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NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders

NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersFrom negative changes in mood to problems concentrating, sleep/wake disorders can have a tremendous impact on patients’ lives. When patients suffer from these disorders, they often seek medical care with the intent of receiving medications to manage symptoms. However, many of the medications used to treat sleep/wake disorders may be addictive, making thorough patient assessments and close follow-up care essential. To prescribe appropriate therapies with patient safety in mind, you must understand not only the pathophysiology of these disorders but also the pharmacologic agents used to treat them. NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThis week, as you study therapies for individuals with sleep/wake disorders, you examine the assessment and treatment of patients with these disorders. You also explore ethical and legal implications of these therapies.Learning ObjectivesStudents will:Synthesize concepts related to the psychopharmacologic treatment of patientsAssess patient factors and history to develop personalized therapy plans for patients with sleep/wake disordersAnalyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for sleep/wake disordersSynthesize knowledge of providing care to patients presenting for sleep/wake disordersAnalyze ethical and legal implications related to prescribing therapy for patients with sleep/wake disordersORDER A PLAGIARISM-FREE PAPER HERELearning ResourcesNURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersRequired Readings (click to expand/reduce)American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596Fernandez-Mendoza, J., & Vgontzas, A. N. (2013). Insomnia and its impact on physical and mental health. Current Psychiatry Reports, 15(12), 418. https://doi.org/10.1007/s11920-012-0418-8Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin. SLEEP, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdfMorgenthaler, T. I., Owens, J., Alessi, C., Boehlecke, B, Brown, T. M., Coleman, J., Friedman, L., Kapur, V. K., Lee-Chiong, T., Pancer, J., & Swick, T. J. (2006). Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. SLEEP, 29(1), 1277–1281. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_NightWakingsChildren.pdfSateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470Winkleman, J. W. (2015). Insomnia disorder. The New England Journal of Medicine, 373(15), 1437–1444. https://doi.org/10.1056/NEJMcp1412740Medication Resources (click to expand/reduce)Required Media (click to expand/reduce)Assignment 1: Short Answer AssessmentAs a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders Photo Credit: Getty Images/Collection Mix: SubTo PrepareReview the Learning Resources for this week.Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersTo complete:Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersList 4 predictors of late onset generalized anxiety disorder.List 4 potential neurobiology causes of psychotic major depression.An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.By Day 7This Assignment is due.Submission and Grading InformationTo submit your completed Assignment for review and grading, do the following:Please save your Assignment using the naming convention “WK8Assgn1+last name+first initial.(extension)” as the name.Click the Week 8 Assignment 1 Rubric to review the Grading Criteria for the Assignment.Click the Week 8 Assignment 1 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 “WK8Assgn1+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. Rubric Detail Select Grid View or List View to change the rubric’s layout.ContentName: NURS_6630_Week8_Assignment1_RubricNURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersGrid ViewList ViewExcellentPoint range: 90–100GoodPoint range: 80–89FairPoint range: 70–79PoorPoint range: 0–69In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why. Be specific. What it is the timeframe that the patient should see resolution of symptoms?NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 12 (16%) – 13 (17.33%)The response accurately and clearly explains in detail the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe response accurately and clearly details which drugs are contraindicated with specific examples.The response accurately and clearly explains in detail the timeframe that the patient should see resolution of symptoms.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 11 (14.67%) – 11 (14.67%)The response accurately explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.The response accurately identifies which drugs are contraindicated with specific examples.The response accurately explains the timeframe that the patient should see resolution of symptoms.Points Range: 10 (13.33%) – 10 (13.33%)The response inaccurately or vaguely explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe response inaccurately or vaguely identifies which drugs are contraindicated with inaccurate or vague examples.The response inaccurately or vaguely explains the timeframe that the patient should see resolution of symptoms.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersNURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 0 (0%) – 9 (12%)The response inaccurately and vaguely explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse, or is missing.The response inaccurately and vaguely identifies which drugs are contraindicated with inaccurate examples, or is missing.The response inaccurately and vaguely explains the timeframe that the patient should see resolution of symptoms, or is missing.List four predictors of late onset generalized anxiety disorder.Points Range: 12 (16%) – 13 (17.33%)The response accurately and clearly lists in detail four predictors of late-onset generalized anxiety disorder.Points Range: 11 (14.67%) – 11 (14.67%)The response accurately lists four predictors of late-onset generalized anxiety disorder.Points Range: 10 (13.33%) – 10 (13.33%)The response inaccurately or vaguely lists four predictors of late-onset generalized anxiety disorder.Points Range: 0 (0%) – 9 (12%)The response inaccurately and vaguely lists four predictors of late-onset generalized anxiety disorder, or is missing.List four potential neurobiology causes of psychotic major depression.