Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients 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\u2019s pathophysiology. For this Assignment, as you examine the patient case study in this week\u2019s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.<\/p>\n
Resources<\/strong><\/h2>\nBe sure to review the Learning Resources before completing this activity.
\nClick the weekly resources link to access the resources.<\/p>\n
WEEKLY RESOURCES<\/strong><\/a><\/h2>\nTo prepare for this Assignment:<\/strong><\/h3>\n\n- Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n
- Reflect on the psychopharmacologic treatments<\/a> you might recommend for the assessment and treatment of patients requiring bipolar therapy.<\/li>\n<\/ul>\n
The Assignment: 5 pages<\/strong><\/h2>\nFor this assignment, you will write a 5\u20136-page paper on the topic of bipolar and bipolar and related disorders.\u00a0You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.<\/p>\n
In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance\/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:<\/p>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/a><\/span><\/h3>\n\n- Prevalence and Neurobiology of your chosen disorder<\/li>\n
- Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria<\/li>\n
- Discuss special populations and considerations (children, adolescents, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:\u00a0 legal considerations, ethical considerations, cultural considerations, social determinants of health<\/li>\n
- Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder<\/li>\n
- Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.\u00a0 What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring<\/li>\n
- Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.<\/em><\/p>\nReminder<\/strong>: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center <\/a><\/p>\nLinks to an external site.<\/a> provides an example of those required elements (available at\u00a0 https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632<\/a>). All papers submitted must use this formatting.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nTitle: <\/strong> NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nIn the provided case study, the 8-year-old Caucasian female patient came to the clinic accompanied by her parents for psychiatric evaluation. The patient’s teacher suggested that the patient might be having attention deficit hyperactivity disorder (ADHD). Their family physician also suggested that the patient should see a psychiatrist for further evaluation of her mental disorder. The patient parents came with a completed Conner\u2019s Teacher Rating Scale-Revised screening tool, which revealed that the patient is easily distracted at school, and with a short attention span. The patient also displayed poor arithmetic, spelling, and reading skills in addition to being inattentive and forgetful most of the time. Her teacher claims that the patient even failing to complete her homework will lack interest in school activities. She also fails to follow instructions at times. Despite the patient’s parents being in denial that their daughter has ADHD, mental status examination results proved otherwise together with the Conner\u2019s Teacher Rating Scale-Revised screening tool completed by the teacher, supporting the diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n![\"NURS](\"https:\/\/nursingassignmentcrackers.com\/wp-content\/uploads\/2023\/03\/NURS-6630-Assessing-and-Treating-Patients-With-Bipolar-Disorder-Assignment-300x145.png\")
NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/figcaption><\/figure>\nDeveloping a treatment plan for pediatric patients with mental disorders is quite challenging given the safety issues associated with this age group. However, appropriate prescriptive practice will involve considering patient-specific factors that might affect the pharmacokinetic and pharmacodynamic processes. Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. The purpose of this discussion is thus to demonstrate the appropriate decision-making process in the selection of the most appropriate intervention in the treatment of the 8-year-old attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n
Decision Point One<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>From the listed options, initiating Ritalin (methylphenidate) 10mg chewable tablets taken every morning was decided on as the initial intervention. Ritalin is recommended by most clinical guidelines as the first-line medication for the management of ADHD among both children and adults (Rodrigues et al., 2021). Despite the psychostimulant not being approved by the FDA, it has displayed great effectiveness in the management of ADHD with a desirable safety profile in most children from ages 6 to 15 years (American Psychiatric Association, 2013; Castells et al., 2021)). It has demonstrated a substantial impact in managing ADHD symptoms such as inattention, forgetfulness, impulsivity, diminished interest, and hyperactivity among children (Hodgkins et al., 2012). The chewable formulation is considered the best option for children with sweeteners to mask the bitter taste of the drug (Breaux et al., 2022). Consequently, the drug has a short onset of action of between 1 to 2 hours with a long duration of action of between 7.5 to 10.5 hours after oral administration (Mechler et al., 2021). This helps in the management of the patient’s symptoms all day long (Coghill et al., 2021).<\/p>\nBupropion is associated with increased risks of seizures among children below the age of 10 years, hence not an appropriate decision (Coghill et al., 2021). Intuniv on the other hand is associated with cardiovascular side effects, hence should only be considered in case there is no other safer and more effective drug for use in the pediatric population (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe patient will experience improved symptoms of ADHD in the next four weeks (Coghill et al., 2021). She should be able to improve her spelling, arithmetic, and language skills, in addition to being more attentive and able to concentrate on school work (Hodgkins et al., 2012). Her school performance will improve significantly within this period.<\/p>\n
Ethical Considerations<\/strong><\/h2>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The patient is 8 years of age, which gives the parents legal responsibility of making decisions concerning the health of their child (American Psychiatric Association, 2013). As such, the PMHNP must educate them adequately regarding the patient’s diagnosis and potential treatment options, to promote sound decision-making in promoting the health of their child (Rodrigues et al., 2021).<\/p>\nDecision Point Two<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The second decision was to change the treatment regimen to long-acting Ritalin 20mg administered orally in the morning. Based on the treatment outcome, Ritalin displayed potential effectiveness given that the patient’s ADHD symptoms improved evidenced by her improved school performance (Breaux et al., 2022). However, since the medication was not able to manage the patient’s symptoms throughout the entire day, it was necessary to introduce a long-acting formulation to prolong the duration of action of the drug (American Psychiatric Association, 2013). Studies show that long-acting Ritalin lasts for between 8 to 12 hours hence, helps in managing the patient’s symptoms throughout the day (Castells et al., 2021). It is also administered once daily which is more convenient and much easier. The patient also reported a side effect of elevated pulse, which is a common self-limiting side effect of Ritalin that is expected to diminish with time (Coghill et al., 2021).<\/p>\nContinuing with the same drug at the same dosage was inappropriate as the patient would still exhibit ADHD symptoms later in the day, once the drug wears off from the body system (Mechler et al., 2021). Replacing Ritalin with Adderall is also inappropriate as Adderall is associated with increased incidences of suicidal events when used among children (Hodgkins et al., 2012).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe long-acting formulation is expected to manage the patient’s symptoms all day long within the following four weeks (Breaux et al., 2022). The patient’s school performance will improve even further. The side effect of elevated heart rate will resolve completely within this time (Coghill et al., 2021).<\/p>\n
Ethical Considerations<\/strong><\/h2>\nIn making this decision, the PMHNP had to consider several ethical principles including justice, beneficence, nonmaleficence, and respect for the patient’s autonomy (Breaux et al., 2022). The patient was quite comfortable with how the drug was working, but only concerned with the side effect, and effectiveness of the medication later in the day (Rodrigues et al., 2021). As such, it was necessary to respect the patient and display clinical judgment in making decisions that will promote the patient’s mental health.<\/p>\n
Decision Point Three<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\nMaintaining the patient on the current medication and reevaluating after four weeks, seemed to be the most appropriate decision for the third intervention. The patient reported great effectiveness and tolerance to the medication, with resolved side effects of an elevated pulse (Mechler et al., 2021). Previous evidence shows that once the optimal dose of Ritalin has been attained, it can take between 8 to 12 weeks to completely manage the patient’s symptoms of ADHD (American Psychiatric Association, 2013; Castells et al., 2021). Consequently, at safe doses, long-term use of the drug has been associated with limited possibilities of side effects, hence the need to reevaluate the patient within 4 weeks (Hodgkins et al., 2012). Studies also show that long-term use of Ritalin normally reduces the risks of side effects as the patient will display further tolerance to the drug, enhancing its safety profile (Breaux et al., 2022).<\/p>\n
