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NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder

NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderWeek 5: Therapy for Patients With Bipolar DisordersMarcus, 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. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderCases 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.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 ObjectivesStudents will:Assess patient factors and history to develop personalized plans of bipolar therapy for patientsAnalyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring bipolar therapySynthesize knowledge of providing care to patients presenting for bipolar therapyAnalyze ethical and legal implications related to prescribing bipolar therapy to patients across the life spanORDER A PLAGIARISM-FREE PAPER HERELearning Resources NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderRequired 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) NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder. 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.pdfChen, 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/s00228-015-1855-6Hirschfeld, 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.pdfVitiello, 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/s40263-013-0060-3Medication Resources (click to expand/reduce)Required Media (click to expand/reduce) NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderOptional Resources (click to expand/reduce)Assignment: Assessing and Treating Patients With Bipolar DisorderBipolar 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.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 pagesExamine 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. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderAt 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). NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderExplain 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. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderDecision #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. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderNote: 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 athttps://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.By Day 7Submit your Assignment. Rubric Detail Select Grid View or List View to change the rubric’s layout.ContentName: NURS_6630_Week5_Assignment_Rubric NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderGrid ViewList ViewExcellentPoint range: 90–100GoodPoint range: 80–89FairPoint range: 70–79PoorPoint range: 0–69Introduction 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. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 9 (9%) – 10 (10%)The response accurately, clearly, and fully summarizes in detail the case for the Assignment.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.Points Range: 8 (8%) – 8 (8%)The response accurately summarizes the case for the Assignment.The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 7 (7%) – 7 (7%)The response inaccurately or vaguely summarizes the case for the Assignment.The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.Points Range: 0 (0%) – 6 (6%)The response inaccurately and vaguely summarizes the case for the Assignment, or is missing.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.Decision #1 (1–2 pages)• 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.Points Range: 18 (18%) – 20 (20%)The response accurately and clearly explains in detail the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderExamples provided fully support the decisions and responses provided.Points Range: 16 (16%) – 17 (17%)The response accurately explains the decision selected.The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.The response accurately explains how ethical considerations impact the treatment plan and communication with patients.Examples provided support the decisions and responses provided. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 14 (14%) – 15 (15%)The response inaccurately or vaguely explains the decision selected.The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderExamples provided may support the decisions and responses provided.Points Range: 0 (0%) – 13 (13%)The response inaccurately and vaguely explains the decision selected.The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.Examples provided do not support the decisions and responses provided, or is missing.Decision #2 (1–2 pages)• 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.Points Range: 18 (18%) – 20 (20%)The response accurately and clearly explains in detail the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderExamples provided fully support the decisions and responses provided. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 16 (16%) – 17 (17%)The response accurately explains the decision selected.The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.The response accurately explains how ethical considerations impact the treatment plan and communication with patients.Examples provided support the decisions and responses provided.Points Range: 14 (14%) – 15 (15%)The response inaccurately or vaguely explains the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.Examples provided may support the decisions and responses provided. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 0 (0%) – 13 (13%)The response inaccurately and vaguely explains in detail the decision selected.The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.Examples provided do not support the decisions and responses provided, or is missing.Decision #3 (1–2 pages)• 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.Points Range: 18 (18%) – 20 (20%)The response accurately and clearly explains in detail the decision selected.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected.The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response.The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.Examples provided fully support the decisions and responses provided. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 16 (16%) – 17 (17%)The response accurately explains the decision selected.The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response.The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response.The response accurately explains how ethical considerations impact the treatment plan and communication with patients.Examples provided support the decisions and responses provided.Points Range: 14 (14%) – 15 (15%)The response inaccurately or vaguely explains the decision selected. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected.The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response.The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients.Examples provided may support the decisions and responses provided.Points Range: 0 (0%) – 13 (13%)The response inaccurately and vaguely explains in detail the decision selected.The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing.The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing.The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing.The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing.Examples provided do not support the decisions and responses provided, or is missing. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderConclusion (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.Points Range: 14 (14%) – 15 (15%)The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.Points Range: 12 (12%) – 13 (13%)The response accurately summarizes the recommendations on the treatment options selected for this patient.The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.Points Range: 11 (11%) – 11 (11%)The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient.NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderThe response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.Points Range: 0 (0%) – 10 (10%)The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing.The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.Written Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity.A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 4 (4%) – 4 (4%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.Purpose, introduction, and conclusion of the assignment is vague or off topic. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 0 (0%) – 3 (3%)Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.No purpose statement, introduction, or conclusion were provided.Written Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuationPoints Range: 5 (5%) – 5 (5%)Uses correct grammar, spelling, and punctuation with no errors. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 4 (4%) – 4 (4%)Contains a few (1 or 2) grammar, spelling, and punctuation errors.Points Range: 3.5 (3.5%) – 3.5 (3.5%)Contains several (3 or 4) grammar, spelling, and punctuation errors. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderPoints Range: 0 (0%) – 3 (3%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.Points Range: 5 (5%) – 5 (5%)Uses correct APA format with no errors.Points Range: 4 (4%) – 4 (4%)Contains a few (1 or 2) APA format errors.Points Range: 3.5 (3.5%) – 3.5 (3.5%)Contains several (3 or 4) APA format errors.Points Range: 0 (0%) – 3 (3%)Contains many (≥ 5) APA format errors. Total Points: 100Name: NURS_6630_Week5_Assignment_Rubric   NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderAssessing and Treating Patients with Bipolar DisorderWalden UniversityNurs 6630 Psychopharmacologic Approaches to Treatment of Psychopathology Assessing and Treating Patients with Bipolar DisorderBipolar I disorder is a serious mental condition characterized by alternating periods of intense depression and manic states. While some people have both depressed and manic emotions, at least one manic or mixed episode is required to be identified (Carvalho et al., 2020) NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder. According to Carvalho et al. (2020), around 4.4 percent of persons in the United States suffer from bipolar disorder at some time in their life. Asian Americans are far less likely to seek mental health care than other ethnic groups. A person must experience a persistent elevation in mood that normally lasts one week for the majority of the day to be diagnosed with Bipolar I Disorder, manic episode. At least 3 different manifestations of mood behavior, such as distractibility, pressurized speech, flight of ideas, egomania, increased activity, or reduced sleep, are required for diagnosis. The goal of this research is to present a thorough analysis of a case study of an Asian American lady diagnosed with bipolar illness. It investigates therapeutic options for the patient, subjective data, and mental status test findings supplied to determine the best drug alternatives to assist the client to achieve full remission of the condition.Case BackgroundThe Asian-American is a 26-year-old female diagnosed with Bipolar 1 Disorder, who arrives as a new client after previously being hospitalized for 21-days following an acute manic episode. Following hospital discharge, the client claims improved mood, decreased urge for sleep, and admission to noncompliance with prescribed lithium prescription. Following genetic testing, the findings were positive for the CYP2D6*10 allele, as well as a score of 22 on The Young Mania Rating Scale. I will examine pharmacological options for the patient based on the information supplied by the client.  NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderDecision 1Depending on the available options, I have opted to use lithium as my pharmacological agent for therapy. Because of the client’s positive genetic testing confirming the CYP2D6*10 allele, I believe this will be the best option to start with. Risperdal is extensively metabolized by the enzyme CYP450 2D6 and exhibits a wide range of enzymatic activity in terms of how prescription medicine impacts clinical therapy. Medication clearance is decreased when CYP450 3A4 inhibitors like quetiapine and CYP450 2D6 inhibitors combine, resulting in a rise in plasma concentration (Forster et al., 2021). Nevertheless, lithium is useful in patients with bipolar disorder and is a well-established first-line treatment option. Lithium is recognized as the gold standard treatment option for bipolar disorder.Furthermore, managing clients with bipolar illness have resulted in improved outcomes in treating severe manic and depressive episodes, such as lowering the frequency of depressive episodes and lowering the risk of suicidal conduct. By choosing lithium as my pharmacological agent, I expected to see a decrease in the client’s acute manic episodes on the initial appointment. In terms of overall symptom relief, mood, and ideation, lithium outperforms other antipsychotic drugs in the treatment of bipolar illness. Nevertheless, when the patient came for a follow-up appointment, it was revealed that she had been non-compliant with her prescriptions, which resulted in the same complaints as her first encounter. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderI was not anticipating the client to sustain her noncompliance behavior based on the results. Nonetheless, the consequences were radically different due to the client’s cognitive level and failure to fully comprehend the need of taking the medication as recommended, as well as recurrent non-compliance. While I am cognizant that the client has previously taken this medicine and has been non-compliant, I was anticipating that her preceding medication regimen and non-compliance would teach her the significance of taking her prescription on time to assist lessen the signs and symptoms of manic behavior. And so, I did not expect ongoing noncompliance. