Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies.
Assessing and Treating Pediatric Clients With Mood Disorders
Therapy for Pediatric Clients With Mood Disorders
Case Study: An African American Child Suffering From Depression
Mood disorders can impact every facet of a child’s life, making the most basic activities difficult for clients and their families. This was the case for 13-year-old Kara, who was struggling at home and at school. For more than 8 years, Kara suffered from temper tantrums, impulsiveness, inappropriate behavior, difficulty in judgment, and sleep issues. As a psychiatric mental health nurse practitioner working with pediatric clients, you must be able to assess whether these symptoms are caused by psychological, social, or underlying growth and development issues. You must then be able recommend appropriate therapies.
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This week, as you examine antidepressant therapies, you explore the assessment and treatment of pediatric clients with mood disorders. You also consider ethical and legal implications of these therapies.
Case Study: An African American Child Suffering From Depression
When pediatric clients 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 clients with the same disorders, but they also metabolize medications much differently. As a result, psychiatric mental health nurse practitioners must exercise caution when prescribing psychotropic medications to these clients. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat pediatric clients presenting with mood disorders.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Note: This Case Study: An African American Child Suffering From Depression Assignment is the first of 10 assignments that are based on interactive client case studies. For these assignments, you will be required to make decisions about how to assess and treat clients. Each of your decisions will have a consequence. Some consequences will be insignificant, and others may be life altering. You are not expected to make the “right” decision every time; in fact, some scenarios may not have a “right” decision. You are, however, expected to learn from each decision you make and demonstrate the ability to weigh risks versus benefits to prescribe appropriate treatments for clients.
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Case Study: An African American Child Suffering From Depression Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 7, “Antidepressants”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Review the following medications:
amitriptyline
bupropion
amitriptylinebupropioncitalopramclomipraminedesipraminedesvenlafaxinedoxepinduloxetine Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studiesescitalopramfluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine
citalopram
clomipramine
Case Study: An African American Child Suffering From Depression
Magellan Health, Inc. (2013). Appropriate use of psychotropic drugs in children and adolescents: A clinical monograph. Retrieved from http://www.magellanhealth.com/media/445492/magellan-psychotropicdrugs-0203141.pdf
Rao, U. (2013). Biomarkers in pediatric depression. Depression & Anxiety, 30(9), 787–791. doi:10.1002/da.22171
Note: Retrieved from Walden Library databases.
Vitiello, B. (2012). Principles in using psychotropic medication in children and adolescents. In J. M. Rey (Ed.), IACAPAP e-Textbook of Child and Adolescent Mental Health. Geneva: International Association for Child and Adolescent Psychiatry and Allied Professions. Retrieved from http://iacapap.org/wp-content/uploads/A.7-PSYCHOPHARMACOLOGY-072012.pdf
Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Note: Retrieved from Walden Library databases.
Case Study: An African American Child Suffering From Depression Required Media
Laureate Education (2016e). Case study: An African American child suffering from depression [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Case Study: An African American Child Suffering From Depression Optional Resources
El Marroun, H., White, T., Verhulst, F., & Tiemeier, H. (2014). Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: A systematic review. European Child & Adolescent Psychiatry, 23(10), 973–992. doi:10.1007/s00787-014-0558-3
Gordon, M. S., & Melvin, G. A. (2014). Do antidepressants make children and adolescents suicidal? Journal of Pediatrics and Child Health, 50(11), 847–854. doi:10.1111/jpc.12655
Seedat, S. (2014)NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment . Controversies in the use of antidepressants in children and adolescents: A decade since the storm and where do we stand now? Journal of Child & Adolescent Mental Health, 26(2), iii–v. doi:10.2989/17280583.2014.938497
To prepare for this Case Study: An African American Child Suffering From Depression Assignment:
Review this week’s Learning Resources. Consider how to assess and treat pediatric clients requiring antidepressant therapy.
The Case Study: An African American Child Suffering From Depression Assignment
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 client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
BACKGROUND INFORMATION
The client is an 8-year-old African American male who arrives at the ER with his mother. He is exhibiting signs of depression.
