Assessing and Treating Patient with Bipolar Disorder Essay
CASE SCENARIO: The client is a 26-year-old woman of Korean descent who present to her first appointment following a 21- day hospitalization for the onset of acute mania. She was diagnosed with bipolar 1 disorder. Upon arrival in the office, she is quite ” busy”, playing with things on your desk and shifting from side to side in her chair. She informed you that ” they said I was bipolar, I don’t believe that, do you? I just like to talk, dance, and sing. Did I tell you that I like to cook?” She weighs 110lbs. and is 5ft 5inches. Patient reports ” fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, its no fun.” You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find out that the patient had genetic testing in the hospital ( specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. Genetic testing reveals that she is positive for the CYP2D6*10 allele. The patient did well enough on lithium to be discharged from the hospital but admits she has not been taking it as prescribed. When further questioned on the subject, she provides no additional details. The young Mania Rating Scale (YMRS) score is 22. Assessing and Treating Patient with Bipolar Disorder Essay The patient is alert and oriented to person, place, time, and events. She dressed quite oddly-wearing what appears to be an evening gown to her apartment. Speech is rapid, pressured, and tangential. The self-reported mood is euthymic. Affect broad. The patient denies visual or auditory hallucination, no overt delusional thought process is readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation. Assessing and Treating Patient with Bipolar Disorder Essay
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DECISION POINT ONE:
Select what the PMHNP should do:
1. Begin Lithium 300mg orally BID
2. Begin Risperdal 1mg orally BID
3.BeginSeroquel XR 300mg orally at HS.
To Prepare for this Assignment:
Review the learning resources, including the medication resources indicated for this week.
Reflect on the psychopharmacology treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy. Be sure to consider factors that may impact the patient’s pharmacokinetic and pharmacodynamic process.
You are required to make three decisions concerning the medication to prescribe to this patient. SEE above medications. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Make sure you have researched each option before you make your decision. Be sure to research each option using the primary literature. Assessing and Treating Patient with Bipolar Disorder Essay
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 for this patient.
* Decision #1 (1 page)
1. Which decision did you select?
2. Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
3* 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. Assessing and Treating Patient with Bipolar Disorder Essay
4* 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)
5* Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
DECISION #2 (1 Page): Assessing and Treating Patient with Bipolar Disorder Essay
1* Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
2* 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.
3* 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).
4* Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Assessing and Treating Patient with Bipolar Disorder Essay
DECISION #3 ( 1 Page ):
(A)* Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
(B) 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. Assessing and Treating Patient with Bipolar Disorder Essay
(C) What were you hoping to achieve by making this decision? Support your response with references to the learning resources ( including the primary literature).
(D) Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.
CONCLUSION (1 Page): Assessing and Treating Patient with Bipolar Disorder Essay
1. Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendation and support your response with clinically and patient-specific resources including the primary literature. Support your rationale with a minimum of five academic resources. You should be utilizing the primary and secondary literature. Reminder: The college requires all papers submitted to include a title page, introduction, summary, and references. Please answer all parts of the assignment questions with no spelling or grammar errors using APA writing rules and style. Assessing and Treating Patient with Bipolar Disorder Essay
