Assignment: Decision Tree for Neurological and Musculoskeletal Disorders<\/a><\/span><\/b>\u00a0<\/span><\/p>\n For your Assignment, your Instructor will assign you one of the decision tree interactive media pieces provided in the Resources. As you examine the patient case studies in this module\u2019s Resources, consider how you might assess and treat patients presenting symptoms of neurological and musculoskeletal disorders.<\/span>\u00a0<\/span><\/p>\n Photo Credit: KATERYNA KON\/SCIENCE PHOTO LIBRARY \/ Science Photo Library \/ Getty Images<\/span>\u00a0<\/span><\/p>\n To Prepare<\/span><\/b>\u00a0<\/span><\/p>\n By Day 7 of Week 8<\/span><\/b>\u00a0<\/span><\/p>\n Write a 1- to 2-page summary paper that addresses the following:<\/span>\u00a0<\/span><\/p>\n You will submit this Assignment in Week 8.<\/span><\/b>\u00a0<\/span><\/p>\n Submission and Grading Information<\/span><\/b>\u00a0<\/span><\/p>\n To submit your completed Assignment for review and grading, do the following:<\/span><\/b>\u00a0<\/span><\/p>\n Grading Criteria<\/span><\/b>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n To access your rubric:<\/span>\u00a0<\/span><\/p>\n Week 8 Assignment Rubric<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n Check Your Assignment Draft for Authenticity<\/span><\/b>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n To check your Assignment draft for authenticity:<\/span>\u00a0<\/span><\/p>\n Submit your Week 8 Assignment draft and review the originality report.<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n Submit Your Assignment by Day 7 of Week 8<\/span><\/b>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n To participate in this Assignment:<\/span>\u00a0<\/span><\/p>\n Week 8 Assignment<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for \u201cstrange behavior.\u201d Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad\u2019s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.\u00a0<\/span>\u00a0<\/span><\/p>\n According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client\u2019s son, the family noticed that Mr. Akkad\u2019s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more \u201ccritical\u201d of everyone. They also noticed that things he used to take seriously had become a source of \u201camusement\u201d and \u201cridicule.\u201d\u00a0<\/span>\u00a0<\/span><\/p>\n Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult \u201cfinding the right words\u201d in a conversation and then will shift to an entirely different line of conversation.\u00a0<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so you perform a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n Mr. Akkad is 76 year old Iranian male who is cooperative with today\u2019s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but \u201cwound up here\u201d- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad\u2019s standing up during the clinical interview and walking towards the door. When you asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.\u00a0<\/span>\u00a0<\/span><\/p>\n Alzheimer\u2019s is one of the most common progressive neurological disorders among the elderly caused by dementia. Patients will present with mild to moderate cognitive signs and symptoms at the onset of the disorder, which will progress to severe memory loss with time, as they grow much older (Li et al., 2019). However, several treatment options have been proven to be effective in the management of Alzheimer\u2019s disorder among the elderly. The purpose of this discussion is to illustrate the decision process in selecting the most effective drug, based on pharmacokinetic and pharmacodynamic factors, for treating an elderly patient diagnosed with Alzheimer\u2019s disease.<\/p>\n The assigned case study demonstrates a 76-year-old Iranian male with symptoms of Alzheimer\u2019s disorder. The patient displays strange behavior upon arrival at the clinic reporting symptoms of memory loss, forgetfulness, confusion, and diminished interest in religious activities for the last 2 years. Pharmacokinetic and pharmacodynamic patient factors which contributed to the selection of drugs for this patient include his advanced age, male gender, Iranian race, and presenting symptoms in addition to the mini-mental exam results of moderate dementia. the patient\u2019s diagnosis of Alzheimer\u2019s disorder will also be considered.