Client complained of feeling “sad”
Mother reports that teacher said child is withdrawn from peers in class
Mother notes decreased appetite and occasional periods of irritation
Client reached all developmental landmarks at appropriate ages
Physical exam unremarkable
Laboratory studies WNL
Child referred to psychiatry for evaluation
Client seen by Psychiatric Nurse Practitioner
MENTAL STATUS EXAM
Alert & oriented X 3, speech clear, coherent, goal directed, spontaneous. Self-reported mood is “sad”. Affect somewhat blunted, but child smiled appropriately at various points throughout the clinical interview. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. Judgment and insight appear to be age-appropriate. He is not endorsing active suicidal ideation, but does admit that he often thinks about himself being dead and what it would be like to be dead.
The PMHNP administers the Children’s Depression Rating Scale, obtaining a score of 30 (indicating significant depression)
Case Study: An African American Child Suffering From Depression RESOURCES
§ Poznanski, E., & Mokros, H. (1996). Child Depression Rating Scale–Revised. Los Angeles, CA: Western Psychological Services.
Decision Point One
Select what the PMHNP should do:
Begin Zoloft 25 mg orally daily
Begin Paxil 10 mg orally daily
Begin Wellbutrin 75 mg orally BID
Case Study of the above client
Decision Point One
I selected Zoloft 25 mg orally daily
RESULTS OF DECISION POINT ONE
Client returns to clinic in four weeks
No change in depressive symptoms at all
Decision Point Two
Increase dose to 50 mg orally daily
RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Depressive symptoms decrease by 50%. Cleint tolerating well
Decision Point Three
Maintain current dose
Guidance to Student
At this point, sufficient symptom reduction has been achieved. This is considered a “response” to therapy. Can continue with current dose for additional 4 week to see if any further reductions in depressive symptoms are noted. An increase in dose may be warranted since this is not “full” remission- Discuss pros/cons of increasing drug dose with client at this time and empower the client to be part of the decision. There is no indication that the drug therapy should be changed to an SNRI at this point as the client is clearly responding to this therapy.
SAMPLE DECISION TREE ASSIGNMENT
An Elderly Iranian Man with Alzheimer’s
Alzheimer’s condition is a neurodegenerative disease that begins slowly and worsens over a long period of time. The condition has been associated with almost 70% of all dementia cases in the world. The most prevalent early symptoms entail the absence of memory concerning recent events. As the condition progresses, other symptoms such as language difficulties, mood swings, disorientation, behavioral issues, lack of self-care management, and disorientation may occur (Houmani
et al.,
2018). In a gradual manner, all the bodily functions will be lost resulting in eventual death. As much as the disease’s life expectancy varies, the typical expectancy does not go beyond nine years after diagnosis. Importantly, the disease does not have a cure but it could be managed to ensure that the quality of life of patients suffering from it is improved.
The case study for the present assignment entails the examination and treatment of an elderly Iranian man who displays strange behaviors according to his son. Mr. Akan has lost interest in things that erstwhile interested him. Further, the client has been forgetting things and his subjective test revealed confabulation during mental health testing process. Mr. Akad also has restricted affect and impaired impulse and judgment. A mini-mental state examination reveals that Mr. Akad suffers from major neurocognitive disorder caused by presumptive Alzheimer’s disease. This paper describes the assessment outcomes and treatment options for an elderly Iranian man, who has been diagnosed with Alzheimer’s. The condition can be treated with pharmacological interventions, which are dependent on among other factors dosage, proper selection of drug, and time of use, and administration route. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
NURS 6630 Week 3 Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Case Study: An Elderly Hispanic Man With Major Depressive Disorder
Needs to be 6-8 pages, & total references, but 3 need to be Academic References. Apa Format. Please Read the case study and choose one of the medications below and answer the questions below. The instructor states its ok if we don’t choose the best medication for the patient just as long as we answer the questions and state why we chose the medication and why we did not choose the others.
Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders
Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.
Case Study: An Elderly Hispanic Man With Major Depressive Disorder Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
Note: To access the following medications, click on the The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
amitriptyline
bupropion
citalopram
bupropion
citalopram
clomipramine
desipramine
desvenlafaxine
doxepin
duloxetine
escitalopram
fluoxetine
fluvoxamine
imipramine
ketamine
mirtazapine
nortriptyline
paroxetine
selegiline
sertraline
trazodone
venlafaxine
vilazodone
vortioxetine
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf
Case Study: An Elderly Hispanic Man With Major Depressive Disorder Required Media
Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment
Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies.
