Jay, an 18-year-old high school senior, presents with symptoms of difficulty sleeping and feeling sad, which results in an initial diagnosis of depression. His mother later reports, however, that Jay 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, Jay’s psychiatric mental health nurse practitioner diagnosed him with bipolar disorder.

Cases like this are not uncommon with bipolar disorder, as initial assessments rarely provides all the information needed. In your role, as a psychiatric mental health nurse  you must develop strategies for properly assessing and diagnosing these clients 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 clients with bipolar disorder. You also consider ethical and legal implications of these therapies.

 

Assignment: Assessing and Treating Clients with With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients 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 client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.

Learning Objectives

Students will:

· Assess client factors and history to develop personalized plans of bipolar therapy for clients

· Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy

· Evaluate efficacy of treatment plans

· Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan

Required Readings( 3 + references needed)

Note: All Stahl resources can be accessed through this link provided.

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

  • Chapter 6, “Mood      Disorders”
  • Chapter 8, “Mood Stabilizers”

Stahl, S. M., & Ball, S. (2009b). Stahl’s illustrated mood stabilizers. New York, NY: Cambridge University Press.

To access the following chapters, click on the Illustrated Guides tab and then the Mood Stabilizers tab.

  • Chapter 4,      “Lithium and Various Anticonvulsants as Mood Stabilizers for Bipolar      Disorder”
  • Chapter 5, “Atypical      Antipsychotics as Mood Stabilizers for Bipolar Disorder”

Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs, 27(5), 331-333. doi:10.1007/s40263-013-0060-3

Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6

Note: Retrieved from Walden Library databases.

Required Media

Laureate Education. (2016f). Case study: An Asian American woman with bipolar disorder [Interactive media file]. Baltimore, MD: Author

Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources

Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: a randomized double-blind placebo-controlled trial. Acta Medica Iranica, 52(10), 734-739.
Retrieved from http://acta.tums.ac.ir/index.php/acta

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