealed that 14% of women experience depression while pregnant. These medications should not be abruptly ceased and providers must consider basic testing, holistic approaches and stress reduction during pregnancy. Another commonly prescribed medication that must be considered high risk and labeled teratogenic in pregnancy is Valproic Acid(Essential Reads – Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles – Mgh Center for Women’s Mental Health, 2021). Many patients are prescribed valproic acid, a mood stabilizer and anticonvulsant for general seizures prior to a confirmed pregnancy. Providers are recommended to have their patients’ liver function tests drawn and the neonates who survive pregnancy have major congenital malformations and decreased mental capacity(Laura D. Rosenthal DNP RN ACNP-BC FAANP & Jacqueline Rosenjack Burchum DNSc FNP-BC CNE, 2025, Table 21.4) these examples of consideration make the responsibility of the advanced practice nurse more complex and require more intellectual skills for safe and effective patient-centered care. Other factors to consider are therapeutic consolidation when managing a pregnant patient with a mental health disorder. Open, non-judgmental communication is essential. Patients must feel supported and have resources in order to meet their needs and those of the unborn child. Consideration of access to prescriptions, compliance with medication and the length of current medication use are detrimental when assessing a patient’s cognitive state and assessing risks such as suicide. As leaders in the public health industry, practitioners have a responsibility to assess according to each unique situation, prevent oversights, provide supportive measures to all patients and identify which patient issues and diagnosis take precedence.

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