Week 4 assignment
Assignment: Assessing and Treating Clients with 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.
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.
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.
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.
Retrieved from http://acta.tums.ac.ir/index.php/acta
To prepare for this Assignment:
Review this week’s Learning Resources. Consider how to assess and treat clients requiring bipolar therapy.
The 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.
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.
Walden NURS 6630 Week 4 Sample Paper
(Assessing and Treating Adult and Geriatric Clients With Mood Disorders)
Bipolar Disorder
Student’s Name:
Institutional Affiliation:
Bipolar Disorder
Bipolar disorder refers to a mental health condition that normally causes a person to experience extreme mood swings, such as emotional highs and lows. When depressed, people tend to feel hopeless or sad and may also lose pleasure and interest in their daily activities. On the other hand, the moods of a person can shift to hypomania or mania, which causes a person to start feeling euphoric. Some people suffering from this condition may experience emotional symptoms between episodes, while other people may fail to experience any symptoms (Grande, Berk, Birmaher, & Vieta, 2016). A treatment plan can help in the management of mood swings and other symptoms despite the bipolar disorder being a lifelong condition. Men and women are equally likely to suffer from bipolar disorder. This paper discusses three decisions made concerning the medication that should be prescribed to an Asian American woman with bipolar 1 disorder.
Decision One
The first decision that I selected, in this case, was to prescribe Begin Risperdal 1 mg orally BID. The reason I selected this decision is that this medicine is used to treat certain moods/mental disorders such as bipolar disorder, schizophrenia, and irritability associated with autistic disorder. Risperidone is a medicine that belongs to a class of drugs that is referred to as atypical antipsychotics, which has been approved by the U.S Food and Drug Administration. It helps in restoring the balance of certain. The effects of dopamine in the brain are usually blocked by Risperidone, which helps in reducing the symptoms of bipolar disorder (Corena-McLeod, 2015). Dopamine is a chemical messenger in the brain that occurs naturally. The chemical is involved in emotions, thinking, perception, and behavior. Another reason for selecting this decision is because Risperidone also affects other neurotransmitters in the brain such as serotonin. This is beneficial in the management of the symptoms (Wu, Hsieh, Tang, & Chang, 2016). I also selected the decision because the medicine can be taken with or without food, and this is an essential factor in ensuring that the patient adheres to the prescribed medication. Food does not affect the extent and rate of absorption of Risperidone. I also selected this decision because the medicine is extensively metabolized in the liver. According to past research the medicine is relatively well tolerated in bipolar manic patients and metabolic and weight gain concerns may be less when using this medicine in a clinical setting (Corena-McLeod, 2015). Although there were other options of medications that could be used in this case I considered them as being less effective. The reason I did not opt to start the treatment plan with Lithium 300 mg orally BID is because Risperidone is considered to be significantly superior to Lithium (Kowatch et al., 2015). Also, there is greater tolerability for Risperidone compared to Lithium. I did also not select the use of Begin Seroquel XR 100mg in this case because of its potential long-term side effects such as weight gain, which will not be healthy considering that the patient already weighs 110lbs. Other side effects of this drug include increased blood sugar, cataracts, and tardive dyskinesia. The medicine can also cause an increase in suicidal thoughts and behaviors (Roberts, Lohano, & El‐Mallakh, 2016). Another reason why I did not select Lithium is that it had been prescribed in the hospital, but it had not worked.
By selecting this decision, I was hoping to help the patient to start thinking clearly and start taking part in everyday life. I was hoping the patient will experience a positive change in her state of mind and develop some positive attitude, such as stopping to hate sleep. There was no major difference between what I expected to achieve and the actual results of the decision. The patient’s health condition was improving as expected. The only difference was that some of the side effects of the medication were affecting the treatment plan. After taking the medication, the patient was experiencing some form of drowsiness and sedation. The race of the patient was one of the factors that contributed to this side effect.
Decision Two
The second decision that I selected, in this case, was to decrease Risperdal to 1 mg at bedtime due to an increase in sedation and lethargy. The reason for making this decision was to avoid administering the patient with a new prescription, considering that her health had started to improve. This was an indication that the drug was helping manage the symptoms of the bipolar 1 disorder. By making this decision, I Was hoping to reduce the episodes of sedation and drowsiness, which would, in turn, help improve the health outcome of the patient as expected. Sedation can be troublesome to patients who are trying to be reintegrated into society, and it can also interfere with the treatment plan (Jann, 2014). By making this decision, I was hoping to achieve the maximum benefit from administering the medication. I was hoping to manage the manic episodes associated with bipolar 1 disorder that the patient was experiencing. I was also hoping to reduce sedation and lethargy that the patient was experiencing. There was no difference between what was expected to be achieved, and the actual results since the symptoms of bipolar 1 disorder had reduced significantly, which led to the improvement of the patient’s health outcome.
Decision Three
The third decision that I selected was to continue using Risperdal 1 mg at bedtime. The reason I selected this decision was because the health of the patient had improved, which was an indication that the medication was effective. Another reason for selecting this decision was to prevent a situation whereby a new medication is administered to the patient. This can lead to resistance from the patient, which can affect the treatment plan and lead to negative health outcomes. By making this decision, I was hoping to restore the mood of the patient to normal and manage the symptoms of bipolar 1 disorder that the patient was experiencing. I was also hoping to improve the mental stability of the patient. There was no difference between what I expected to achieve, and the results of the decision. The health of the patient had improved.
Ethical Considerations
It is essential to respect the decisions of the patient about the treatment plan. It is crucial to educate the patient about the advantages and disadvantages of the medications that will be used in the treatment plan. This is important as it helps a patient to make an informed decision. This can affect the treatment plan and communication because the decision of the patient and that of the health provider can, at times, differ. Another ethical consideration is ensuring that the treatment does not cause any harm to the patient and that medication is administered correctly.
In conclusion, bipolar disorder is a brain problem that causes unusual shifts in energy, mood, and activity levels in a person. The condition also affects a person’s ability to conduct their daily activities. One of the medications that can be used to manage the symptoms associated with bipolar 1 disorder.
References
Corena-McLeod, M. (2015). Comparative pharmacology of risperidone and paliperidone. Drugs in R&D, 15(2), 163-174.
Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561-1572.
Jann, M. W. (2014). Diagnosis and treatment of bipolar disorders in adults: a review of the evidence on pharmacologic treatments. American health & drug benefits, 7(9), 489.
Kowatch, R. A., Scheffer, R. E., Monroe, E., Delgado, S., Altaye, M., & Lagory, D. (2015). Placebo-controlled trial of valproic acid versus risperidone in children 3–7 years of age with bipolar I disorder. Journal of child and adolescent psychopharmacology, 25(4), 306-313.
Roberts, R. J., Lohano, K. K., & El‐Mallakh, R. S. (2016). Antipsychotics as antidepressants. Asia‐Pacific Psychiatry, 8(3), 179-188.
Wu, C. S., Hsieh, M. H., Tang, C. H., & Chang, C. J. (2016). Comparative effectiveness of long-acting injectable risperidone vs. long-acting injectable first-generation antipsychotics in bipolar disorder. Journal of affective disorders, 197, 189-195.
PLACE THIS ORDER OR A SIMILAR ORDER WITH NURSING PAPERS MARKET TODAY AND GET AN AMAZING DISCOUNT
