Sample Answer for NURS 6630 psychopharmacologic treatments Assignment Included After Question
SHORT ANSWER ASSESSMENT NURS 6630 WEEK 8
As 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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare
• Review 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.
To complete:
Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.
1. 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?
2. List 4 predictors of late onset generalized anxiety disorder.
3. List 4 potential neurobiology causes of psychotic major depression.
4. 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.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
By Day 7
This Assignment is due.
submission information
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Rubric
NURS_6630_Week8_Assignment1_Rubric
NURS_6630_Week8_Assignment1_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning Outcome 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 it is the timeframe that the patient should see resolution of symptoms? 13 to >11.0 pts
Excellent Point range: 90–100
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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…. The 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. 11 to >10.0 pts
Good Point range: 80–89
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. 10 to >9.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse…. The 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. 9 to >0 pts
Poor Point range: 0–69
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.
13 pts
This criterion is linked to a Learning Outcome List four predictors of late onset generalized anxiety disorder. 13 to >11.0 pts
Excellent Point range: 90–100
The response accurately and clearly lists in detail four predictors of late-onset generalized anxiety disorder. 11 to >10.0 pts
Good Point range: 80–89
The response accurately lists four predictors of late-onset generalized anxiety disorder. 10 to >9.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely lists four predictors of late-onset generalized anxiety disorder. 9 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely lists four predictors of late-onset generalized anxiety disorder, or is missing.
13 pts
This criterion is linked to a Learning Outcome List four potential neurobiology causes of psychotic major depression. 13 to >11.0 pts
Excellent Point range: 90–100
The response accurately and clearly lists in detail four potential neurobiology causes of psychotic major depression. 11 to >10.0 pts
Good Point range: 80–89
The response accurately lists four potential neurobiology causes of psychotic major depression. 10 to >9.0 pts
Fair Point range: 70–79
The response inaccurately or vaguely lists four potential neurobiology causes of psychotic major depression. 9 to >0 pts
Poor Point range: 0–69
The response inaccurately and vaguely lists four potential neurobiology causes of psychotic major depression.
13 pts
This criterion is linked to a Learning Outcome 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. 13 to >11.0 pts
Excellent Point range: 90–100
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. 11 to >10.0 pts
Good Point range: 80–89
The response accurately explains at least five symptoms for the episode of major depression to occur…. Specific examples provided support the response. 10 to >9.0 pts
Fair Point range: 70–79
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. 9 to >0 pts
Poor Point range: 0–69
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.
13 pts
This criterion is linked to a Learning Outcome List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific. 13 to >11.0 pts
Excellent Point range: 90–100
The response accurately and clearly lists in detail 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia…. Examples provided fully support the response provided. 11 to >10.0 pts
Good Point range: 80–89
The response accurately lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia…. Examples provided support the response provided. 10 to >9.0 pts
Fair Point range: 70–79
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. 9 to >0 pts
Poor Point range: 0–69
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.
13 pts
This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation 5 to >4.0 pts
Excellent Point range: 90–100
Uses correct grammar, spelling, and punctuation with no errors. 4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) grammar, spelling, and punctuation errors. 3.5 to >2.0 pts
Fair Point range: 70–79
Contains several (3 or 4) grammar, spelling, and punctuation errors. 2 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
5 pts
This criterion is linked to a Learning Outcome 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. 5 to >4.0 pts
Excellent Point range: 90–100
Uses correct APA format with no errors. 4 to >3.5 pts
Good Point range: 80–89
Contains a few (1 or 2) APA format errors. 3.5 to >2.0 pts
Fair Point range: 70–79
Contains several (3 or 4) APA format errors. 2 to >0 pts
Poor Point range: 0–69
Contains many (≥ 5) APA format errors.
5 pts
Total Points: 75
NURS 6630 psychopharmacologic treatments Assignment Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
|
Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
|
| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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||
| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
|
The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
AND/OR
|
The following was present:
AND/OR
AND/OR
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Read Also: NURS 6630 Discussion Foundational Neuroscience
As we begin this session, I would like to take this opportunity to clarify my expectations for this course:
Please note that GCU Online weeks run from Thursday (Day 1) through Wednesday (Day 7).
Course Room Etiquette:
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Discussion questions:
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LopesWrite
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Grade of Incomplete
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Grade Disputes
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A Sample Answer For the Assignment: NURS 6630 psychopharmacologic treatments Assignment
Title: NURS 6630 psychopharmacologic treatments Assignment
Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult
Insomnia is one of the critical predictors of mental health problems including depression. Diurnal and nocturnal symptoms characterize insomnia disorder. Patients with the disorder complain of being dissatisfied with the quality or duration of their sleep alongside prolonged or frequent awakenings. Difficulties to return to sleep follow the awakenings. The consequence of insomnia disorder in patients include reduction in energy, fatigue, mood disturbances and impaired cognitive functions such as attention and decision-making. As a result, patients suffer from significant inabilities to perform in their social as well as occupational roles.