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderDecision 2After the patient disclosed her reason for noncompliance, I sought to analyze and enlighten her on the purpose and impacts of the medicine. According to Li et al. (2021), the most common reason for relapse of manic episodes following lithium medication is noncompliance. As a consequence, the administration of this lithium should be supported with steps to maintain compliance and counter drop-out by emphasizing the value of prescriptions, family support, and prescription monitoring. By opting to enlighten the client about non-compliant conduct, I hoped to urge the patient to be compliant with treatment, so that a drop in symptoms might be attributed to a decrease in manic behavior. A behavioral approach that directly encourages the patient’s adherence to lithium prescription is beneficial. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderMoreover, discovering a link between the patient’s level of comprehension of the condition, therapy, and the degree of compliance with lithium therapy through the process of psychoeducation is an essential controllable component of noncompliance. And so, I believed that properly communicating with clients about the value of treatment adherence, would promote an awareness of the need of taking the drugs as prescribed. Consistently teaching the patient on medication compliance has resulted in continuous noncompliance, but this instance owing to side effects of nausea and diarrhea. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderI expect the client to report favorable outcomes following instructions in regards to her compliance and diminution in manic behaviors. Unfortunately, because of the negative impacts of nausea and vomiting, the client stopped taking the medicine until the symptoms subsided. In contrast, gastrointestinal symptoms such as nausea and diarrhea may be caused by serum lithium levels that are within a normal range. Regrettably, the client instantly stopped taking the medication once again, regardless of the fact that a discussion regarding adverse effects, particularly grounds why the treatment should not be withdrawn prematurely, was conducted. The outcome and my expectation differed since the patient opted to discontinue taking the medication as she had encountered nasty side effects. Nevertheless, the client had previously quit taking the meds since she felt much better, so when she began to experience unpleasant side effects, she opted not to continue taking the prescription. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar DisorderDecision 3In my ultimate decision, I chose to adjust the lithium to a sustained release and keep the dosage and frequency intact. Because lithium is rapidly absorbed through the gastrointestinal system, I opted for a sustained release formulation. Furthermore, since lithium has a narrow therapeutic index, it induces common side effects at an acceptable blood concentration range, requiring regular maintenance medication and compromising patient compliance. I thought that by shifting to sustained release, the negative effects of the pills would be mitigated, allowing the patient to follow her prescription as directed and observe a great improvement in her ailments and manic behavior.According to Pacholko & Bekar (2021) NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder, the sustained release of lithium offers several benefits, such as stabilizing lithium concentrations, reduced side effects, and increased medication compliance. As a consequence, my general aim is to achieve a positive drop in outcomes for the client. The final decision indicated that the outcomes of extended-release formulations may relieve the symptoms and contribute to improved lithium outcomes for the client. Switching to extended-release lithium may result in a reduction in adverse effects and a positive outcome for the client, increasing compliance and adherence to the pharmacological alternative and diminishing manic behavior.Ethical and Legal ConsiderationsIn rare cases, a patient’s ethnicity may have an impact on how well she copes with and embraces a psychiatric diagnosis. Asian Americans, in particular, have culturally specific views about mental health and rehabilitation that lead to feelings of shame and humiliation, which can greatly affect whether or not a patient seeks psychotherapy while suffering from psychiatric problems. As a result, the physician must be aware of the client’s cultural viewpoints and maintain their information confidentially. The practitioner must inform the client of the limitations of their confidentiality, including how their data will be utilized for psychiatric therapy. Moreover, legal issues would require getting informed permission from the client before issuing therapy (Clark-Kazak, 2017). Owing to the genetic screening result of the positive CYP2D6*10 allele, this puts the client at a higher risk of hazardous side effects. Moreover, the clinician must educate patients on the risks, advantages, contraindications, and side effects of the given drug, as well as the need of adhering to prescription administration guidelines. NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder  In conclusion, it is critical to identify the influence of bipolar disease not only towards the person but also in regards to the ethnic background. The case study provided more detail on the patient’s bipolar illness symptoms as well as specific pharmacological decisions taken to help in the client’s treatment. Furthermore, the ethical implications for the Asian Americans, therapeutic strategies, communications, and genetic screening for the CYP2D6*10 allele were examined. ReferencesCarvalho, A. F., Firth, J., & Vieta, E. (2020). Bipolar disorder. New England Journal of Medicine, 383(1), 58-66.Clark-Kazak, C. (2017). Ethical considerations: Research with people in situations of forced migration. Refuge: Canada’s Journal on Refugees/Refuge: revue canadienne sur les réfugiés, 33(2), 11-17.Forster, J., Duis, J., & Butler, M. G. (2021). Pharmacogenetic Testing of Cytochrome P450 Drug Metabolizing Enzymes in a Case Series of Patients with Prader-Willi Syndrome. Genes, 12(2), 152.Li, K., Liao, Y., Yang, Z., Yang, C., Chen, M., Wu, X., & Gan, Z. (2021). Case Report: Paliperidone Palmitate in the Management of Bipolar I Disorder with Non-compliance. Frontiers in Psychiatry, 11, 1438.Pacholko, A. G., & Bekar, L. K. (2021). Lithium orotate: A superior option for lithium therapy? Brain and Behavior, 11(8) doi:http://dx.doi.org/10.1002/brb3.2262 NURS 6630 Week 5 Assignment: Assessing and Treating Patients With Bipolar Disorder

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