The Case Study: An Elderly Hispanic Man With Major Depressive Disorder Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Case Study: An Elderly Hispanic Man With Major Depressive Disorder
BACKGROUND INFORMATION
The client is a 32-year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse.
SUBJECTIVE
During today’s clinical interview, client reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He describes his home life as “good.” Stating “Dad did what he could for us, there were 8 of us.” He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.
MENTAL STATUS EXAM
The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. The PMHNP administers the
“Montgomery- Asberg Depression Rating Scale (MADRS)”
and obtained a score of 51
(indicating severe depression)
.
RESOURCES
Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Decision Point One
Select what the PMHNP should do:
Begin zoloft 25 mg orally daily
Begin Effexor XR 37.5 mg orally daily
Begin Phenelzine 15 mg orally TID
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Support your rationale with a minimum of three academic resources but need 7 in total.. While you may use the course text to support your rationale, it will not count toward the resource requirement.
Stahl, S. M. (2013).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications
(4th ed.). New York, NY: Cambridge University Press.
Note:
To access the following chapters, click on the
Essential Psychopharmacology, 4th ed
tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Stahl, S. M. (2014b).
The prescriber’s guide
(5th ed.). New York, NY: Cambridge University Press.
Note:
To access the following medications, click on the
The Prescriber’s Guide, 5th ed
tab on the Stahl Online website and select the appropriate medication.
American Psychiatric Association. (2013).
Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: Author.
Note:
Retrieved from Walden Library databases.
Montgomery, S. A., & Asberg, M. (1979).
A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134
, 382-389. Retrieved from
https://www.researchgate.net/profile/Marie_Asberg/…
Required Media
Laureate Education. (2016g).
Case study: An elderly Hispanic man with major depressive disorder
[Interactive media file]. Baltimore, MD: Author.
Note:
This case study will serve as the foundation for this week’s Assignment.
Case Study: An Elderly Hispanic Man With Major Depressive Disorder
SAMPLE APPROACH
Geriatric Depression Therapy
Mood disorders, such as depression, are prevalent in geriatric population and older adults. According to studies, conditions such as depression may have debilitating impacts on the family, the patient and their social constructs. Further, studies have revealed that there exist particularities in the etiology, management and clinical presentation of mood disorders in the elderly and older adults (Flint, 2012). Thus, taking cognizance of these particularities and their clinical importance are significant for their effective management in the geriatric population. However, before the management, comprehensive diagnostic undertakings including using the Geriatric Depression Scale (American Psychiatric Association, 2013) are necessary so as to identify the kind of condition that a PMHNP nurse will be addressing. After the identification of the significant variables, and the administration of effective drugs to arrest the condition is recommended. The formulation of the treatment regimen for depression depends on the safety and efficacy of a drug. Other medications and psychotherapeutic interventions are encouraged if the first intervention proves unsuccessful. In the current paper, a 31-year old Hispanic has been diagnosed with severe depression based on score of 51 that was obtained from the Montgomery- Asberg Depression Rating Scale (MADRS) (Montgomery & Asberg, 1979) by the PMHNP. The diagnosis, medication choice, and alterations made in the present analysis will facilitate a greater comprehension of how PMHNP nurses can therapeutically address depression in an elderly patient.
NURS 6630 Week 4 Assignment
Assignment: Assessing and Treating Clients with With Bipolar Disorder
Case Study: An Asian American Woman With Bipolar Disorder
Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients often present as depressive or manic, but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment: Case Study: An Asian American Woman With Bipolar Disorder
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 6, “Mood Disorders”
Chapter 8, “Mood Stabilizers”
Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.
To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.
Chapter 4, “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar Disorder”
Chapter 5, “Atypical Antipsychotics as Mood Stabilizers for Bipolar Disorder”
Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3
Note: Retrieved from Walden Library databases.
Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6
Note: Retrieved from Walden Library databases.