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 12 (16%) – 13 (17.33%)The response accurately and clearly lists in detail four potential neurobiology causes of psychotic major depression.Points Range: 11 (14.67%) – 11 (14.67%)The response accurately lists four potential neurobiology causes of psychotic major depression.Points Range: 10 (13.33%) – 10 (13.33%)The response inaccurately or vaguely lists four potential neurobiology causes of psychotic major depression.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 0 (0%) – 9 (12%)The response inaccurately and vaguely lists four potential neurobiology causes of psychotic major depression.An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least five symptoms required for the episode to occur. Be specific.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 12 (16%) – 13 (17.33%)The response accurately and clearly explains in detail at least five symptoms for the episode of major depression to occur.Specific examples provided fully support the response.Points Range: 11 (14.67%) – 11 (14.67%)The response accurately explains at least five symptoms for the episode of major depression to occur.Specific examples provided support the response.Points Range: 10 (13.33%) – 10 (13.33%)The response inaccurately or vaguely explains at least five symptoms for the episode of major depression to occur.Specific examples provided inaccurately or vaguely support the response.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 0 (0%) – 9 (12%)The response inaccurately and vaguely explains at least five symptoms for the episode of major depression to occur, or is missing.Specific examples provided do not support the response, or is missing.List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.Points Range: 12 (16%) – 13 (17.33%)The response accurately and clearly lists in detail 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersExamples provided fully support the response provided.Points Range: 11 (14.67%) – 11 (14.67%)The response accurately lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.Examples provided support the response provided.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 10 (13.33%) – 10 (13.33%)The response inaccurately or vaguely lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.Examples provided inaccurately or vaguely support the response provided.Points Range: 0 (0%) – 9 (12%)The response inaccurately and vaguely lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia, or is missing.Examples provided do not support the response provided, or is missing.Written Expression and Formatting – English writing standards:Correct grammar, mechanics, and proper punctuationPoints Range: 5 (6.67%) – 5 (6.67%)Uses correct grammar, spelling, and punctuation with no errors.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 4 (5.33%) – 4 (5.33%)Contains a few (1 or 2) grammar, spelling, and punctuation errors.Points Range: 3.5 (4.67%) – 3.5 (4.67%)Contains several (3 or 4) grammar, spelling, and punctuation errors.Points Range: 0 (0%) – 2 (2.67%)Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersWritten 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 (6.67%) – 5 (6.67%)Uses correct APA format with no errors.Points Range: 4 (5.33%) – 4 (5.33%)Contains a few (1 or 2) APA format errors.Points Range: 3.5 (4.67%) – 3.5 (4.67%)Contains several (3 or 4) APA format errors.Points Range: 0 (0%) – 2 (2.67%)Contains many (≥ 5) APA format errors. Total Points: 75NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersName: NURS_6630_Week8_Assignment1_Rubric Short Answer Assessment: Major Depressive Disorder (MDD)Walden UniversityNurs 6630- Psychopharmalogical Approaches to Treat PsychopathologyShort Answer Assessment: Major depressive disorder (MDD)Question oneSSRI and SNRI medications are efficient therapeutic options for a patient with MDD and a history of alcohol addiction. Paroxetine, in particular, is useful in treating social anxiety and alcoholism; so, it would be an excellent choice of medications (Egic, 2021).  Individuals with a history of alcoholism frequently suffer from anxiety. Paroxetine, an SSRI, would thus be an appropriate medication. Due to the danger of seizures, venlafaxine is not advisable (Zhang et al., 2019). Most clients will see remission after at least three weeks of SSRI medication.Question twoThe principle predictors of late-onset generalized anxiety disorder are female, respiratory disorders, history of GAD, heart failure, and phobia (Baldwin et al., 2018).NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersQuestion threeNeurobiological causes of major depression include elevated circulating cortisol levels and a greater ventricular-to-cortical brain ratio. Others include Abnormalities in the hypothalamic-pituitary axis and dopamine imbalance consistent with MDD (Boas et al., 2019).Question fourSymptoms necessary for a significant depressive episode to occur includes a general lack of interest and pleasure in most activities almost every day, having a depressed mood nearly every day, a five-percent weight loss or gain over the course of one month, insomnia, and Psychomotor agitation almost every day (Kinser et al.,2018).Question fiveThree Classes of drugs that precipitate insomnia include Selective serotonin reuptake inhibitors (SSRIs), a typical example being sertraline, Serotonin-norepinephrine reuptake inhibitors (SRNIs) medication such as venlafaxine, and Serotonin Receptor Antagonist, for instance, vortioxetine.