<\/p>\n Based on the patient history and the pharmacokinetic and pharmacodynamic factors mentioned above, the most appropriate intervention is to initiate Exelon 1.5mg twice daily. Exelon (rivastigmine) is an FFDA-approved drug for treating mild to moderate Alzheimer\u2019s disease (Fish et al., 2019). Previous studies support great effectiveness, and safety profile for use of the drug among the elderly diagnosed with Alzheimer\u2019s (Khoury et al., 2018). The second decision was to increase the dose of Exelon to 4.5 mg twice daily as recommended by most clinical practice guidelines for patients who have displayed great tolerance but with minimal effectiveness. The last decision was to increase the dose further to 6mg twice daily, to promote optimal effectiveness as the patient still displayed limited remission of symptoms with the previous intervention.<\/p>\n Studies show that Exelon when administered appropriately takes between 8 to 12 weeks to completely manage symptoms of Alzheimer\u2019s among elderly patients. As such, with the initial intervention of 1.5mg Exelon twice daily, the patient was expected to display approximately 50% remission of symptoms (Nguyen et al., 2021). The dose was however to be titrated to obtain the optimum outcome, not exceeding 6mg twice daily. The same results were expected with the second and third interventions with no side effects expected.<\/p>\n Just like expected, the patient displayed a minimal reduction of symptoms of Alzheimer\u2019s with no side effects reported with the first intervention. After the dose was increased in the second intervention, the patient reported further remission of symptoms, but at a slow rate, hence increasing the dose in the last intervention, which led to optimal remission of Alzheimer\u2019s symptoms just as expected (Huang et al., 2020).<\/p>\n Alzheimer\u2019s is a common disorder among the elderly compromising their quality of life and well-being. For the patient in the provided case study, it was necessary to administer Exelon at a starting dose of 1.5 mg which was titrated to 4.5mg then 6.5mg twice daily. The patient displayed great effectiveness with this medication in the management of his Alzheimer\u2019s symptoms, with no side effects reported.<\/p>\n <\/p>\n Fish, P. V., Steadman, D., Bayle, E. D., & Whiting, P. (2019). New approaches for the treatment of Alzheimer\u2019s disease.\u00a0Bioorganic & medicinal chemistry letters<\/em>,\u00a029<\/em>(2), 125-133. https:\/\/doi.org\/10.1016\/j.bmcl.2018.11.034<\/a><\/p>\n Huang, L. K., Chao, S. P., & Hu, C. J. (2020). Clinical trials of new drugs for Alzheimer\u2019s disease.\u00a0Journal of biomedical science<\/em>,\u00a027<\/em>(1), 1-13. https:\/\/doi.org\/10.1186\/s12929-019-0609-7<\/a><\/p>\n Khoury, R., Rajamanickam, J., & Grossberg, G. T. (2018). An update on the safety of current therapies for Alzheimer\u2019s disease: focus on rivastigmine.\u00a0Therapeutic Advances in Drug Safety<\/em>,\u00a09<\/em>(3), 171-178. https:\/\/doi.org\/10.1177\/2042098617750555<\/a><\/p>\n Li, D. D., Zhang, Y. H., Zhang, W., & Zhao, P. (2019). Meta-analysis of randomized controlled trials on the efficacy and safety of donepezil, galantamine, rivastigmine, and memantine for the treatment of Alzheimer\u2019s disease.\u00a0Frontiers in neuroscience<\/em>,\u00a013<\/em>, 472. https:\/\/doi.org\/10.3389\/fnins.2019.00472<\/a><\/p>\n![\"NURS](\"http:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2024\/02\/Capture-2-4-300x59.png\")
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A Sample Answer For the Assignment: NURS 6521 Alzheimer\u2019s Disease 76-year-old Iranian Male Essay<\/strong><\/h2>\n
Title: NURS 6521 Alzheimer\u2019s Disease 76-year-old Iranian Male Essay<\/strong><\/h2>\n
BACKGROUND<\/span>\u00a0<\/span><\/h2>\n
SUBJECTIVE<\/span>\u00a0<\/span><\/h2>\n
MENTAL STATUS EXAM<\/span>\u00a0<\/span><\/h2>\n
A Sample Answer 2 For the Assignment: NURS 6521 Alzheimer\u2019s Disease 76-year-old Iranian Male Essay<\/strong><\/h2>\n
Title: NURS 6521 Alzheimer\u2019s Disease 76-year-old Iranian Male Essay<\/strong><\/h2>\n
Patient Case Study Summary<\/strong><\/h2>\n
Treatment Decisions<\/strong><\/h2>\n
Expected Outcome<\/strong><\/h2>\n
Difference Between Expected Outcome and Actual Outcome<\/strong><\/h2>\n
Conclusion<\/strong><\/h2>\n
References<\/strong><\/h2>\n