Increasing the dose of Ritalin to 30mg was not necessary at this point, as studies suggest that low effective doses are safer to use to promote positive outcomes, with reduced risks of side effects (Mechler et al., 2021). Consequently, obtaining EKG at this point was not necessary given that the patient’s pulse had already resolved back to normal for her age, with a recording of 92 during the current visit (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nWith great compliance to the treatment regimen, the patient will report even further management of the ADHD symptoms over the following two weeks (Breaux et al., 2022). Her academic performance is also expected to improve (American Psychiatric Association, 2013). No side effects are expected.<\/p>\n
Ethical Considerations<\/strong><\/h2>\nThe nurse’s main objective is to promote the health of the patient and not harm. At this point, the patient was satisfied with the treatment outcome (Hodgkins et al., 2012). It was thus necessary to respect the patient’s autonomy and maintain the dose for further evaluation of the treatment outcome (Mechler et al., 2021).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nThe 8-year-old patient in the case study presented with symptoms of ADHD. Formulating a treatment plan for the patient involved consideration of certain patient-specific factors which affect her pharmacokinetic and pharmacodynamic processes (American Psychiatric Association, 2013). Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. Based on these factors, the first decision was to initiate a 10mg Ritalin chewable table once daily as recommended by most clinical guidelines given its effectiveness in the management of ADHD and safety for pediatric use (Coghill et al., 2021). Intuniv and bupropion were neglected because of their increased risks of side effects among children as reported by most studies (Mechler et al., 2021). After 4 weeks, the patient came back to the clinic reporting improved symptoms but with side effects of increased pulse rate. The second decision was thus to change the treatment regimen to long-acting Ritalin 20mg once daily in the morning, to prolong the duration of action of the medication throughout the day (Castells et al., 2021). Maintaining the dose would still lead to ineffectiveness, while Adderall display increased risks of suicidality hence neglected (Breaux et al., 2022).<\/p>\n
The patient reported further improvement in ADHD symptoms all day long, with resolved side effects of elevated pulse, which led to the final decision of maintaining the treatment regimen and reevaluating the patient after 4 weeks. Obtaining EKG and increasing the dose of Ritalin was not necessarily due to safety issues (Hodgkins et al., 2012). Finally, the PMHNP encountered several ethical considerations in each decision process with the observation of ethical principles such as justice, respect for patient autonomy, not harm, and beneficence (Rodrigues et al., 2021).<\/p>\n
<\/p>\n
References NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:\/\/doi.org\/10.1176\/appi.books.9780890425596<\/a><\/p>\nBreaux, R., Dunn, N. C., Swanson, C. S., Larkin, E., Waxmonsky, J., & Baweja, M. D. (2022). A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD.\u00a0Frontiers in Psychiatry<\/em>, 151. https:\/\/doi.org\/10.3389\/fpsyt.2022.794044<\/a><\/p>\nCastells, X., Ramon, M., Cunill, R., Oliv\u00e9, C., & Serrano, D. (2021). Relationship between treatment duration and efficacy of pharmacological treatment for ADHD: a meta-analysis and meta-regression of 87 randomized controlled clinical trials.\u00a0Journal of attention disorders<\/em>,\u00a025<\/em>(10), 1352-1361. https:\/\/doi.org\/10.1177\/1087054720903372<\/a><\/p>\nCoghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., … & Simonoff, E. (2021). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG).\u00a0European Child & Adolescent Psychiatry<\/em>, 1-25. https:\/\/doi.org\/10.1007\/s00787-021-01871-x<\/a><\/p>\nHodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245\u2013268. https:\/\/doi.org\/10.2165\/11599630-000000000-00000<\/a><\/p>\nMechler, K., Banaschewski, T., Hohmann, S., & H\u00e4ge, A. (2021). Evidence-based pharmacological treatment options for ADHD in children and adolescents.\u00a0Pharmacology & Therapeutics<\/em>, 107940. https:\/\/doi.org\/10.1016\/j.pharmthera.2021.107940<\/a><\/p>\nRodrigues, R., Lai, M. C., Beswick, A., Gorman, D. A., Anagnostou, E., Szatmari, P., … & Ameis, S. H. (2021). Practitioner Review: Pharmacological treatment of attention\u2010deficit\/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta\u2010analysis.\u00a0Journal of Child Psychology and Psychiatry<\/em>,\u00a062<\/em>(6), 680-700. https:\/\/doi.org\/10.1111\/jcpp.13305<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week5_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis criterion is linked to a Learning Outcome Write a 5\u20136-page paper on the topic of bipolar and bipolar related disorders: \u2022 Prevalence \u2022 Neurobiology<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion is vague regarding Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is missing one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or missing more than one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM version older than DSM 5 TR criteria.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is vague in differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria and\/or missing discussion presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or does not include the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss special populations and considerations (children, adolescent, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder-be specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Special Populations and Considerations are discussed and specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Special Populations and Considerations are discussed not specific, but general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Special Populations Considerations are discussed not specific, but general and missing 1-2 of EACH category and does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Special Populations Considerations are vaguley or not discussed, not specific, is inaccurate and\/or general and missing 3+ or more of or none of EACH category, inaccurate discussion and\/or does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder \u2022 Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues with why important formonitoring.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes vague FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is vague discussion regarding side effects, FDA approvals and warnings. Paper includes vague discussion what is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion includes pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is missing elements for discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion inaccurate and\/or missing pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is inaccurate or no elements for discussion regarding side effects, FDA approvals and warnings. Paper does not include what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 1-2 elements of the following; date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Provides two examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 3 of the following: date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Provides one example of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 4+ or is inaccurately written for date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014English writing standards: Correct grammar, mechanics, and punctuation; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources; Paper is 5-6 pages not counting title page and reference page.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources. Paper is 5-6 pages not counting title page and reference page.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (one or two) grammar, spelling, and punctuation errors; includes the following: title page and reference page. Only contains 2 scholarly supporting resources outside of course provided resources. Paper is 4 pages not counting title page and reference page.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (three or four) grammar, spelling, and punctuation errors; missing one of the following; title page or reference page; only contains 1 scholaraly supporting resources outside of course provided. Paper is 3 pages or exceeds to page 7 not counting title page and reference page.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 five) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding; missing the following; title page and reference page; contains no scholaraly supporting resources outside of course provided resources. Paper is 2 pages or exceeds 8 pages not counting title page and reference page.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\nClick the weekly resources link to access the resources.<\/p>\n
To prepare for this Assignment:<\/strong><\/h3>\n\n- Review this week\u2019s Learning Resources, including the Medication Resources indicated for this week.<\/li>\n
- Reflect on the psychopharmacologic treatments<\/a> you might recommend for the assessment and treatment of patients requiring bipolar therapy.<\/li>\n<\/ul>\n
The Assignment: 5 pages<\/strong><\/h2>\nFor this assignment, you will write a 5\u20136-page paper on the topic of bipolar and bipolar and related disorders.\u00a0You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.<\/p>\n
In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance\/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:<\/p>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/a><\/span><\/h3>\n\n- Prevalence and Neurobiology of your chosen disorder<\/li>\n
- Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria<\/li>\n
- Discuss special populations and considerations (children, adolescents, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:\u00a0 legal considerations, ethical considerations, cultural considerations, social determinants of health<\/li>\n
- Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder<\/li>\n
- Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.\u00a0 What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring<\/li>\n
- Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.<\/em><\/p>\nReminder<\/strong>: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center <\/a><\/p>\nLinks to an external site.<\/a> provides an example of those required elements (available at\u00a0 https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632<\/a>). All papers submitted must use this formatting.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nTitle: <\/strong> NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nIn the provided case study, the 8-year-old Caucasian female patient came to the clinic accompanied by her parents for psychiatric evaluation. The patient’s teacher suggested that the patient might be having attention deficit hyperactivity disorder (ADHD). Their family physician also suggested that the patient should see a psychiatrist for further evaluation of her mental disorder. The patient parents came with a completed Conner\u2019s Teacher Rating Scale-Revised screening tool, which revealed that the patient is easily distracted at school, and with a short attention span. The patient also displayed poor arithmetic, spelling, and reading skills in addition to being inattentive and forgetful most of the time. Her teacher claims that the patient even failing to complete her homework will lack interest in school activities. She also fails to follow instructions at times. Despite the patient’s parents being in denial that their daughter has ADHD, mental status examination results proved otherwise together with the Conner\u2019s Teacher Rating Scale-Revised screening tool completed by the teacher, supporting the diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\nNURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/figcaption><\/figure>\nDeveloping a treatment plan for pediatric patients with mental disorders is quite challenging given the safety issues associated with this age group. However, appropriate prescriptive practice will involve considering patient-specific factors that might affect the pharmacokinetic and pharmacodynamic processes. Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. The purpose of this discussion is thus to demonstrate the appropriate decision-making process in the selection of the most appropriate intervention in the treatment of the 8-year-old attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n
Decision Point One<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>From the listed options, initiating Ritalin (methylphenidate) 10mg chewable tablets taken every morning was decided on as the initial intervention. Ritalin is recommended by most clinical guidelines as the first-line medication for the management of ADHD among both children and adults (Rodrigues et al., 2021). Despite the psychostimulant not being approved by the FDA, it has displayed great effectiveness in the management of ADHD with a desirable safety profile in most children from ages 6 to 15 years (American Psychiatric Association, 2013; Castells et al., 2021)). It has demonstrated a substantial impact in managing ADHD symptoms such as inattention, forgetfulness, impulsivity, diminished interest, and hyperactivity among children (Hodgkins et al., 2012). The chewable formulation is considered the best option for children with sweeteners to mask the bitter taste of the drug (Breaux et al., 2022). Consequently, the drug has a short onset of action of between 1 to 2 hours with a long duration of action of between 7.5 to 10.5 hours after oral administration (Mechler et al., 2021). This helps in the management of the patient’s symptoms all day long (Coghill et al., 2021).<\/p>\nBupropion is associated with increased risks of seizures among children below the age of 10 years, hence not an appropriate decision (Coghill et al., 2021). Intuniv on the other hand is associated with cardiovascular side effects, hence should only be considered in case there is no other safer and more effective drug for use in the pediatric population (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe patient will experience improved symptoms of ADHD in the next four weeks (Coghill et al., 2021). She should be able to improve her spelling, arithmetic, and language skills, in addition to being more attentive and able to concentrate on school work (Hodgkins et al., 2012). Her school performance will improve significantly within this period.<\/p>\n
Ethical Considerations<\/strong><\/h2>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The patient is 8 years of age, which gives the parents legal responsibility of making decisions concerning the health of their child (American Psychiatric Association, 2013). As such, the PMHNP must educate them adequately regarding the patient’s diagnosis and potential treatment options, to promote sound decision-making in promoting the health of their child (Rodrigues et al., 2021).<\/p>\nDecision Point Two<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The second decision was to change the treatment regimen to long-acting Ritalin 20mg administered orally in the morning. Based on the treatment outcome, Ritalin displayed potential effectiveness given that the patient’s ADHD symptoms improved evidenced by her improved school performance (Breaux et al., 2022). However, since the medication was not able to manage the patient’s symptoms throughout the entire day, it was necessary to introduce a long-acting formulation to prolong the duration of action of the drug (American Psychiatric Association, 2013). Studies show that long-acting Ritalin lasts for between 8 to 12 hours hence, helps in managing the patient’s symptoms throughout the day (Castells et al., 2021). It is also administered once daily which is more convenient and much easier. The patient also reported a side effect of elevated pulse, which is a common self-limiting side effect of Ritalin that is expected to diminish with time (Coghill et al., 2021).<\/p>\nContinuing with the same drug at the same dosage was inappropriate as the patient would still exhibit ADHD symptoms later in the day, once the drug wears off from the body system (Mechler et al., 2021). Replacing Ritalin with Adderall is also inappropriate as Adderall is associated with increased incidences of suicidal events when used among children (Hodgkins et al., 2012).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe long-acting formulation is expected to manage the patient’s symptoms all day long within the following four weeks (Breaux et al., 2022). The patient’s school performance will improve even further. The side effect of elevated heart rate will resolve completely within this time (Coghill et al., 2021).<\/p>\n
Ethical Considerations<\/strong><\/h2>\nIn making this decision, the PMHNP had to consider several ethical principles including justice, beneficence, nonmaleficence, and respect for the patient’s autonomy (Breaux et al., 2022). The patient was quite comfortable with how the drug was working, but only concerned with the side effect, and effectiveness of the medication later in the day (Rodrigues et al., 2021). As such, it was necessary to respect the patient and display clinical judgment in making decisions that will promote the patient’s mental health.<\/p>\n
Decision Point Three<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\nMaintaining the patient on the current medication and reevaluating after four weeks, seemed to be the most appropriate decision for the third intervention. The patient reported great effectiveness and tolerance to the medication, with resolved side effects of an elevated pulse (Mechler et al., 2021). Previous evidence shows that once the optimal dose of Ritalin has been attained, it can take between 8 to 12 weeks to completely manage the patient’s symptoms of ADHD (American Psychiatric Association, 2013; Castells et al., 2021). Consequently, at safe doses, long-term use of the drug has been associated with limited possibilities of side effects, hence the need to reevaluate the patient within 4 weeks (Hodgkins et al., 2012). Studies also show that long-term use of Ritalin normally reduces the risks of side effects as the patient will display further tolerance to the drug, enhancing its safety profile (Breaux et al., 2022).<\/p>\n
Increasing the dose of Ritalin to 30mg was not necessary at this point, as studies suggest that low effective doses are safer to use to promote positive outcomes, with reduced risks of side effects (Mechler et al., 2021). Consequently, obtaining EKG at this point was not necessary given that the patient’s pulse had already resolved back to normal for her age, with a recording of 92 during the current visit (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nWith great compliance to the treatment regimen, the patient will report even further management of the ADHD symptoms over the following two weeks (Breaux et al., 2022). Her academic performance is also expected to improve (American Psychiatric Association, 2013). No side effects are expected.<\/p>\n
