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NURS 6630 Week 7 Discussion: Sleep/Wake Disorders

NURS 6630 Week 7 Discussion: Sleep/Wake Disorders

It is not uncommon to experience a night or two of disrupted sleep when there is
something major going on in your life. However, sleep/wake disorders are much more
than an occasional night of disrupted sleep. A recent report from the Centers for
Disease Control and Prevention estimated that between 50 and 70 million American
have problems with sleep/wake disorders (CDC, 2015). Although the vast majority of
Americans will visit their primary care provider for treatment of these disorders, many
providers will refer patients for further evaluation. For this Discussion, you consider how
you might assess and treat the individuals based on the provided client factors.
Learning Objectives
Students will:
 Assess client factors and history to develop personalized therapy plans for clients with
sleep/wake disorders
 Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients
requiring therapy for sleep/wake disorders
 Evaluate efficacy of treatment plans for clients presenting for sleep/wake therapy
 Apply knowledge of providing care to adult and geriatric clients presenting for sleep/wake
disorders
Learning Resources
Note: To access this week’s required library resources, please click on the link to the
Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
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 11, “Disorders of Sleep and Wakefulness and Their Treatment”
Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge
University Press.

To access information on the following medications, click on The Prescriber’s Guide,
5th ed tab on the Stahl Online website and select the appropriate medication.

Review the following medications:
For insomnia
 alprazolam
 amitriptyline
 amoxapine
 clomipramine
 clonazepam
 desipramine
 diazepam
 doxepin
 flunitrazepam
 flurazepam
 hydroxyzine
 imipramine
 lorazepam
 nortriptyline
 ramelteon
 temazepam
 trazodone
 triazolam
 trimipramine
 zaleplon
 zolpidem

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (5th ed.). Washington, DC: Author.

Davidson, J. (2016). Pharmacotherapy of post-traumatic stress disorder: Going beyond
the guidelines. British Journal of Psychiatry, 2(6), e16-e18.
doi:10.1192/bjpo.bp.116.003707. Retrieved from http://bjpo.rcpsych.org/content/2/6/e16

To prepare for this Discussion:

NURS 6630 Week 7 Discussion Sleep Wake Disorders

NURS 6630 Week 7 Discussion Sleep Wake Disorders

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Note: By Day 1 of this week, your Instructor will have assigned you to one of the
following case studies to review for this Discussion. To access the following case
studies, click on the Case Studies tab on the Stahl Online website and select the
appropriate volume and case number.
Case 1: Volume 2, Case #16: The woman who liked late-night TV
Case 2: Volume 2, Case #11: The figment of a man who looked upon the lady
Case 3: Volume 1, Case #5: The sleepy woman with anxiety
 Review this week's Learning Resources and reflect on the insights they provide.
 Go to the Stahl Online website and examine the case study you were assigned.
 Take the pretest for the case study.
 Review the patient intake documentation, psychiatric history, patient file, medication history, etc.
As you progress through each section, formulate a list of questions that you might ask the
patient if he or she were in your office.
 Based on the patient’s case history, consider other people in his or her life that you would need
to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).
 Consider whether any additional physical exams or diagnostic testing may be necessary for the
patient.
 Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning
Resources for guidance.
 Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and
consider medications you might select for this patient.
 Review the posttest for the case study.
Note: For this Discussion, you are required to complete your initial post before you will
be able to view and respond to your colleagues’ postings. Begin by clicking on the "Post
to Discussion Question" link and then select "Create Thread" to complete your initial
post. Remember, once you click on Submit, you cannot delete or edit your own posts,
and you cannot post anonymously. Please check your post carefully before clicking
on Submit!
By Day 3
Post a response to the following:
 Provide the case number in the subject line of the Discussion.
 List three questions you might ask the patient if he or she were in your office. Provide a
rationale for why you might ask these questions.
 Identify people in the patient’s life you would need to speak to or get feedback from to further
assess the patient’s situation. Include specific questions you might ask these people and why.
 Explain what physical exams and diagnostic tests would be appropriate for the patient and how
the results would be used.
 List three differential diagnoses for the patient. Identify the one that you think is most likely and
explain why.
 List two pharmacologic agents and their dosing that would be appropriate for the patient’s
sleep/wake therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of
action perspective, provide a rationale for why you might choose one agent over the other.
 If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate
any therapeutic changes that you might make based on the data provided.
 Explain “lessons learned” from this case study, including how you might apply this case to your
own practice when providing care to patients with similar clinical presentations.

Read a selection of your colleagues' responses.
By Day 6
Respond to at least two of your colleagues who were assigned to a different case than
you. For example, if you were assigned to Case Study 1, respond to one colleague
assigned to Case Study 2 and one colleague assigned to Case Study 3. Explain how
you might apply knowledge gained from your colleagues’ case studies to you own
practice in clinical settings.
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 7 Discussion Rubric
Post by Day 3 and Respond by Day 6
To participate in this Discussion:
Week 7 Discussion

Name:  Discussion Rubric

  Excellent

90–100

Good

80–89

Fair

70–79

Poor

0–69

Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

40 (40%) – 44 (44%)

Thoroughly responds to the Discussion question(s).

Is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources.

No less than 75% of post has exceptional depth and breadth.

Supported by at least three current credible sources.

35 (35%) – 39 (39%)

Responds to most of the Discussion question(s).

Is somewhat reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module.

50% of the post has exceptional depth and breadth.

Supported by at least three credible references.

31 (31%) – 34 (34%)

Responds to some of the Discussion question(s).

One to two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Cited with fewer than two credible references.

0 (0%) – 30 (30%)

Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible references.

Main Posting:

Writing

6 (6%) – 6 (6%)

Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

5 (5%) – 5 (5%)

Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style.

4 (4%) – 4 (4%)

Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors.

0 (0%) – 3 (3%)

Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

Does not adhere to current APA manual writing rules and style.

Main Posting:

Timely and full participation

9 (9%) – 10 (10%)

Meets requirements for timely, full, and active participation.

Posts main Discussion by due date.

8 (8%) – 8 (8%)

Meets requirements for full participation.

Posts main Discussion by due date.

7 (7%) – 7 (7%)

Posts main Discussion by due date.

0 (0%) – 6 (6%)

Does not meet requirements for full participation.

Does not post main Discussion by due date.

First Response:

Post to colleague’s main post that is reflective and justified with credible sources.

9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

First Response:

Writing

6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

First Response:

Timely and full participation

5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Second Response:
Post to colleague’s main post that is reflective and justified with credible sources.
9 (9%) – 9 (9%)

Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives.

8 (8%) – 8 (8%)

Response has some depth and may exhibit critical thinking or application to practice setting.

7 (7%) – 7 (7%)

Response is on topic and may have some depth.

0 (0%) – 6 (6%)

Response may not be on topic and lacks depth.

Second Response:
Writing
6 (6%) – 6 (6%)

Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.

5 (5%) – 5 (5%)

Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

Provides opinions and ideas that are supported by few credible sources.

Response is written in standard, edited English.

4 (4%) – 4 (4%)

Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited.

0 (0%) – 3 (3%)

Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.

Second Response:
Timely and full participation
5 (5%) – 5 (5%)

Meets requirements for timely, full, and active participation.

Posts by due date.

4 (4%) – 4 (4%)

Meets requirements for full participation.

Posts by due date.

3 (3%) – 3 (3%)

Posts by due date.

0 (0%) – 2 (2%)

Does not meet requirements for full participation.

Does not post by due date.

Total Points: 100

Name:  Discussion Rubric

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