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersReferencesBaldwin, D., Stein, M. B., & Hermann, R. (2018). Generalized anxiety disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis. UpToDate [Internet]. Waltham (MA): UpToDate.Boas, G. R. V., de Lacerda, R. B., Paes, M. M., Gubert, P., da Cruz Almeida, W. L., Rescia, V. C., … & Oesterreich, S. A. (2019). Molecular aspects of depression: a review from neurobiology to treatment. European journal of pharmacology, 851, 99-121.Egic, M. (2021). Social anxiety disorder: SSRI vs. placebo. https://www.diva-portal.org/smash/record.jsf?pid=diva2%3A1579407&dswid=-3190Kinser, P. A., Thacker, L. R., Lapato, D., Wagner, S., Roberson-Nay, R., Jobe-Shields, L., … & York, T. P. (2018). Depressive symptom prevalence and predictors in the first half of pregnancy. Journal of Women’s Health, 27(3), 369-376.Zhang, Y., Bi, X., Adebiyi, O., Wang, J., Mooshekhian, A., Cohen, J., … & Li, X. M. (2019). Venlafaxine improves cognitive impairment and depression-like behaviors in a cuprizone mouse model by alleviating demyelination and neuroinflammation in the brain. Frontiers in pharmacology, 10, 332.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders    Assignment 2: Assessing and Treating Patients With Sleep/Wake DisordersSleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersReference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersTo 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 with sleep/wake disorders.The Assignment: 5 pagesExamine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersIntroduction 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersDecision #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 8: Therapy for Patients With Sleep/Wake DisordersDecision #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 8: Therapy for Patients With Sleep/Wake DisordersNote: 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 7Submit your Assignment.Submission and Grading InformationTo submit your completed Assignment for review and grading, do the following:Please save your Assignment using the naming convention “WK8Assgn2+last name+first initial.(extension)” as the name.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersClick the Week 8 Assignment 2 Rubric to review the Grading Criteria for the Assignment.Click the Week 8 Assignment 2 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 “WK8Assgn2+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. Rubric Detail Select Grid View or List View to change the rubric’s layout.ContentName: NURS_6630_Week8_Assignment2_RubricNURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersGrid 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.Points Range: 9 (9%) – 10 (10%)NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe response accurately, clearly, and fully summarizes in detail the case for the Assignment.The 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.Points Range: 7 (7%) – 7 (7%)The response inaccurately or vaguely summarizes the case for the Assignment.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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.The 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 18 (18%) – 20 (20%)The response accurately and clearly explains in detail the decision selected.The 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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.The 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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.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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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.The 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 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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.The 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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.Points 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.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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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.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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 18 (18%) – 20 (20%)The response accurately and clearly explains in detail the decision selected.The 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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.The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersExamples provided fully support the decisions and responses provided.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersPoints Range: 16 (16%) – 17 (17%)The response accurately explains the decision selected.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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.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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe 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.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.