This assignment is develops the treatment decisions that would be used in treating a patient with insomnia disorder. The patient in the case study is a 31-year old male who presents to the office with the primary complaint of insomnia. The history taken from the client shows that the symptoms of insomnia have progressively worsened over the last six months. The patient complaints that he is having difficulties both in sleeping and staying asleep at night. The onset of the problem was about six months ago after the sudden loss of his fiancé. The patient reports that his problem has affected his ability to perform his job in a local chemical company as a forklift operator. The mental status examination showed that the patient is alert and oriented to place, time, person and event. He also makes good eye contact, dressed appropriately, and denies any visual or auditory hallucinations.
Patient factors will influence the decisions that will be made in this case study. The factors include his past medical record that shows that he has a history of opiate abuse. The patient has also been using alcohol to help him fall asleep. The patient also has used diphenhydramine in the past and did not like the way it made him fell afterwards. Therefore, the above factors will be considered in the decision-making.
Decision Point One
The first decision that will be made for the patient in the case study is the administration of Trazodone 50-100 mg daily at bedtime. Trazodone is a drug approved for treating depression but also an off-label medication for insomnia. Trazodone produces its effects in insomnia by antagonizing serotonin, histamine and alpha adrenergic receptors. The inhibition of the above receptors cause hypnosis, hence, its effectiveness in insomnia. The use of Trazodone at low disease induces alongside maintain sleep without predisposing patients to daytime drowsiness and tolerance because of its short half-life (Jaffer et al., 2017). The use of Zolpidem 10 mg daily at bedtime was not selected as the first option of treatment because it is associated with the adverse effects of the patient feeling drugged, dizziness and drowsiness. As a result, Zolpidem is not selected as the first line drug for insomnia (Wong et al., 2020). The use of hydroxyzine 50 mg daily at bedtime was not selected because it is associated with side effects that include strong sedation, xeropthalmia and xerostomia (Bruni et al., 2018). The side effects might result in worsening in the symptoms of insomnia in the patient.
The selection in the first decision was made with the expectation that the symptoms of insomnia in the patient will improve. The administration of low dose of Trazodone is effective in improving the symptoms of insomnia and daytime drowsiness. The improvement in symptoms was expected to lead to enhanced functioning in the workplace by the client (Morin et al., 2020). The client came to the clinic after 2 weeks. He reports that medication works well but gives hum the unpleasant side effect of prolonged erection of the penis, approximately 15 minutes after waking. The patient states that prolonged erection makes it difficult for him to get ready for work or go downstairs and have coffee with his girlfriend and daughter in the morning. He also denies visual or auditor hallucinations and is future oriented. The outcomes were expected because Traodone has the side effect of priapism (Jaffer et al., 2017). The improvement in symptoms was expected because of the therapeutic effectiveness of Trazodone.
Decision Point Two
The decision that is selected for the patient at the second step is explaining to the patient that priapism is a side effect of trazodone that should diminish over time. As a result, the current dose of trazodone should be continued. The use of trazodone in decision point one led to a significant improvement in the symptoms of insomnia that the client experienced initially. The improvement in symptoms is evidenced by the fact that the client reports the medication to work well (Wong et al., 2020). The side effect of priapism was expected. The side effects of trazodone are expected to improve over time, as the patient tolerates the medication. Based on the above outcomes, the best option for the patient would be to maintain the current dosage of trazodone. Maintaining the dosage will ensure that the therapeutic effects of the medication are sustained. In addition, maintaining the current dose will ensure that the risk of symptom relapse is eliminated (Wang et al., 2020). Educating the patient is therefore important to raise his level of awareness, enable him to make informed decisions and promote adherence to medications. The decision to discontinue trazodone and initiate therapy with suvorexant 10 mg daily bedtime was not considered at this stage because there is no indication for changing the therapy. The decision to decrease the dosage of trazodone to 25 mg daily at bedtime was not considered at this step because the client did not experience any severe side effects with the initial dose of trazodone. Decreasing the dose to 25 mg at bedtime was also associated with the risk of symptom relapse, hence, the decision not to select this decision (Jaffer et al., 2017).
The decision above was made with the aim of maintaining the current therapeutic effects of Trazodone. It was also expected that the patient would tolerate the dose, as evidenced by the lessening of the side effects of trazodone (Lavigne et al., 2019). The client was assessed after 2 weeks. He reported that priapism has diminished over time. The patient also denied auditory or visual hallucinations and is future oriented. The client also stated that trazodone is effective at 50 mg dose but sometimes wakes up following day with drowsiness. The outcomes of the decision were achieved because of the enhanced therapeutic effectiveness of trazodone. The complaint of waking up the following day with drowsiness was expected due to the prolonged hypnotic effects of trazodone (Jaffer et al., 2017). Therefore, reducing the dosage might be an appropriate decision.