Case Study: An Asian American Woman With Bipolar Disorder Required Media
Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Case Study: An Asian American Woman With Bipolar Disorder Optional Resources
Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Retrieved from http://acta.tums.ac.ir/index.php/acta
Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan ..
Learning Objectives
Students will:
Assess client factors and history to develop personalized plans of bipolar therapy for clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
Evaluate efficacy of treatment plans
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring bipolar therapy.
The Case Study: An Asian American Woman With Bipolar Disorder Assignment
Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
SAMPLE APPROACH FROM STUDENT. IF YOU WANT AN ORIGINAL CUSTOM PAPER FROM OUR EXPERTS, SIMPLY ORDER NOW
Assessing and Treatment for Bipolar Disorder Patient
Introduction
Bipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017).
If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
NURS 6630 Week 5 Assignment
Assignment: Assessing and Treating Clients With Anxiety Disorders
Common symptoms of anxiety disorders include chest pains, shortness of breath, and other physical symptoms that may be mistaken for a heart attack or other physical ailment. These manifestations often prompt clients to seek care from their primary care providers or emergency departments. Once it is determined that there is no organic basis for these symptoms, clients are typically referred to a psychiatric mental health practitioner for anxiolytic therapy. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with anxiety disorders.
Assignment: Assessing and Treating Clients With Anxiety Disorders
– NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.
Assignment: Assessing and Treating Clients With Anxiety Disorders
Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 9, “Anxiety Disorder and Anxiolytics”
Stahl, S. M., & Grady, M. (2010). Stahl’s illustrated anxiety, stress, and PTSD. New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
To access the following chapters, click on the Illustrated Guides tab and then the Anxiety, Stress, and PTSD tab.
Chapter 4, “First-Line Medications for PTSD”
Chapter 5, “Second-Line, Adjunct, and Investigational Medications for PTSD”
Strawn, J. R., Wehry, A. M., DelBello, M. P., Rynn, M. A., & Strakowski, S. (2012). Establishing the neurobiologic basis of treatment in children and adolescents with generalized anxiety disorder. Depression and Anxiety, 29(4), 328–-339. doi:10.1002/da.21913
Note: Retrieved from Walden Library databases.
Hamilton, M. (1959). Hamilton Anxiety Rating Scale. Psyctests, doi:10.1037/t02824-0
Note: Retrieved from Walden Library databases.
Assignment: Assessing and Treating Clients With Anxiety Disorders
Required Media
Laureate Education. (2016b). Case study: A middle-aged Caucasian man with anxiety [Interactive media file]. Baltimore, MD: Author.
Note: This case study will serve as the foundation for this week’s Assignment.
Assignment: Assessing and Treating Clients With Anxiety Disorders
Optional Resources
Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., & … Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. doi:10.1155/2014/537306
To prepare for this Assignment:NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
The Assignment: Assessing and Treating Clients With Anxiety Disorders Assignment
Examine Case Study: A Middle-Aged Caucasian Man With Anxiety. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1 NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
A Middle-Aged Caucasian Man with Anxiety
The case study is about a 46-year old white male who works as a welder. His primary care physician refers the man to psychiatry after a trip to the emergency room where he showed symptoms of a heart attack. The patient indicated instances of chest tightness, shortness of breath, and a feeling of impending doom. He has light hypertension but manages it with low sodium diet; he is also a little overweight. The possibility of myocardial infarction was ruled out in the emergency room, and the electrocardiogram did not reveal significant results. The client admits that he occasionally consumes 3-4 beers to counter work-related stress. The patient takes care of his aging parents and encounters stress at the workplace. The mental health exam reveals that the client is alert and oriented; however, he does not have any suicidal or homicidal thoughts. The psychiatric-mental health practitioner (PMHNP) administered the Hamilton Anxiety Rating Scale (HAM-A) and revealed a score of 26. The PMHNP diagnosed the client with generalized anxiety disorder. The PMHNP made three treatment decisions for the patient; the first was to apply Zoloft 50 mg po daily, start Imipramine 25 mg po BID, and useBuspirone.
NURS 6630 Week 6 Assignment
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia
NURS 6630 Week 6: Antipsychotic Therapy
According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients.
This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.