Ethical Considerations<\/strong><\/h2>\nThe nurse’s main objective is to promote the health of the patient and not harm. At this point, the patient was satisfied with the treatment outcome (Hodgkins et al., 2012). It was thus necessary to respect the patient’s autonomy and maintain the dose for further evaluation of the treatment outcome (Mechler et al., 2021).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nThe 8-year-old patient in the case study presented with symptoms of ADHD. Formulating a treatment plan for the patient involved consideration of certain patient-specific factors which affect her pharmacokinetic and pharmacodynamic processes (American Psychiatric Association, 2013). Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. Based on these factors, the first decision was to initiate a 10mg Ritalin chewable table once daily as recommended by most clinical guidelines given its effectiveness in the management of ADHD and safety for pediatric use (Coghill et al., 2021). Intuniv and bupropion were neglected because of their increased risks of side effects among children as reported by most studies (Mechler et al., 2021). After 4 weeks, the patient came back to the clinic reporting improved symptoms but with side effects of increased pulse rate. The second decision was thus to change the treatment regimen to long-acting Ritalin 20mg once daily in the morning, to prolong the duration of action of the medication throughout the day (Castells et al., 2021). Maintaining the dose would still lead to ineffectiveness, while Adderall display increased risks of suicidality hence neglected (Breaux et al., 2022).<\/p>\n
The patient reported further improvement in ADHD symptoms all day long, with resolved side effects of elevated pulse, which led to the final decision of maintaining the treatment regimen and reevaluating the patient after 4 weeks. Obtaining EKG and increasing the dose of Ritalin was not necessarily due to safety issues (Hodgkins et al., 2012). Finally, the PMHNP encountered several ethical considerations in each decision process with the observation of ethical principles such as justice, respect for patient autonomy, not harm, and beneficence (Rodrigues et al., 2021).<\/p>\n
<\/p>\n
References NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:\/\/doi.org\/10.1176\/appi.books.9780890425596<\/a><\/p>\nBreaux, R., Dunn, N. C., Swanson, C. S., Larkin, E., Waxmonsky, J., & Baweja, M. D. (2022). A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD.\u00a0Frontiers in Psychiatry<\/em>, 151. https:\/\/doi.org\/10.3389\/fpsyt.2022.794044<\/a><\/p>\nCastells, X., Ramon, M., Cunill, R., Oliv\u00e9, C., & Serrano, D. (2021). Relationship between treatment duration and efficacy of pharmacological treatment for ADHD: a meta-analysis and meta-regression of 87 randomized controlled clinical trials.\u00a0Journal of attention disorders<\/em>,\u00a025<\/em>(10), 1352-1361. https:\/\/doi.org\/10.1177\/1087054720903372<\/a><\/p>\nCoghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., … & Simonoff, E. (2021). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG).\u00a0European Child & Adolescent Psychiatry<\/em>, 1-25. https:\/\/doi.org\/10.1007\/s00787-021-01871-x<\/a><\/p>\nHodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245\u2013268. https:\/\/doi.org\/10.2165\/11599630-000000000-00000<\/a><\/p>\nMechler, K., Banaschewski, T., Hohmann, S., & H\u00e4ge, A. (2021). Evidence-based pharmacological treatment options for ADHD in children and adolescents.\u00a0Pharmacology & Therapeutics<\/em>, 107940. https:\/\/doi.org\/10.1016\/j.pharmthera.2021.107940<\/a><\/p>\nRodrigues, R., Lai, M. C., Beswick, A., Gorman, D. A., Anagnostou, E., Szatmari, P., … & Ameis, S. H. (2021). Practitioner Review: Pharmacological treatment of attention\u2010deficit\/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta\u2010analysis.\u00a0Journal of Child Psychology and Psychiatry<\/em>,\u00a062<\/em>(6), 680-700. https:\/\/doi.org\/10.1111\/jcpp.13305<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week5_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis criterion is linked to a Learning Outcome Write a 5\u20136-page paper on the topic of bipolar and bipolar related disorders: \u2022 Prevalence \u2022 Neurobiology<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion is vague regarding Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is missing one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or missing more than one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM version older than DSM 5 TR criteria.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is vague in differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria and\/or missing discussion presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or does not include the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss special populations and considerations (children, adolescent, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder-be specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Special Populations and Considerations are discussed and specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Special Populations and Considerations are discussed not specific, but general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Special Populations Considerations are discussed not specific, but general and missing 1-2 of EACH category and does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Special Populations Considerations are vaguley or not discussed, not specific, is inaccurate and\/or general and missing 3+ or more of or none of EACH category, inaccurate discussion and\/or does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder \u2022 Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues with why important formonitoring.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes vague FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is vague discussion regarding side effects, FDA approvals and warnings. Paper includes vague discussion what is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion includes pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is missing elements for discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion inaccurate and\/or missing pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is inaccurate or no elements for discussion regarding side effects, FDA approvals and warnings. Paper does not include what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 1-2 elements of the following; date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Provides two examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 3 of the following: date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Provides one example of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 4+ or is inaccurately written for date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014English writing standards: Correct grammar, mechanics, and punctuation; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources; Paper is 5-6 pages not counting title page and reference page.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources. Paper is 5-6 pages not counting title page and reference page.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (one or two) grammar, spelling, and punctuation errors; includes the following: title page and reference page. Only contains 2 scholarly supporting resources outside of course provided resources. Paper is 4 pages not counting title page and reference page.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (three or four) grammar, spelling, and punctuation errors; missing one of the following; title page or reference page; only contains 1 scholaraly supporting resources outside of course provided. Paper is 3 pages or exceeds to page 7 not counting title page and reference page.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 five) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding; missing the following; title page and reference page; contains no scholaraly supporting resources outside of course provided resources. Paper is 2 pages or exceeds 8 pages not counting title page and reference page.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
The Assignment: 5 pages<\/strong><\/h2>\nFor this assignment, you will write a 5\u20136-page paper on the topic of bipolar and bipolar and related disorders.\u00a0You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.<\/p>\n
In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance\/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:<\/p>\n
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/a><\/span><\/h3>\n\n- Prevalence and Neurobiology of your chosen disorder<\/li>\n
- Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria<\/li>\n
- Discuss special populations and considerations (children, adolescents, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:\u00a0 legal considerations, ethical considerations, cultural considerations, social determinants of health<\/li>\n
- Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder<\/li>\n
- Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.\u00a0 What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring<\/li>\n
- Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.<\/em><\/p>\nReminder<\/strong>: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center <\/a><\/p>\nLinks to an external site.<\/a> provides an example of those required elements (available at\u00a0 https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632<\/a>). All papers submitted must use this formatting.<\/p>\nBy Day 7<\/strong><\/h2>\nSubmit<\/strong> your Assignment.<\/p>\nsubmission information<\/strong><\/h3>\nBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n\n- To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nTitle: <\/strong> NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nIn the provided case study, the 8-year-old Caucasian female patient came to the clinic accompanied by her parents for psychiatric evaluation. The patient’s teacher suggested that the patient might be having attention deficit hyperactivity disorder (ADHD). Their family physician also suggested that the patient should see a psychiatrist for further evaluation of her mental disorder. The patient parents came with a completed Conner\u2019s Teacher Rating Scale-Revised screening tool, which revealed that the patient is easily distracted at school, and with a short attention span. The patient also displayed poor arithmetic, spelling, and reading skills in addition to being inattentive and forgetful most of the time. Her teacher claims that the patient even failing to complete her homework will lack interest in school activities. She also fails to follow instructions at times. Despite the patient’s parents being in denial that their daughter has ADHD, mental status examination results proved otherwise together with the Conner\u2019s Teacher Rating Scale-Revised screening tool completed by the teacher, supporting the diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\nNURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/figcaption><\/figure>\nDeveloping a treatment plan for pediatric patients with mental disorders is quite challenging given the safety issues associated with this age group. However, appropriate prescriptive practice will involve considering patient-specific factors that might affect the pharmacokinetic and pharmacodynamic processes. Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. The purpose of this discussion is thus to demonstrate the appropriate decision-making process in the selection of the most appropriate intervention in the treatment of the 8-year-old attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n
Decision Point One<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>From the listed options, initiating Ritalin (methylphenidate) 10mg chewable tablets taken every morning was decided on as the initial intervention. Ritalin is recommended by most clinical guidelines as the first-line medication for the management of ADHD among both children and adults (Rodrigues et al., 2021). Despite the psychostimulant not being approved by the FDA, it has displayed great effectiveness in the management of ADHD with a desirable safety profile in most children from ages 6 to 15 years (American Psychiatric Association, 2013; Castells et al., 2021)). It has demonstrated a substantial impact in managing ADHD symptoms such as inattention, forgetfulness, impulsivity, diminished interest, and hyperactivity among children (Hodgkins et al., 2012). The chewable formulation is considered the best option for children with sweeteners to mask the bitter taste of the drug (Breaux et al., 2022). Consequently, the drug has a short onset of action of between 1 to 2 hours with a long duration of action of between 7.5 to 10.5 hours after oral administration (Mechler et al., 2021). This helps in the management of the patient’s symptoms all day long (Coghill et al., 2021).<\/p>\nBupropion is associated with increased risks of seizures among children below the age of 10 years, hence not an appropriate decision (Coghill et al., 2021). Intuniv on the other hand is associated with cardiovascular side effects, hence should only be considered in case there is no other safer and more effective drug for use in the pediatric population (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe patient will experience improved symptoms of ADHD in the next four weeks (Coghill et al., 2021). She should be able to improve her spelling, arithmetic, and language skills, in addition to being more attentive and able to concentrate on school work (Hodgkins et al., 2012). Her school performance will improve significantly within this period.<\/p>\n
Ethical Considerations<\/strong><\/h2>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The patient is 8 years of age, which gives the parents legal responsibility of making decisions concerning the health of their child (American Psychiatric Association, 2013). As such, the PMHNP must educate them adequately regarding the patient’s diagnosis and potential treatment options, to promote sound decision-making in promoting the health of their child (Rodrigues et al., 2021).<\/p>\nDecision Point Two<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The second decision was to change the treatment regimen to long-acting Ritalin 20mg administered orally in the morning. Based on the treatment outcome, Ritalin displayed potential effectiveness given that the patient’s ADHD symptoms improved evidenced by her improved school performance (Breaux et al., 2022). However, since the medication was not able to manage the patient’s symptoms throughout the entire day, it was necessary to introduce a long-acting formulation to prolong the duration of action of the drug (American Psychiatric Association, 2013). Studies show that long-acting Ritalin lasts for between 8 to 12 hours hence, helps in managing the patient’s symptoms throughout the day (Castells et al., 2021). It is also administered once daily which is more convenient and much easier. The patient also reported a side effect of elevated pulse, which is a common self-limiting side effect of Ritalin that is expected to diminish with time (Coghill et al., 2021).<\/p>\nContinuing with the same drug at the same dosage was inappropriate as the patient would still exhibit ADHD symptoms later in the day, once the drug wears off from the body system (Mechler et al., 2021). Replacing Ritalin with Adderall is also inappropriate as Adderall is associated with increased incidences of suicidal events when used among children (Hodgkins et al., 2012).<\/p>\n
Expected Outcome<\/strong><\/h2>\nThe long-acting formulation is expected to manage the patient’s symptoms all day long within the following four weeks (Breaux et al., 2022). The patient’s school performance will improve even further. The side effect of elevated heart rate will resolve completely within this time (Coghill et al., 2021).<\/p>\n
Ethical Considerations<\/strong><\/h2>\nIn making this decision, the PMHNP had to consider several ethical principles including justice, beneficence, nonmaleficence, and respect for the patient’s autonomy (Breaux et al., 2022). The patient was quite comfortable with how the drug was working, but only concerned with the side effect, and effectiveness of the medication later in the day (Rodrigues et al., 2021). As such, it was necessary to respect the patient and display clinical judgment in making decisions that will promote the patient’s mental health.<\/p>\n
Decision Point Three<\/strong><\/h2>\nSelected Decision and Rationale<\/strong><\/h3>\nMaintaining the patient on the current medication and reevaluating after four weeks, seemed to be the most appropriate decision for the third intervention. The patient reported great effectiveness and tolerance to the medication, with resolved side effects of an elevated pulse (Mechler et al., 2021). Previous evidence shows that once the optimal dose of Ritalin has been attained, it can take between 8 to 12 weeks to completely manage the patient’s symptoms of ADHD (American Psychiatric Association, 2013; Castells et al., 2021). Consequently, at safe doses, long-term use of the drug has been associated with limited possibilities of side effects, hence the need to reevaluate the patient within 4 weeks (Hodgkins et al., 2012). Studies also show that long-term use of Ritalin normally reduces the risks of side effects as the patient will display further tolerance to the drug, enhancing its safety profile (Breaux et al., 2022).<\/p>\n
Increasing the dose of Ritalin to 30mg was not necessary at this point, as studies suggest that low effective doses are safer to use to promote positive outcomes, with reduced risks of side effects (Mechler et al., 2021). Consequently, obtaining EKG at this point was not necessary given that the patient’s pulse had already resolved back to normal for her age, with a recording of 92 during the current visit (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\nWith great compliance to the treatment regimen, the patient will report even further management of the ADHD symptoms over the following two weeks (Breaux et al., 2022). Her academic performance is also expected to improve (American Psychiatric Association, 2013). No side effects are expected.<\/p>\n
Ethical Considerations<\/strong><\/h2>\nThe nurse’s main objective is to promote the health of the patient and not harm. At this point, the patient was satisfied with the treatment outcome (Hodgkins et al., 2012). It was thus necessary to respect the patient’s autonomy and maintain the dose for further evaluation of the treatment outcome (Mechler et al., 2021).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nThe 8-year-old patient in the case study presented with symptoms of ADHD. Formulating a treatment plan for the patient involved consideration of certain patient-specific factors which affect her pharmacokinetic and pharmacodynamic processes (American Psychiatric Association, 2013). Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. Based on these factors, the first decision was to initiate a 10mg Ritalin chewable table once daily as recommended by most clinical guidelines given its effectiveness in the management of ADHD and safety for pediatric use (Coghill et al., 2021). Intuniv and bupropion were neglected because of their increased risks of side effects among children as reported by most studies (Mechler et al., 2021). After 4 weeks, the patient came back to the clinic reporting improved symptoms but with side effects of increased pulse rate. The second decision was thus to change the treatment regimen to long-acting Ritalin 20mg once daily in the morning, to prolong the duration of action of the medication throughout the day (Castells et al., 2021). Maintaining the dose would still lead to ineffectiveness, while Adderall display increased risks of suicidality hence neglected (Breaux et al., 2022).<\/p>\n
The patient reported further improvement in ADHD symptoms all day long, with resolved side effects of elevated pulse, which led to the final decision of maintaining the treatment regimen and reevaluating the patient after 4 weeks. Obtaining EKG and increasing the dose of Ritalin was not necessarily due to safety issues (Hodgkins et al., 2012). Finally, the PMHNP encountered several ethical considerations in each decision process with the observation of ethical principles such as justice, respect for patient autonomy, not harm, and beneficence (Rodrigues et al., 2021).<\/p>\n