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 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersThe 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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 8: Therapy for Patients With Sleep/Wake DisordersPoints 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_Week8_Assignment2_RubricAssessing and Treating Patients with Sleep/Wake DisordersWalden UniversityNurs 6630- Psychopharmalogical Approaches to Treat PsychopathologyNURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders Assessing and Treating Patients with Sleep/Wake DisordersSleep-wake disorders are characterized by sleep quality, timing, and quantity (Nassan & Videnovic, 2021). This promotes daily discomfort and impairments in functionality. Sleep-wake conditions typically coincide with medical issues or other psychological issues, such as sadness, anxiety, or cognitive deficiencies. These disorders are classified into numerous categories, the most prevalent being insomnia. Other categories include parasomnias, narcolepsy, and restless leg syndrome. Sleep disorders are connected to both physical and mental issues. Sleep issues may aggravate psychological problems and be a manifestation of other mental health disorders. Over 30% of people have insomnia, and 6-10% fit the threshold for illness (Hershner & Auckley, 2021)NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders. This paper aims to investigate pharmacological approaches for treating insomnia in younger individuals; in this case, a 31-year-old adult who has been complaining of six-month sleeplessness following the loss of his fiancée. Several variables, such as patient-specific variables, are essential in evaluating and treating young adults as they help make more informed therapeutic strategies. The first factor that might have contributed to the patient’s sleeplessness is the unexpected death of his fiancée. Another factor to examine is the patient’s use of alcohol and her mental status, which was satisfactory.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersDecision point 1The initial step in treating the clients’ insomnia is to give him 50-100mg of Desyrel (trazodone) at bedtime. This decision was based on trazodone’s efficacy in relieving insomnia and controlling depression, which may be the primary cause of patient sleeplessness. Insomnia, according to Yi et al. (2018), is typified by problems getting asleep, troubles remaining asleep or early-morning awakening, impacting performance of daytime duties. Trazodone has been proven to be a safe and effective treatment for insomnia. A small dosage of 25-100mg fosters and sustains sleep and significantly reduces daytime drowsiness due to its 3–6-hour half-life.The first decision rules out zolpidem 10mg once daily at bedtime. It’s because, while it is effective in treating insomnia by having a patient sleep faster and much more deeply, it is also connected with side effects like dizziness, uncontrolled shaking, and odd night behavioral patterns like night-eating and sleep-walking (Mittal et al.,2021). According to the patient, the medications blend nicely with alcohol. Therefore, it is not the ideal choice. Hydroxyzine 50mg is also not featured. It has comparable effects to diphenhydramine and is connected with being drowsy, sleepy, and fatigued the following morning, making the patient’s career as a forklift operator extremely unsafe.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersI wanted to minimize sleeplessness and enhance patient safety throughout daily tasks by making this decision. The use of trazodone accomplished this. The medications the client was initially taking were ineffective and led him to fall asleep at work, which was dangerous considering the nature of his job. Therefore, my aim was to alleviate sleeplessness, despair and improve patient safety in doing everyday tasks.The ethical concern that may impact the plan of care and communications is preserving autonomy by obtaining patient consent through outlining treatment alternatives, justification, and possible adverse effects. Communication is a key for acquiring comprehensive data, involving clients in decision-making, and addressing essential and contentious concerns.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersDecision point 2At this point, I will choose to maintain the patient on exact dosage while emphasizing priapism as a side effect of trazodone to the patient and assuring him that the effect will dissipate over time. Priapism is a known side effect of trazodone, albeit it has minimal impact on patients’ daily tasks because it lasts only 15 minutes (Scherzer et al., 2019). It is crucial to highlight that it will diminish with time and is efficacious in preventing insomnia and depression. The patient reported decreased priapism during the subsequent visit and that the 50mg trazodone dosing is efficient; nonetheless, he periodically awakens and reports next-day drowsiness.The first decision requiring the discontinuation of trazodone and the commencement of suvorexant 10mg was never used. This is because abrupt quitting of trazodone is linked with withdrawal symptoms (Zayour & Wakhlu, 2021). Suvorexant efficiently cures insomnia by reducing sleep latency and raising sleep duration; nevertheless, it causes somnolence or drowsiness (Kishi et al.,2020). The decision to reduce trazodone at bedtime to 25mg was also not incorporated into the patient’s treatment plan since the client stated that the dosage of 50mg is satisfactory; hence, cutting the strength to 25mg will be ineffective in treating insomnia.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe expected outcomes of continuing trazodone and elucidating the genesis of priapism include improved insomnia treatment and educating the patient in understanding that priapism is a side effect that will diminish over time. I also expected the client to report less priapism and an improved sleep cycle at the next visit.An ethical consideration that may impact treatment and communication with patients is the failure of healthcare practitioners to communicate the adverse effect of the drug to the patient. If a patient experiences a poor side effect from medicine, they may stop using it. According to Fischhoff (2019), clear communication is necessary for optimal medication administration. Proper communication promotes the client’s pleasure and degree of participation in the therapy while exercising his autonomous rights. Empathy allows patients to express their aspirations, opinions, and concerns, which translates to improved health outcomes.