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Home » NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

    NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

    NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

    Marcus, an 18-year-old high school senior, presents with symptoms of difficulty sleeping and feeling sad, which result in an initial diagnosis of depression. His mother later reports, however, that Marcus exhibits symptoms of irritability and risk-taking behaviors. (His little brother reported to his mother that they were driving over 90 miles an hour on the highway.) After further evaluation, Marcus’ psychiatric nurse practitioner diagnoses him with bipolar disorder.

    Cases like this are not uncommon with bipolar disorder, as initial assessments rarely provide all the information needed. In your role, as a psychiatric nurse practitioner, you must develop strategies for properly assessing and diagnosing these patients because treatments for bipolar disorder are significantly different than treatments for depression or other mood disorders. NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

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    This week, as you examine bipolar therapies, you explore the assessment and treatment of patients with bipolar disorder. You also consider ethical and legal implications of these therapies.

    Learning Objectives

    Students will:

    Assess patient factors and history to develop personalized plans of bipolar therapy for patients
    Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring bipolar therapy
    Synthesize knowledge of providing care to patients presenting for bipolar therapy
    Analyze ethical and legal implications related to prescribing bipolar therapy to patients across the life span

    Learning Resources

    Required Readings (click to expand/reduce)

    Ostacher, M. J., & Hsin, H. (2016). The use of antiepileptic drugs in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 93–98). Elsevier.
    Perlis, R. H., & Ostacher, M. J. (2016a). Bipolar disorder. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 48–60). Elsevier.
    Perlis, R. H., & Ostacher, M. J. (2016b). Lithium and its role in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 86–92). Elsevier.
    Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.
    American Psychiatric Association. (2010b). Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf
    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. https://doi.org/10.1007/s00228-015-1855-6
    Hirschfeld, R. M. A. (n.d.). Guideline watch: Practice guideline for the treatment of patients with bipolar disorder (2nd ed.).  https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf
    Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331–333. https://doi.org/10.1007/s40263-013-0060-3

    Medication Resources

    IBM Corporation. (2020). IBM Micromedex. https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

    Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

    Review the following medications:

    amitriptyline
    bupropion
    citalopram
    clomipramine
    desipramine
    desvenlafaxine
    doxepin
    duloxetine
    escitalopram
    fluoxetine
    fluvoxamine

    imipramine
    ketamine
    mirtazapine
    nortriptyline
    paroxetine
    selegiline
    sertraline
    trazodone
    venlafaxine
    vilazodone
    vortioxetine

    Required Media

    Case Study: An Asian American Woman with Bipolar Disorder

    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. http://acta.tums.ac.ir/index.php/acta

    Assignment: Assessing and Treating Patients With Bipolar Disorder

    Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients 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 patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder. NURS 4430 Week 5: Therapy for Patients With Bipolar Disorders

    To prepare for this Assignment:

    Review this week’s Learning Resources, including the Medication Resources indicated for this week.
    Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.

    The Assignment: 5 pages

    Examine Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

    At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

    Introduction to the case (1 page)

    Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

    Decision #1 (1 page)

    Which decision did you select?
    Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
    Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

    Decision #2 (1 page)

    Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
    Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

    Decision #3 (1 page)

    Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
    Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

    Conclusion (1 page)

    Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

    Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

    Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

    By Day 7

    Submit your Assignment.

    Submission and Grading Information

    To submit your completed Assignment for review and grading, do the following:

    Please save your Assignment using the naming convention “WK5Assgn+last name+first initial.(extension)” as the name.
    Click the Week 5 Assignment Rubric to review the Grading Criteria for the Assignment.
    Click the Week 5 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
    Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn+last name+first initial.(extension)” and click Open.
    If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
    Click on the Submit button to complete your submission.

    Grading Criteria

    To access your rubric:

    Week 5 Assignment Rubric

    Check Your Assignment Draft for Authenticity

    To check your Assignment draft for authenticity:

    Submit your Week 5 Assignment draft and review the originality report.

    Submit Your Assignment by Day 7 of Week 5

    To participate in this Assignment:

    Week 5 Assignment
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