#775865 Topic: Part 2 – Assignment: Assessing and Treating Clients with With Bipolar Disorder

Number of Pages: 2 (Double Spaced)

Number of sources: 1

Writing Style: APA

Type of document: Research Paper

Academic Level:Master

Category:   Nursing

#775865 Topic: Part 2 – Assignment: Assessing and Treating Clients with With Bipolar Disorder
Number of Pages: 2 (Double Spaced)
Number of sources: 1
Writing Style: APA
Type of document: Research Paper
Academic Level:Master
Category: Nursing

ATTACHEMENTS;
Order_Files_775826_1.docx (HAS THE INSTRUCTIONS WHAT NEED TO BE DONE AT 2 PAGES)
Finished_Order_775826_3.docx (THE OTHER PART OF THE ASSIGNMENT WHICH IS PART OF THIS.)

Included here is part 1 of this assignment.
the writer already did a good job. The writer needs to use correct information on POINT TWO DECISION AND POINT THREE DECISION . The writer’s introduction is good, DECISION POINT ONE IS GOOD, AND THE CONCLUSION IS GOOD.

You are supposed to work on the information herein for “POINT TWO DECISION AND POINT THREE DECISION”

Decision Point Two

Discontinue Risperdal and start Lithium sustained release 300 mg orally BID

RESULTS OF DECISION POINT TWO
Client returns to clinic in four weeks
Client no longer lethargic after the end of the first week
Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19)
Client reports that her sleep is again decreasing, but that overall, she is happy

Decision Point Three

Increase Lithium SR to 450 mg orally BID

Guidance to Student

Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic /sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. The PMHNP could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, the PMHNP can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients� symptoms are worsening, however, the PMHNP would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy.
Remember decision Two will have
The Selected Decision:
Reason for Selection
Expected Results
Disparities between the Expected Results and the Actual Results

Remember decision Three will have

The Selected Decision:
Reason for Selection
Expected Results
Disparities between the Expected Results and the Actual Results

Decision Point Two

Discontinue Risperdal and start Lithium sustained release 300 mg orally BID

RESULTS OF DECISION POINT TWO

 Client returns to clinic in four weeks

 Client no longer lethargic after the end of the first week

 Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19)

 Client reports that her sleep is again decreasing, but that overall, she is happy

Decision Point Three


https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/04/mm/bipolar_therapy/img/pill-red.pngIncrease Lithium SR to 450 mg orally BID

Guidance to Student


Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic /sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. The PMHNP could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, the PMHNP can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients’ symptoms are worsening, however, the PMHNP would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy.

Remember decision Two will have

The Selected Decision:

Reason for Selection

Expected Results

Disparities between the Expected Results and the Actual Results

Remember decision Three will have

The Selected Decision:

Reason for Selection

Expected Results

Disparities between the Expected Results and the Actual Results

Running head: ASSESSING AND TREATING PATIENTS WITH BIPOLAR DISORDER 1

ASSESSING AND TREATING PATIENTS WITH BIPOLAR DISORDER 10

Assessing and Treating Patients with Bipolar Disorder

Student’s Name

Institution

Assessing and Treating Patients with Bipolar Disease

Bipolar disorder is a mental condition that arouses episodes of high spirits and great moods as well as times of acute discouragement and hopelessness in the affected patients. This state of mind is referred to as hypomania (craziness) based on the seriousness of the patient’s condition or manifestations of cases of psychosis. During such moments, the patients tend to be too irritable, cheerful or lively. Many do not feel the need to rest during such cases of hyper moods and during times of distress and gloom, they cry, expressing a lot of negativity and avoid direct eye contact with others. Most patients also tend to settle on choices that may not suit them, totally disregarding the consequences thereof.

Research has shown that patients suffering from bipolar disorder are prone to suicidal thoughts, with the number of suicides ranging from 6% for those suffering for more than 20 years. There are those who take the option of self-destruction and go ahead to harm themselves, an estimated 30-40%. Other patients display cases of psychological conditions such as high tension. Some tend to seek comfort in substance abuse.

The causes of bipolar disorder are mainly attributed to hereditary (genetic) and ecological factors. Though not clearly understood by many people, people are exposed to many risk factors by qualities they would consider of minimal impact. Ecological factors may reveal a background marred by the mishandling of adolescence and long-term stress. Bipolar disorder can be classified as Bipolar 1if the patient has experienced more than one hyper case, whether or not depression was involved. Bipolar 2 condition is determined by the occurrence of more than one hypomanic case, with a massive depression episode. Patients, who have experienced less extreme drawn-out spans, are often diagnosed with cyclothymic turmoil and it is grouped separately due to compounding therapeutic or medication issues.

Bipolar disorder also manifests itself in terms of conditions such as schizophrenia, identity issues, substance utilize clutter, hyperactivity and restorative cases. Although medical testing may not necessarily be a requirement for the determination of bipolar disorder, it is necessary to conduct some blood tests or perform medical imaging, which is an effective measure of discounting other isolated conditions and problems.

Case Study

Consider th