Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Introduction

In this paper, we examine the case study regarding bipolar disorder in Asian American Woman. A number of Asian American woman face this disorder. Conferring suicide in numerous Asian societies is viewed as a corrupt and insolent act to one’s folks and predecessors. Numerous Asian American women with despondency will express uninvolved self-destructive musings when addressed delicately. The Bipolar disorder refers to outrageous emotional instability through honest to goodness comes about for ordinary living of patients and their gatekeepers. The brain as ordinary primarily involves pharmacotherapy and solid treatment. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

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Regardless, countless shows a defective response to treatment and still experience the evil impacts of unending scenes, symptoms and poor social working. Both psychiatric and…

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1

Which decision did you select?

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Why did you select this decision? Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

2. Write paper addressing all section listed based on the decision tree.

Case Study: Bipolar Therapy for Client of Korean Descent/Ancestry:

BACKGROUND INFORMATION

The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”

She weight 110 lbs. and is 5′ 5″

SUBJECTIVE

Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.”

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work.

Genetic testing reveals that she is positive for CYP2D6*10 allele.

Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago.

MENTAL STATUS EXAM

The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation.

The Young Mania Rating Scale (YMRS) score is 22

RESOURCES

§ Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype & affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype & activity score systems. European Journal of Clinical Pharmacology, 71(7), 835-841. doi:10.1007/s00228-015-1855-6 Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Decisions Made and Outcomes (Needed to formulate the paper) 

Choices for Decision 1: Select what the PMHNP should do: Begin Lithium 300 mg orally BID, Begin Risperdal 1 mg orally BID, or Begin Seroquel XR 100 mg orally at HS.

My decision: I chose to begin Lithium 300 mg orally BID.

Outcome: RESULTS OF DECISION POINT ONE: Client returns to clinic in four weeks

Client informs the PMHNP that she has been taking her drug “off and on” only when she “feels like she needs it”

Today’s presentation is similar to the first day you met her

Choices for Decision 2: Select what the PMHNP should do:Increase Lithium to 450 mg orally BID, Assess rationale for non-compliance to elicit reason for non-compliance and educate client re: drug effects, and pharmacology, or Switch to Depakote ER 500 mg orally at HS.

My decision: I chose to switch to Depakote ER 500 mg orally at HS.

Outcome: RESULTS OF DECISION POINT TWO: Client returns to clinic in four weeks

Client reports that she has been compliant and you notice a marked reduction in manic symptoms. Young Mania Rating Scale was 11 (50% reduction from first office visit)

Client reports that she has gained 6 pounds over the last 4 weeks and wants to stop the medication because of this  Client returns to clinic in four weeks

Choices for Decision 3: Decision Point Three Select what the PMHNP should do next: Educate client regarding diet/weight loss and continue client on the same drug/dose, Decrease Depakote ER to 250 mg orally at HS, or Switch medication to Zyprexa 15 mg orally daily at HS

My decision: I choose to educate client regarding diet/weight loss and continue client on the same drug/dose

Outcome: Guidance to Student Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

The PMHNP should begin by educating the client regarding weight loss/and importance of diet/exercise while taking Depakote which can cause weight gain. Decreasing the dose of Depakote would not be appropriate as she still has symptoms and decreasing dose of Depakote may result in some weight loss, it may result in a return of manic symptoms. The PMHNP can switch to Zyprexa but if weight gain is the issue, then this will be compounded by Zyprexa which is associated with significant weight gain (up to 20 kg over a 24 month period).

 

Assignment: Assessing and Treating Clients with With Bipolar Disorder

Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for clients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) clients 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’s pathophysiology. For this Assessing and Treating Clients with With Bipolar Disorder Case study Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with bipolar disorder.

Learning Objectives

Students will:

• Assess client factors and history to develop personalized plans of bipolar therapy for clients
• Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring bipolar therapy
• Evaluate efficacy of treatment plans
• Assessing and Treating Clients with With Bipolar Disorder Case study Assignment
• Analyze ethical and legal implications related to prescribing bipolar therapy to clients across the lifespan ..

 

The Assignment

Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

• Decision #1
  • Which decision did you select?
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Assessing and Treating Clients with With Bipolar Disorder Case study Assignment
• Decision #2
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
• Decision #3
  • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
  • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Assessing and Treating Clients with With Bipolar Disorder Case study Assignment
  •  you can use my sample/ edit or do a new assignment.

you can edit or use my sample with same medication therapy.