<\/p>\n
References NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\nAmerican Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:\/\/doi.org\/10.1176\/appi.books.9780890425596<\/a><\/p>\nBreaux, R., Dunn, N. C., Swanson, C. S., Larkin, E., Waxmonsky, J., & Baweja, M. D. (2022). A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD.\u00a0Frontiers in Psychiatry<\/em>, 151. https:\/\/doi.org\/10.3389\/fpsyt.2022.794044<\/a><\/p>\nCastells, X., Ramon, M., Cunill, R., Oliv\u00e9, C., & Serrano, D. (2021). Relationship between treatment duration and efficacy of pharmacological treatment for ADHD: a meta-analysis and meta-regression of 87 randomized controlled clinical trials.\u00a0Journal of attention disorders<\/em>,\u00a025<\/em>(10), 1352-1361. https:\/\/doi.org\/10.1177\/1087054720903372<\/a><\/p>\nCoghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., … & Simonoff, E. (2021). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG).\u00a0European Child & Adolescent Psychiatry<\/em>, 1-25. https:\/\/doi.org\/10.1007\/s00787-021-01871-x<\/a><\/p>\nHodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245\u2013268. https:\/\/doi.org\/10.2165\/11599630-000000000-00000<\/a><\/p>\nMechler, K., Banaschewski, T., Hohmann, S., & H\u00e4ge, A. (2021). Evidence-based pharmacological treatment options for ADHD in children and adolescents.\u00a0Pharmacology & Therapeutics<\/em>, 107940. https:\/\/doi.org\/10.1016\/j.pharmthera.2021.107940<\/a><\/p>\nRodrigues, R., Lai, M. C., Beswick, A., Gorman, D. A., Anagnostou, E., Szatmari, P., … & Ameis, S. H. (2021). Practitioner Review: Pharmacological treatment of attention\u2010deficit\/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta\u2010analysis.\u00a0Journal of Child Psychology and Psychiatry<\/em>,\u00a062<\/em>(6), 680-700. https:\/\/doi.org\/10.1111\/jcpp.13305<\/a><\/p>\nNURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment Rubric<\/h2>\n
\n\n\nNURS_6630_Week5_Assignment_Rubric<\/td>\n<\/tr>\n \nCriteria<\/strong><\/td>\nRatings<\/strong><\/td>\nPts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n\nThis criterion is linked to a Learning Outcome Write a 5\u20136-page paper on the topic of bipolar and bipolar related disorders: \u2022 Prevalence \u2022 Neurobiology<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion is vague regarding Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is missing one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or missing more than one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM version older than DSM 5 TR criteria.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion is vague in differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria and\/or missing discussion presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or does not include the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss special populations and considerations (children, adolescent, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder-be specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n \n\n\n\n20 to >17.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Special Populations and Considerations are discussed and specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
17 to >15.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Special Populations and Considerations are discussed not specific, but general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
15 to >13.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Special Populations Considerations are discussed not specific, but general and missing 1-2 of EACH category and does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
13 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Special Populations Considerations are vaguley or not discussed, not specific, is inaccurate and\/or general and missing 3+ or more of or none of EACH category, inaccurate discussion and\/or does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome \u2022 Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder \u2022 Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Discussion includes FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues with why important formonitoring.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Discussion includes vague FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is vague discussion regarding side effects, FDA approvals and warnings. Paper includes vague discussion what is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Discussion includes pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is missing elements for discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Discussion inaccurate and\/or missing pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is inaccurate or no elements for discussion regarding side effects, FDA approvals and warnings. Paper does not include what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n \n\n\n\n15 to >13.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
13 to >11.0 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 1-2 elements of the following; date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
11 to >9.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Provides two examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 3 of the following: date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
9 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Provides one example of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 4+ or is inaccurately written for date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nThis criterion is linked to a Learning Outcome Written Expression and Formatting\u2014English writing standards: Correct grammar, mechanics, and punctuation; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources; Paper is 5-6 pages not counting title page and reference page.<\/td>\n \n\n\n\n5 to >4.0 pts<\/p>\nExcellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources. Paper is 5-6 pages not counting title page and reference page.<\/td>\n
4 to >3.5 pts<\/p>\nGood Point range: 80\u201389<\/p>\n
Contains a few (one or two) grammar, spelling, and punctuation errors; includes the following: title page and reference page. Only contains 2 scholarly supporting resources outside of course provided resources. Paper is 4 pages not counting title page and reference page.<\/td>\n
3.5 to >3.0 pts<\/p>\nFair Point range: 70\u201379<\/p>\n
Contains several (three or four) grammar, spelling, and punctuation errors; missing one of the following; title page or reference page; only contains 1 scholaraly supporting resources outside of course provided. Paper is 3 pages or exceeds to page 7 not counting title page and reference page.<\/td>\n
3 to >0 pts<\/p>\nPoor Point range: 0\u201369<\/p>\n
Contains many (\u2265 five) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding; missing the following; title page and reference page; contains no scholaraly supporting resources outside of course provided resources. Paper is 2 pages or exceeds 8 pages not counting title page and reference page.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \nTotal Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
- \n
- Prevalence and Neurobiology of your chosen disorder<\/li>\n
- Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria<\/li>\n
- Discuss special populations and considerations (children, adolescents, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category:\u00a0 legal considerations, ethical considerations, cultural considerations, social determinants of health<\/li>\n
- Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder<\/li>\n
- Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings.\u00a0 What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring<\/li>\n
- Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.<\/li>\n<\/ul>\n
Note:<\/em><\/strong> Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.<\/em><\/p>\n
Reminder<\/strong>: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center <\/a><\/p>\n
Links to an external site.<\/a> provides an example of those required elements (available at\u00a0 https:\/\/academicguides.waldenu.edu\/writingcenter\/templates\/general#s-lg-box-20293632<\/a>). All papers submitted must use this formatting.<\/p>\n
By Day 7<\/strong><\/h2>\n
Submit<\/strong> your Assignment.<\/p>\n
submission information<\/strong><\/h3>\n
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts<\/strong> from the Start Here<\/strong> area.<\/p>\n
- \n
- To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial<\/strong><\/li>\n
- Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- Next, click on Upload File<\/strong> and select Submit Assignment<\/strong> for review.<\/li>\n<\/ol>\n
A Sample Answer For the Assignment: NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\n
Title: <\/strong> NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\n
In the provided case study, the 8-year-old Caucasian female patient came to the clinic accompanied by her parents for psychiatric evaluation. The patient’s teacher suggested that the patient might be having attention deficit hyperactivity disorder (ADHD). Their family physician also suggested that the patient should see a psychiatrist for further evaluation of her mental disorder. The patient parents came with a completed Conner\u2019s Teacher Rating Scale-Revised screening tool, which revealed that the patient is easily distracted at school, and with a short attention span. The patient also displayed poor arithmetic, spelling, and reading skills in addition to being inattentive and forgetful most of the time. Her teacher claims that the patient even failing to complete her homework will lack interest in school activities. She also fails to follow instructions at times. Despite the patient’s parents being in denial that their daughter has ADHD, mental status examination results proved otherwise together with the Conner\u2019s Teacher Rating Scale-Revised screening tool completed by the teacher, supporting the diagnosis of attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n
NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/figcaption><\/figure>\n Developing a treatment plan for pediatric patients with mental disorders is quite challenging given the safety issues associated with this age group. However, appropriate prescriptive practice will involve considering patient-specific factors that might affect the pharmacokinetic and pharmacodynamic processes. Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. The purpose of this discussion is thus to demonstrate the appropriate decision-making process in the selection of the most appropriate intervention in the treatment of the 8-year-old attention deficit hyperactivity disorder (ADHD), predominantly inattentive presentation.<\/p>\n
Decision Point One<\/strong><\/h2>\n
Selected Decision and Rationale<\/strong><\/h3>\n
\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>From the listed options, initiating Ritalin (methylphenidate) 10mg chewable tablets taken every morning was decided on as the initial intervention. Ritalin is recommended by most clinical guidelines as the first-line medication for the management of ADHD among both children and adults (Rodrigues et al., 2021). Despite the psychostimulant not being approved by the FDA, it has displayed great effectiveness in the management of ADHD with a desirable safety profile in most children from ages 6 to 15 years (American Psychiatric Association, 2013; Castells et al., 2021)). It has demonstrated a substantial impact in managing ADHD symptoms such as inattention, forgetfulness, impulsivity, diminished interest, and hyperactivity among children (Hodgkins et al., 2012). The chewable formulation is considered the best option for children with sweeteners to mask the bitter taste of the drug (Breaux et al., 2022). Consequently, the drug has a short onset of action of between 1 to 2 hours with a long duration of action of between 7.5 to 10.5 hours after oral administration (Mechler et al., 2021). This helps in the management of the patient’s symptoms all day long (Coghill et al., 2021).<\/p>\n
Bupropion is associated with increased risks of seizures among children below the age of 10 years, hence not an appropriate decision (Coghill et al., 2021). Intuniv on the other hand is associated with cardiovascular side effects, hence should only be considered in case there is no other safer and more effective drug for use in the pediatric population (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\n
The patient will experience improved symptoms of ADHD in the next four weeks (Coghill et al., 2021). She should be able to improve her spelling, arithmetic, and language skills, in addition to being more attentive and able to concentrate on school work (Hodgkins et al., 2012). Her school performance will improve significantly within this period.<\/p>\n
Ethical Considerations<\/strong><\/h2>\n
\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The patient is 8 years of age, which gives the parents legal responsibility of making decisions concerning the health of their child (American Psychiatric Association, 2013). As such, the PMHNP must educate them adequately regarding the patient’s diagnosis and potential treatment options, to promote sound decision-making in promoting the health of their child (Rodrigues et al., 2021).<\/p>\n
Decision Point Two<\/strong><\/h2>\n
Selected Decision and Rationale<\/strong><\/h3>\n
\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>The second decision was to change the treatment regimen to long-acting Ritalin 20mg administered orally in the morning. Based on the treatment outcome, Ritalin displayed potential effectiveness given that the patient’s ADHD symptoms improved evidenced by her improved school performance (Breaux et al., 2022). However, since the medication was not able to manage the patient’s symptoms throughout the entire day, it was necessary to introduce a long-acting formulation to prolong the duration of action of the drug (American Psychiatric Association, 2013). Studies show that long-acting Ritalin lasts for between 8 to 12 hours hence, helps in managing the patient’s symptoms throughout the day (Castells et al., 2021). It is also administered once daily which is more convenient and much easier. The patient also reported a side effect of elevated pulse, which is a common self-limiting side effect of Ritalin that is expected to diminish with time (Coghill et al., 2021).<\/p>\n
Continuing with the same drug at the same dosage was inappropriate as the patient would still exhibit ADHD symptoms later in the day, once the drug wears off from the body system (Mechler et al., 2021). Replacing Ritalin with Adderall is also inappropriate as Adderall is associated with increased incidences of suicidal events when used among children (Hodgkins et al., 2012).<\/p>\n
Expected Outcome<\/strong><\/h2>\n
The long-acting formulation is expected to manage the patient’s symptoms all day long within the following four weeks (Breaux et al., 2022). The patient’s school performance will improve even further. The side effect of elevated heart rate will resolve completely within this time (Coghill et al., 2021).<\/p>\n
Ethical Considerations<\/strong><\/h2>\n
In making this decision, the PMHNP had to consider several ethical principles including justice, beneficence, nonmaleficence, and respect for the patient’s autonomy (Breaux et al., 2022). The patient was quite comfortable with how the drug was working, but only concerned with the side effect, and effectiveness of the medication later in the day (Rodrigues et al., 2021). As such, it was necessary to respect the patient and display clinical judgment in making decisions that will promote the patient’s mental health.<\/p>\n
Decision Point Three<\/strong><\/h2>\n
Selected Decision and Rationale<\/strong><\/h3>\n
Maintaining the patient on the current medication and reevaluating after four weeks, seemed to be the most appropriate decision for the third intervention. The patient reported great effectiveness and tolerance to the medication, with resolved side effects of an elevated pulse (Mechler et al., 2021). Previous evidence shows that once the optimal dose of Ritalin has been attained, it can take between 8 to 12 weeks to completely manage the patient’s symptoms of ADHD (American Psychiatric Association, 2013; Castells et al., 2021). Consequently, at safe doses, long-term use of the drug has been associated with limited possibilities of side effects, hence the need to reevaluate the patient within 4 weeks (Hodgkins et al., 2012). Studies also show that long-term use of Ritalin normally reduces the risks of side effects as the patient will display further tolerance to the drug, enhancing its safety profile (Breaux et al., 2022).<\/p>\n
Increasing the dose of Ritalin to 30mg was not necessary at this point, as studies suggest that low effective doses are safer to use to promote positive outcomes, with reduced risks of side effects (Mechler et al., 2021). Consequently, obtaining EKG at this point was not necessary given that the patient’s pulse had already resolved back to normal for her age, with a recording of 92 during the current visit (Rodrigues et al., 2021).<\/p>\n
Expected Outcome<\/strong><\/h2>\n
With great compliance to the treatment regimen, the patient will report even further management of the ADHD symptoms over the following two weeks (Breaux et al., 2022). Her academic performance is also expected to improve (American Psychiatric Association, 2013). No side effects are expected.<\/p>\n
Ethical Considerations<\/strong><\/h2>\n
The nurse’s main objective is to promote the health of the patient and not harm. At this point, the patient was satisfied with the treatment outcome (Hodgkins et al., 2012). It was thus necessary to respect the patient’s autonomy and maintain the dose for further evaluation of the treatment outcome (Mechler et al., 2021).<\/p>\n
Conclusion NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\n
The 8-year-old patient in the case study presented with symptoms of ADHD. Formulating a treatment plan for the patient involved consideration of certain patient-specific factors which affect her pharmacokinetic and pharmacodynamic processes (American Psychiatric Association, 2013). Such factors which will affect the decision on which drugs to prescribe include the patient young age, Caucasian race, female gender, ADHD diagnosis, and presenting symptoms. Based on these factors, the first decision was to initiate a 10mg Ritalin chewable table once daily as recommended by most clinical guidelines given its effectiveness in the management of ADHD and safety for pediatric use (Coghill et al., 2021). Intuniv and bupropion were neglected because of their increased risks of side effects among children as reported by most studies (Mechler et al., 2021). After 4 weeks, the patient came back to the clinic reporting improved symptoms but with side effects of increased pulse rate. The second decision was thus to change the treatment regimen to long-acting Ritalin 20mg once daily in the morning, to prolong the duration of action of the medication throughout the day (Castells et al., 2021). Maintaining the dose would still lead to ineffectiveness, while Adderall display increased risks of suicidality hence neglected (Breaux et al., 2022).<\/p>\n
The patient reported further improvement in ADHD symptoms all day long, with resolved side effects of elevated pulse, which led to the final decision of maintaining the treatment regimen and reevaluating the patient after 4 weeks. Obtaining EKG and increasing the dose of Ritalin was not necessarily due to safety issues (Hodgkins et al., 2012). Finally, the PMHNP encountered several ethical considerations in each decision process with the observation of ethical principles such as justice, respect for patient autonomy, not harm, and beneficence (Rodrigues et al., 2021).<\/p>\n