Decision Point Three
The decision that is selected at this step is continuing the dose and explaining to the patient he may split the 50 mg table in half. The decreased dose should minimize next day drowsiness. Follow-up should be done after 4 weeks. Reducing the dose was expected to lower the extended hypnotic and sedation effect of trazodone 50 mg (Wang et al., 2020). The decision to discontinue trazodone and initiate therapy with sonata was not selected because trazodone had produced the desired therapeutic effect in managing insomnia. Similar basis was considered in not selecting the decision to discontinue trazodone and initiate therapy with hydroxyzine 50 mg at bedtime. The decision to use sonata was also not considered because of the increased risk of complex sleep behaviors. The decision not to use hydroxyzine was also not selected because of its strong sedation effects, which could have led to extended drowsiness after waking up (Narang et al., 2020). The decision at this step was made with the aim of minimizing next day drowsiness experienced by the patient. Reducing the dose would have minimized the sedative effect of trazodone (Morin et al., 2020). The outcomes of this decision were not given in the case study.
Conclusion
The decisions that the PMHNP made in treating the patient in this case study were effective and informed by evidence-based data. The decisions made showed that trazodone was an effective treatment for insomnia over the other options of treatment. Evidence-based data support the outcomes of using trazodone in this case study. Sources of evidence-based data show that trazodone is the first line of drug utilized in insomnia. Trazodone is highly tolerated and is associated with minimal side effects to the patients. Trazodone has demonstrated effectiveness in use in both short and long-term basis in the management of insomnia. Ethics influenced the decisions that the PMHNP made in relation to the management of insomnia. The PMHNP prioritized the safety of the drugs that were selected for use in the treatment process. The PMHNP also ensured that the patient was informed about the side effects that he was experiencing and reassured him that the symptoms will resolve over time. Therefore, I hope to demonstrate similar competency in solving case studies involving patients with mental health illnesses in the future.
References
Bruni, O., Angriman, M., Calisti, F., Comandini, A., Esposito, G., Cortese, S., & Ferri, R. (2018). Practitioner Review: Treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities. Journal of Child Psychology and Psychiatry, 59(5), 489–508. https://doi.org/10.1111/jcpp.12812
Jaffer, K. Y., Chang, T., Vanle, B., Dang, J., Steiner, A. J., Loera, N., Abdelmesseh, M., Danovitch, I., & Ishak, W. W. (2017). Trazodone for Insomnia: A Systematic Review. Innovations in Clinical Neuroscience, 14(7–8), 24–34.
Lavigne, J. E., Hur, K., Kane, C., Au, A., Bishop, T. M., & Pigeon, W. R. (2019). Prescription Medications for the Treatment of Insomnia and Risk of Suicide Attempt: A Comparative Safety Study. Journal of General Internal Medicine, 34(8), 1554–1563. https://doi.org/10.1007/s11606-019-05030-6
Morin, C. M., Edinger, J. D., Beaulieu-Bonneau, S., Ivers, H., Krystal, A. D., Guay, B., Bélanger, L., Cartwright, A., Simmons, B., Lamy, M., & Busby, M. (2020). Effectiveness of Sequential Psychological and Medication Therapies for Insomnia Disorder: A Randomized Clinical Trial. JAMA Psychiatry, 77(11), 1107–1115. https://doi.org/10.1001/jamapsychiatry.2020.1767
Narang, P., Held, J., & Lippmann, S. (2020). Pharmacotherapy for Insomnia. In K. Sedky, R. Nazir, & D. Bennett (Eds.), Sleep Medicine and Mental Health: A Guide for Psychiatrists and Other Healthcare Professionals (pp. 101–128). Springer International Publishing. https://doi.org/10.1007/978-3-030-44447-1_6
Wang, J., Liu, S., Zhao, C., Han, H., Chen, X., Tao, J., & Lu, Z. (2020). Effects of Trazodone on Sleep Quality and Cognitive Function in Arteriosclerotic Cerebral Small Vessel Disease Comorbid With Chronic Insomnia. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00620
Wong, J., Murray Horwitz, M., Bertisch, S. M., Herzig, S. J., Buysse, D. J., & Toh, S. (2020). Trends in Dispensing of Zolpidem and Low-Dose Trazodone Among Commercially Insured Adults in the United States, 2011-2018. JAMA, 324(21), 2211–2213. https://doi.org/10.1001/jama.2020.19224