Assignment:
Assessing and Treating Clients With Psychosis and Schizophrenia
Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia.Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia – NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 4, “Psychosis and Schizophrenia”
Chapter 5, “Antipsychotic Agents”
Stahl, S. M. (2014b)NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment . The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Review the following medications:
amisulpride
aripiprazole
asenapine
chlorpromazine
clozapine
flupenthixol
fluphenazine
haloperidol
iloperidone
loxapine
lurasidone
olanzapine
paliperidone
perphenazine
quetiapine
risperidone
sulpiride
thioridazine
thiothixene
trifluoperazine
ziprasidone
Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002
Note: Retrieved from Walden Library databases.
Document: Midterm Exam Study Guide (PDF)
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Note: Retrieved from Walden Library databases.
Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf
Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Required Media
Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Optional Resources
Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2
Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2
To prepare for this Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
The Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Assignment
Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Decision Point One
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-blue.pngStart Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· A decrease in PANSS score of 25% is noted at this visit
· Client seems to be tolerating medication
· Client’s husband has made sure she makes her appointments for injections (one thus far)
· Client has noted a 2 pound weight gain but it does not seem to be an important point for her
· Client complains of injection site pain telling the PMHNP that she has trouble siting for a few hours after the injections and doesn’t like having to walk around for such a long period of time
Decision Point Two
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-red.pngContinue same decision made but instruct administering nurse to begin injections into the deltoid at this visit and moving forward
RESULTS OF DECISION POINT TWO
· Client returns to clinic in four weeks
· Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna
· When questioned about injection site pain, client states it is much better in the arm
· Client’s weight has increased by an additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is somewhat bothered by the weight gain and is afraid that her husband does not like it. He is not present at this visit as she brought herself
· Client likes how she feels on the Invega Sustenna but is wondering if there is another drug like it that would not cause the weight gain
Decision Point Three
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/06/mm/delusional_disorders/img/pill-red.pngContinue with the Invega Sustenna. Counsel client on the fact that weight gain from Invega Sustenna is not as much as what other drugs with similar efficacy can cause. Make appointment with a dietician and an exercise physiologist. Follow up in one month
Guidance to Student
Weight gain can occur with Invega Sustenna. It is modest in nature and can be controlled with proper nutrition and exercise. It is always a good idea to try and control a client’s weight through consultation with a dietician and exercise physiologist (life coach) before switching to another agent when a product is showing efficacy for at least 6 months.
Abilify Maintena is a good option for someone who has good response to abilify oral. Remember that Abilify does not bind to the D2 receptor for a great period of time (such as Invega) and can be less affective in certain individuals. Also, remember that akathisia can be a possible side effect. Once an IM long acting medication is given, the effects of the drug (both efficacious and untoward effects) can be maintained for a long duration (up to a month or longer). Tolerability and efficacy should be established with oral medication first before administering the first injection. Also a disadvantage to Abilify Maintena is a 2-week overlap of oral therapy is required due to effective blood levels lagging behind the induction dose.
Qsymia is a weight loss medication that is a combination of Phenteramine and Topiramate. It is only indicated to treat obesity. This client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35, Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity). There are two things wrong with this therapy option. First, there are only a few occasions where add-on therapy to treat a side effect is acceptable and weight gain is not one of those scenarios. Secondly, Phenteramine has a lot of cardiovascular toxicities (such as elevated BP, HR, increased workload on the heart).
NURS 6630 Week 7 Assignment
Assignment: Assessing and Treating Clients With Pain
Case Study: A Caucasian Man With Hip Pain
Pain can greatly influence an individual’s quality of life, as uncontrolled pain negatively impacts mood, concentration, and the overall physical and mental well-being of clients. Although pain can often be controlled with medications, the process of assessing and treating clients can be challenging because pain is such a subjective experience. Only the person experiencing the pain truly knows the intensity of the pain and whether there is a need for medication therapies. Sometimes, beliefs about pain and treatments for pain can have an adverse effect on the provider-client relationship. For this Assignment, as you examine the interactive case study consider how you might assess and treat clients presenting with pain.Case Study: A Caucasian Man With Hip Pain : NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Case Study: A Caucasian Man With Hip Pain Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.