<\/p>\n
References NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment<\/strong><\/h2>\n
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https:\/\/doi.org\/10.1176\/appi.books.9780890425596<\/a><\/p>\n
Breaux, R., Dunn, N. C., Swanson, C. S., Larkin, E., Waxmonsky, J., & Baweja, M. D. (2022). A Mini-Review of Pharmacological and Psychosocial Interventions for Reducing Irritability Among Youth With ADHD.\u00a0Frontiers in Psychiatry<\/em>, 151. https:\/\/doi.org\/10.3389\/fpsyt.2022.794044<\/a><\/p>\n
Castells, X., Ramon, M., Cunill, R., Oliv\u00e9, C., & Serrano, D. (2021). Relationship between treatment duration and efficacy of pharmacological treatment for ADHD: a meta-analysis and meta-regression of 87 randomized controlled clinical trials.\u00a0Journal of attention disorders<\/em>,\u00a025<\/em>(10), 1352-1361. https:\/\/doi.org\/10.1177\/1087054720903372<\/a><\/p>\n
Coghill, D., Banaschewski, T., Cortese, S., Asherson, P., Brandeis, D., Buitelaar, J., … & Simonoff, E. (2021). The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG).\u00a0European Child & Adolescent Psychiatry<\/em>, 1-25. https:\/\/doi.org\/10.1007\/s00787-021-01871-x<\/a><\/p>\n
Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012). The pharmacology and clinical outcomes of amphetamines to treat ADHD: Does composition matter? CNS Drugs, 26(3), 245\u2013268. https:\/\/doi.org\/10.2165\/11599630-000000000-00000<\/a><\/p>\n
Mechler, K., Banaschewski, T., Hohmann, S., & H\u00e4ge, A. (2021). Evidence-based pharmacological treatment options for ADHD in children and adolescents.\u00a0Pharmacology & Therapeutics<\/em>, 107940. https:\/\/doi.org\/10.1016\/j.pharmthera.2021.107940<\/a><\/p>\n
Rodrigues, R., Lai, M. C., Beswick, A., Gorman, D. A., Anagnostou, E., Szatmari, P., … & Ameis, S. H. (2021). Practitioner Review: Pharmacological treatment of attention\u2010deficit\/hyperactivity disorder symptoms in children and youth with autism spectrum disorder: a systematic review and meta\u2010analysis.\u00a0Journal of Child Psychology and Psychiatry<\/em>,\u00a062<\/em>(6), 680-700. https:\/\/doi.org\/10.1111\/jcpp.13305<\/a><\/p>\n
NURS 6630 Assessing and Treating Patients With Bipolar Disorder Assignment Rubric<\/h2>\n
\n\n
\n NURS_6630_Week5_Assignment_Rubric<\/td>\n<\/tr>\n \n Criteria<\/strong><\/td>\n Ratings<\/strong><\/td>\n Pts <\/strong><\/td>\n<\/tr>\n<\/thead>\n\n \n This criterion is linked to a Learning Outcome Write a 5\u20136-page paper on the topic of bipolar and bipolar related disorders: \u2022 Prevalence \u2022 Neurobiology<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Discussion includes Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
17 to >15.0 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Discussion is vague regarding Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
15 to >13.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Discussion is missing one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n
13 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or missing more than one section for Prevalence and Neurobiology of chosen bipolar and related disorder.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome \u2022 Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria.<\/td>\n
17 to >15.0 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM version older than DSM 5 TR criteria.<\/td>\n
15 to >13.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Discussion is vague in differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria and\/or missing discussion presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n
13 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Discussion is inaccurate or does not include the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria or older version of DSM.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome \u2022 Discuss special populations and considerations (children, adolescent, pregnancy\/post-partum, older adult, emergency care) for your chosen bipolar and related disorder-be specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n \n \n\n
\n 20 to >17.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Special Populations and Considerations are discussed and specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
17 to >15.0 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Special Populations and Considerations are discussed not specific, but general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
15 to >13.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Special Populations Considerations are discussed not specific, but general and missing 1-2 of EACH category and does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n
13 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Special Populations Considerations are vaguley or not discussed, not specific, is inaccurate and\/or general and missing 3+ or more of or none of EACH category, inaccurate discussion and\/or does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
20 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome \u2022 Discuss FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder \u2022 Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n \n \n\n
\n 15 to >13.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Discussion includes FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues with why important formonitoring.<\/td>\n
13 to >11.0 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Discussion includes vague FDA and\/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is vague discussion regarding side effects, FDA approvals and warnings. Paper includes vague discussion what is important to monitor in terms of labs, comorbid medical issues with why important for monitoring.<\/td>\n
11 to >9.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Discussion includes pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is missing elements for discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n
9 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Discussion inaccurate and\/or missing pharmacological treatment options but not aligned with FDA approved and\/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is inaccurate or no elements for discussion regarding side effects, FDA approvals and warnings. Paper does not include what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n \n \n\n
\n 15 to >13.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
13 to >11.0 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Provides three examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 1-2 elements of the following; date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
11 to >9.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Provides two examples of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 3 of the following: date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n
9 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Provides one example of how to write a proper prescription that would be provided to patient and\/or transmitted to pharmacy. Prescription is missing 4+ or is inaccurately written for date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
15 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Written Expression and Formatting\u2014Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused\u2014neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.<\/td>\n \n \n\n
\n 5 to >4.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.<\/td>\n
4 to >3.5 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.<\/td>\n
3.5 to >3.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%\u201379% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic.<\/td>\n
3 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \n This criterion is linked to a Learning Outcome Written Expression and Formatting\u2014English writing standards: Correct grammar, mechanics, and punctuation; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources; Paper is 5-6 pages not counting title page and reference page.<\/td>\n \n \n\n
\n 5 to >4.0 pts<\/p>\n Excellent Point range: 90\u2013100<\/p>\n
Uses correct grammar, spelling, and punctuation with no errors; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources. Paper is 5-6 pages not counting title page and reference page.<\/td>\n
4 to >3.5 pts<\/p>\n Good Point range: 80\u201389<\/p>\n
Contains a few (one or two) grammar, spelling, and punctuation errors; includes the following: title page and reference page. Only contains 2 scholarly supporting resources outside of course provided resources. Paper is 4 pages not counting title page and reference page.<\/td>\n
3.5 to >3.0 pts<\/p>\n Fair Point range: 70\u201379<\/p>\n
Contains several (three or four) grammar, spelling, and punctuation errors; missing one of the following; title page or reference page; only contains 1 scholaraly supporting resources outside of course provided. Paper is 3 pages or exceeds to page 7 not counting title page and reference page.<\/td>\n
3 to >0 pts<\/p>\n Poor Point range: 0\u201369<\/p>\n
Contains many (\u2265 five) grammar, spelling, and punctuation errors that interfere with the reader\u2019s understanding; missing the following; title page and reference page; contains no scholaraly supporting resources outside of course provided resources. Paper is 2 pages or exceeds 8 pages not counting title page and reference page.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/td>\n
5 pts<\/td>\n<\/tr>\n \n Total Points: 100<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n - Then, click on Start Assignment<\/strong> near the top of the page.<\/li>\n
- To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial<\/strong><\/li>\n