Treatment For A Patient With a Common Condition Essay Paper

Treatment For A Patient With a Common Condition Essay Paper

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Discussion: Treatment for a Patient With a Common Condition
Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patientâ€s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being. Treatment For A Patient With a Common Condition Essay Paper

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For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patientâ€s health needs.
Case: An elderly widow who just lost her spouse.
Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husbandâ€s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: Treatment For A Patient With a Common Condition Essay Paper
• Metformin 500mg BID
• Januvia 100mg daily
• Losartan 100mg daily
• HCTZ 25mg daily
• Sertraline 100mg daily
Current weight: 88 kg
Current height: 64 inches
Temp: 98.6 degrees F
BP: 132/86
By Day 3 of Week 7
Post a response to each of the following:
• List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
• Identify people in the patientâ€s life you would need to speak to or get feedback from to further assess the patientâ€s situation. Include specific questions you might ask these people and why.
• Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
• List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
• List two pharmacologic agents and their dosing that would be appropriate for the patientâ€s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
• For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
• Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen. Treatment For A Patient With a Common Condition Essay Paper

Learning Resources

Required Readings (click to expand/reduce)

Freudenreich, O., Goff, D. C., & Henderson, D. C. (2016). Antipsychotic drugs. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 72–85). Elsevier.

American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophrenia. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/APA-Draft-Schizophrenia-Treatment-Guideline.pdf

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medications. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/Directories/Library-and-Archive/resource_documents/Resource-Document-2018-QTc-Prolongation-and-Psychotropic-Med.pdf

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/ Treatment For A Patient With a Common Condition Essay Paper

McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600-9/pdf

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002

Rubric Detail

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Name: NURS_6630_Week7_Discussion_Rubric

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• List View
Excellent

Point range: 90–100 Good

Point range: 80–89 Fair

Point range: 70–79 Poor

Point range: 0–69
Main Posting:

Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. 40 (40%) – 44 (44%)
Thoroughly responds to the Discussion question(s).

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

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

Supported by at least three current credible sources. 35 (35%) – 39 (39%)
Responds to most of the Discussion question(s).

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

50% of the post has exceptional depth and breadth.

Supported by at least three credible references. 31 (31%) – 34 (34%)
Responds to some of the Discussion question(s). Treatment For A Patient With a Common Condition Essay Paper

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

Is somewhat lacking reflection and critical analysis and synthesis.

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

Post is cited with fewer than two credible references. 0 (0%) – 30 (30%)
Does not respond to the Discussion question(s).

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

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

Contains only one or no credible references.
Main Posting:

Writing 6 (6%) – 6 (6%)
Written clearly and concisely.

Contains no grammatical or spelling errors.

Adheres to current APA manual writing rules and style. 5 (5%) – 5 (5%)
Written concisely.

May contain one to two grammatical or spelling errors.

Adheres to current APA manual writing rules and style. 4 (4%) – 4 (4%)
Written somewhat concisely.

May contain more than two spelling or grammatical errors.

Contains some APA formatting errors. 0 (0%) – 3 (3%)
Not written clearly or concisely.

Contains more than two spelling or grammatical errors.

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

Timely and full participation 9 (9%) – 10 (10%)
Meets requirements for timely, full, and active participation.

Posts main Discussion by due date. 8 (8%) – 8 (8%)
Posts main Discussion by due date.

Meets requirements for full participation. 7 (7%) – 7 (7%)
Posts main Discussion by due date. 0 (0%) – 6 (6%)
Does not meet requirements for full participation.

Does not post main Discussion by due date.
First Response: Treatment For A Patient With a Common Condition Essay Paper

Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%)
Response is on topic, may have some depth. 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
First Response:
Writing 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

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

Response is effectively written in Standard, Edited English. 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

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

Response is written in Standard, Edited English. 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.

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Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited. 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited. Treatment For A Patient With a Common Condition Essay Paper
First Response:
Timely and full participation 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.

Posts by due date. 4 (4%) – 4 (4%)
Meets requirements for full participation.

Posts by due date. 3 (3%) – 3 (3%)
Posts by due date. 0 (0%) – 2 (2%)
Does not meet requirements for full participation.

Does not post by due date.
Second Response:
Post to colleague’s main post that is reflective and justified with credible sources. 9 (9%) – 9 (9%)
Response exhibits critical thinking and application to practice settings.

Responds to questions posed by faculty.

The use of scholarly sources to support ideas demonstrates synthesis and understanding of learning objectives. 8 (8%) – 8 (8%)
Response has some depth and may exhibit critical thinking or application to practice setting. 7 (7%) – 7 (7%)
Response is on topic, may have some depth. 0 (0%) – 6 (6%)
Response may not be on topic, lacks depth.
Second Response:
Writing 6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.

Response to faculty questions are fully answered, if posed.

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

Response is effectively written in Standard, Edited English. 5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.

Response to faculty questions are mostly answered, if posed.

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

Response is written in Standard, Edited English. 4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.

Response to faculty questions are somewhat answered, if posed.

Few or no credible sources are cited. 0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.

Response to faculty questions are missing.

No credible sources are cited.
Second Response:
Timely and full participation 5 (5%) – 5 (5%)
Meets requirements for timely, full, and active participation.

Posts by due date. 4 (4%) – 4 (4%)
Meets requirements for full participation.

Posts by due date. 3 (3%) – 3 (3%)
Posts by due date. 0 (0%) – 2 (2%)
Does not meet requirements for full participation.

Does not post by due date.
Total Points: 100
Name: NURS_6630_Week7_Discussion_Rubric Treatment For A Patient With a Common Condition Essay Paper