To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 10, “Chronic Pain and Its Treatment”
Stahl, S. M., & Ball, S. (2009a). Stahl’s illustrated chronic pain and fibromyalgia. New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
To access the following chapter, click on the Illustrated Guides tab and then the Chronic Pain and Fibromyalgia tab.
Chapter 5, “Pain Drugs”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
amitriptyline
amoxapine
carbamazepine
clomipramine
clonidine (adjunct)NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
desipramine
dothiepin
doxepin
duloxetine
gabapentin
imipramine
lamotrigine
levetiracetam
lofepramine
maprotiline
memantine
milnacipran
nortriptyline
pregabalin
tiagabine
topiramate
trimipramine
valproate (divalproex)
zonisamide
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Note: Retrieved from Walden Library databases.
National Institute of Neurological Disorders and Stroke. (2016). Pain: Hope through research. Retrieved from http://www.ninds.nih.gov/disorders/chronic_pain/detail_chronic_pain.htm#3084_2
Case Study: A Caucasian Man With Hip Pain Required Media
Laureate Education (2016a). Case study: A Caucasian man with hip pain [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for pain and sleep/wake disorders.
The Case Study: A Caucasian Man With Hip Pain Assignment
Examine Case Study: A Caucasian Man With Hip Pain. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #3
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology- Case Study: A Caucasian Man With Hip Pain Essay Assignment
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 10 Assignment
Assignment: Assessing and Treating Clients With Dementia
Case study: An elderly Iranian man with Alzheimer’s disease
The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment.
Reference: Alzheimer’s Association. (2016). What is dementia? Retrieved from http://www.alz.org/what-is-dementia.asp
Case study: An elderly Iranian man with Alzheimer’s disease Required Readings
Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
To access the following chapter, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.
Chapter 13, “Dementia and Its Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.
To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.
Review the following medications:
For insomnia
donepezil
galantamine
memantine
rivastigmine
Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22. Retrieved from http://www.aafp.org/journals/afp.html
Note: Retrieved from from the Walden Library databases.
Meltzer, H. Y., Mills, R., Revell, S., Williams, H., Johnson, A., Bahr, D., & Friedman, J. H. (2010). Pimavanserin, a serotonin receptor inverse agonist for the treatment of Parkinson’s disease psychosis. Neuropsychopharmacology, 35, 881–891. Retrieved from http://www.nature.com/npp/journal/v35/n4/pdf/npp2009176a.pdf
Case study: An elderly Iranian man with Alzheimer’s disease Required Media
Laureate Education. (2016h). Case study: An elderly Iranian man with Alzheimer’s disease [Interactive media file]. Baltimore, MD: Author.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring therapy for dementia.
The Case study: An elderly Iranian man with Alzheimer’s disease Assignment
Examine Case Study: An Elderly Iranian Man With Alzheimer’s Disease. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
At each decision point stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients.
Week 6 Midterm
Question 1
A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP).NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Question 2
Which statement about neurotransmitters and medications is true?
Question 3
When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be:
Question 4
During gene expression, what must occur prior to a gene being expressed?
Question 5
While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Assignment: Assessing and Treating Clients With ADHD
Case Study: A Young Caucasian Girl With ADHD
Not only do children and adults have different presentations for ADHD, but males and females may also have vastly different clinical presentations. They may also respond to medication therapies differently. For example, some ADHD medications may cause children to experience stomach pain, while others can be highly addictive for adults. In your role, as a psychiatric mental health nurse practitioner, you must perform careful assessments and weigh the risks and benefits of medication therapies for clients across the lifespan. For this Assignment, you consider how you might assess and treat clients presenting with ADHD. NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Learning Case Study: A Young Caucasian Girl With ADHD Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Case Study: A Young Caucasian Girl With ADHD Required Readings
Note: Review all materials from the Discussion.
Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology Essay Assignment
Note: Retrieved from Walden Library databases.
Case Study: A Young Caucasian Girl With ADHD Required Media
Laureate Education (2016d). Case study: A young Caucasian girl with ADHD [Interactive media file]. Baltimore, MD: Author
Note: This case study will serve as the foundation for this week’s Assignment.
To prepare for this Assignment:
This case study will serve as the foundation for this week’s Assignment.