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersDecision point 3The third alternative is to continue the dosage while highlighting to the client why the dosages (50mg) have to be divided into half. Decreasing the amount will result in less lethargy the next day. This decision was drawn solely because trazodone effectively treats insomnia and the likelihood that the 50mg dose triggered the next-day lethargy. Thus, dividing the medicine is a preferable option to initiating therapy. According to Gonçalo and Vieira-Coelho (2021), trazodone has a minimal side effect profile, and dosage modification can alleviate them.The first choice, which was not adopted, was to cease the dosage and begin zaleplon (sonata) 10mg daily at bedtime. Zaleplon acts by slowing the sleep onset rather than increasing sleep duration or wakefulness, making it ineffective for treating insomnia (Bhandari & Sapra, 2019). Zaleplon is also linked to irregular sleeping patterns. On the contrary, hydroxyzine, an antihistamine, has sedative effects that cause lethargy, dry mouth, and blurred vision.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersThe outcomes I was aiming for were a drop in next-day sleepiness and improved patient safety. Trazodone has been linked to intoxication when combined with alcohol; thus, abstaining from alcohol is recommended. This decision seeks to cure insomnia and depression; consequently, staying with trazodone and changing dose was the optimal approach, evidenced by the client’s positive outcomes.Complementary treatments that may harm the client and a failure to exercise autonomy are two ethical difficulties that may influence the care plan and the patient’s engagement. These ethical issues can be resolved by providing the client with proper knowledge about therapeutic options and including him in decision-making.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersConclusionTo conclude, beginning treatment for insomnia with trazodone 50mg is an excellent option. Trazodone, an FDA-approved antidepressant, is widely used off-label to treat insomnia (Dhuna & Malkani, 2020). The sudden death of his fiancee brought on the patient’s sleeplessness; as a result, he became depressed, which rendered him sleepless. Trazodone is primarily used to treat insomnia and depression, resulting in improved sleep patterns and everyday tasks for patients. The therapy alternative offered the predicted benefits for a patient due to its low side effect profile and success in treating sleep/wake disorders. While hydroxyzine can aid with insomnia, low-dose antidepressants or non-benzodiazepine anxiolytics are preferred over sedative-hypnotics. Furthermore, antihistamines such as hydroxyzine and diphenhydramine are not recommended owing to anticholinergic symptoms such as dizziness and sleepiness.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersInsomnia therapeutic solutions vary based on the condition of the patient and health concerns. Health care practitioners should be cognizant of medicine that may be useful in treating one individual while detrimental to another. Alcohol usage when using sleeping pills is dangerous and should be avoided. An additional aspect of designing treatment plans and promoting dialogue with patients is adhering to ethical concepts like autonomy, beneficence, and non-maleficence. Patients should be given reliable information about their disease, educated about alternative treatments, and included in making informed decisions. Practitioners must constantly prioritize doing what is suitable for the patient, exemplified by providing effective treatments. NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersReferencesNassan, M., & Videnovic, A. (2021). Circadian rhythms in neurodegenerative disorders. Nature Reviews Neurology, 1-18.Hershner, S., & Auckley, D. (2021). Perioperative management of insomnia, restless legs, narcolepsy, and parasomnias. Anesthesia & Analgesia, 132(5), 1287-1295.Yi, X. Y., Ni, S. F., Ghadami, M. R., Meng, H. Q., Chen, M. Y., Kuang, L., … & Zhou, X. Y. (2018). Trazodone for the treatment of insomnia: a meta-analysis of randomized placebo-controlled trials. Sleep medicine, 45, 25-32.Mittal, N., Mittal, R., & Gupta, M. C. (2021). Zolpidem for Insomnia: A Double-Edged Sword. A Systematic Literature Review on Zolpidem-Induced Complex Sleep Behaviors. Indian Journal of Psychological Medicine, 0253717621992372.Scherzer, N. D., Reddy, A. G., Le, T. V., Chernobylsky, D., & Hellstrom, W. J. (2019). Unintended consequences: a review of pharmacologically-induced priapism. Sexual medicine reviews, 7(2), 283-292.Zayour, Z., & Wakhlu, S. (2021). Benzodiazepine Withdrawal Insomnia. In Sleep Disorders in Selected Psychiatric Settings (pp. 3-7). Springer, Cham.NURS 6630 Week 8: Therapy for Patients With Sleep/Wake DisordersKishi, T., Nomura, I., Matsuda, Y., Sakuma, K., Okuya, M., Ikuta, T., & Iwata, N. (2020). Lemborexant vs. suvorexant for insomnia: a systematic review and network meta-analysis. Journal of Psychiatric Research, 128, 68-74.Fischhoff, B. (2019). Evaluating science communication. Proceedings of the National Academy of Sciences, 116(16), 7670-7675.Gonçalo, A. M. G., & Vieira-Coelho, M. A. (2021). The effects of trazodone on human cognition: a systematic review. European journal of clinical pharmacology, 1-15.Bhandari, P., & Sapra, A. (2019). Zaleplon. https://europepmc.org/article/nbk/nbk551571Dhuna, N. A., & Malkani, R. G. (2020). Antidepressants and Their Impact on Sleep. Current Sleep Medicine Reports, 1-10. NURS 6630 Week 8: Therapy for Patients With Sleep/Wake Disorders

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