The Case Study: A Young Caucasian Girl With ADHD Assignment
Examine Case Study: A Young Caucasian Girl With ADHD You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
Case Study: A Young Caucasian Girl With ADHD
Three decisions have been made concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
At each decision point there will be three decisions. I will choose one out of the three and give the outcome. At each decision point these are the thoughts to ponder:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
***
Also include how ethical considerations might impact your treatment plan and communication with clients.***
Write paper addressing all section listed based on the decisions
Case Study: A Young Caucasian Girl With ADHD
BACKGROUND
Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.
The parents give the PMHNP a copy of a form titled “Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.
Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.
SUBJECTIVE
Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.”
Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.
MENTAL STATUS EXAM
The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies
Diagnosis:
Attention deficit hyperactivity disorder, predominantly inattentive presentation
Decisions Made and Outcomes (Needed to formulate the paper) (Must use and formulate paper based off of the chosen decision. Then tell why the other two decision were not a good choice with in-text citations noted for each.)
Choices for Decision 1: Select what the PMHNP should do:
Begin Wellbutrin (bupropion) XL 150 mg orally daily
Begin Intuniv extended release 1 mg orally at BEDTIME
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING
Decision Choice Chosen:
Begin Ritalin (methylphenidate) chewable tablets 10 mg orally in the MORNING
***Explain why other two choice were rejected (not adequate choices)***
Outcome: RESULTS OF DECISION POINT ONE
:
Client returns to clinic in four weeks
Katie’s parents report that they spoke with Katie’s teacher who notices that her symptoms are much better in the morning, which has resulted in improvement in her overall academic performance. However, by the afternoon, Katie is “staring off into space” and “daydreaming” again
Katie’s parents are very concerned, however, because Katie reported that her “heart felt” You obtain a pulse rate and find that Katie’s heart is beating about 130 beats per minute
Choices for Decision 2: Select what the PMHNP should do:
Continue same dose of Ritalin and re-evaluate in 4 weeks
Change to Ritalin LA 20 mg orally daily in the MORNING
Discontinue Ritalin and begin Adderall XR 15 mg orally daily
Decision Choice Chosen:
Change to Ritalin LA 20 mg orally daily in the MORNING
***Explain why other two choice were rejected (not adequate choices)***
Outcome: RESULTS OF DECISION POINT TWO:
Client returns to clinic in four weeks
Katie’s academic performance is still improved, and the switch to the LA preparation is lasting Katie throughout the school day
Katie’s reports of her heart feeling “funny” have gone away. Pulse was 92 during today’s office visit
Choices for Decision 3: Decision Point Three Select what the PMHNP should do next:
Maintain current dose of Ritalin LA and reevaluate in 4 weeks
Increase Ritalin LA to 30 mg orally daily
Obtain EKG based on current heart rate
Decision Choice Chosen:
Maintain current dose of Ritalin LA and reevaluate in 4 weeks
***Explain why other two choice were rejected (not adequate choices)***
Outcome: Guidance to Student
RESULT FROM CHOOSING TO MAINTAIN CURRENT DOES OF RITALIN LA AND REEVALUATE IN 4 WEEKS
Guidance to Student
At this point, Katie’s symptoms are well controlled (her attention is sustained throughout the school day) and her side effects have gone away following change to a long-acting preparation. There is no indication at this point that the dose should be increased as it is always advisable to use the lowest effective dose of stimulant medication. Katie’s heart rate is appropriate for an 8 year old girl and an EKG would not be indicated based on her heart rate.
Make sure that this paper has at least
6 References from 2014
.
Please use in-text citations for each section of each decision.
Don’t forget the ethical considerations for this assignment. Make it a section by itself.***
***Also please make sure when looking at the ethical consideration for this assignment that you look at how the Caucasian (male) ethnicity and pain medications interact.***
SOME RESOURCE
Note:
Review all materials from the Discussion.
Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners’ Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity.
Journal of Abnormal Child Psychology, 26
, 279-291.
Course Texts These course texts are available through Stahl Online Resources http://stahlonline.cambridge.org/ Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. Geriatric Clients With Mood Disorders, Major Depressive Disorder, Bipolar Disorder, Anxiety Disorders, Psychosis and Schizophrenia, Dementia, Attention deficit hyperactivity disorder (ADHD) decision tree case studies