Walden University .. 6630n

2 Assessing and Treatment for Bipolar Disorder Patient Introduction Bipolar disorder is not an uncommon illness. It is a very chronic and severe mental disorder, affecting approximately 1-2% of the adult population. The signs and symptoms of bipolar disorder are different depending on the type of episode (i.e., manic or depressive). Each episode marks a critical change from the way a person usually acts and their typical mood, and can be characterized by a sudden change in the general attitude of the patient, the way the patient thinks and the behavior. 1 The changes will be sudden that it will be noticed by people around (Robert et al., 2017). This dangerous demonstrative unpredictability mood disorder can be found in all area of life, that is, from the poor to the rich, this disorder affects millions of people in all facets of life (Robert et al., 2017). Bipolar disorder can be seen mostly in the age starting at 25years or older, but it is not totally absent in the teenage age. It shows that about 2.6 percent of the population are diagnosed as bipolar. 3 (National Alliance on Mental Illness, 2017). Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

If not well treated ,Bipolar disorder can be critical; 1 early identification of symptoms with an appropriate treatment plan may include psychotherapy, medications, a healthy lifestyle and a regular schedule will keep the patient healthy (National Alliance on Mental Illness. (2017). 1 The NP should have a good understand of this disorder to be able to take care of this the patient because of its long-term management and how it affects the health in totality (National Alliance on Mental Illness. (2017). 1 My focus of this paper will look into an Asian American Woman with a bipolar disorder, symptoms management, diagnosing the symptom, and the complete treatment. The paper will consider the most safe and appropriate options of treatment and the outcome as the treatment, and care.

Decision Selected My patient is an Asian American woman age 39 years with 4 children and 3 ground children. The husband notices that sometimes she will be singing loud to the top of her voice and dancing not to the music she sang. In another time she will just fill like not doing anything and nothing will interest her, and she will lay on the bed for hours without going to the business she spent her years building and love so much.Patient is withdrawn and non-interactive. 4 She is diagnosed Bipolar disorder.

1 Decision # 1 Reason Selected My best treatment of choice for this disorder will be to begin Risperdal 2 mg orally twice a day. Risperdal is the best choice to treat bipolar disorder. (Lee et al., 2011). Risperdal called risperidone is in the chemical class benzisoxazole derivatives which are antipsychotic. It is an effective medication for bipolar disorder (Lee et al., 2011). The reasons of choosing Risperdal is because it is used to treat schizophrenia and the risperidone works with the brain to stabilize the brain (Lee et al., 2011). Risperidone rebalances dopamine and serotonin to improve thinking, mood, and behavior. Risperidone belongs to a class of drugs called atypical antipsychotics approved by U.S. Food and Drug Administration (FDA) The drug is also used to treat symptoms of bipolar disorder and irritability (NAMI, 2017).

Expected Results We will need to have some subjective and objective changes. 1Patient should be able to verbalize changes within the first month of the treatment.

During the next visit with the patient after one month, she is expected to express changes in the clarity of her brain. The freedom from indistinctness or ambiguity because of the medicine will help her to balance certain natural substances in her brain.She should also notice a change in her ability to concentrate on her activities (Lee et al., 2011). No side effects. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Differences between Expected outcome and Actual outcome Patient came back after a month (4 WEEKS) and report that she experiences some improvement in the symptom including some improvement with concentration. My patient reported some drowsiness. 1 Drowsiness is one of the side effect of high dose of Risperdal. The genetic testing, reveals that she is positive for CYP2D6. Asians are more likely to have decreased CYP2D6 activity compared to Caucasians (Lee et al., 2011). I will reduce the dosage of this medication. 1 A positive outcome should be that there was a little bit of improvement in symptoms, patient able to sleep, more concentration. Patient and family report drowsiness during the day time which is one the side effect of high dose Risperdal.

Decision Point Two Reason Selected The next best option is not to discontinue Risperdal, but to lower dose to Risperdal 1 mg orally at hours of sleep (HS) since expected outcome was not achieved based on decision one. My patient and , her family reported that patient has been drowsy during the day because of Risperdal 2mg. I will continue on Risperdal because the patient confirm improvement on the symptoms and the side effect observed was a regular adverse reaction because of her descendant background (American Psychiatric Association, 2017). The reduction to Risperdal 1mg BID to Risperdal 1 mg will be closely monitor.

Expected Results Risperdal 1mg orally at bedtime is a reduced dosage from the 2mg which is expected to eliminate the drowsiness and toxicity in the patient Stahl, (2013).The patient is expected to continue to have decrease in the bipolar symptom. The effect of the medication should be observable and notice by the family member as a testimony (American Psychiatric Association, 2017).

Differences between Expected outcome and Actual outcome During the patient four weeks follow up examination shows that the bipolar disorder symptom dissipated to noticeable level. This indicate a therapeutic effect of Risperdal 1mg at night brought about the therapeutic effect on the patient and patient is tolerating and adjusting to the medication in a positive way (Dean, 2017). The patient did not experience the drowsiness and there was no toxicity, therefore the expected result and the actual result were the same. Risperdal therapy will continue with this medication and the dosage, and a close monitoring will still be needed until the next four weeks appointment (Dean, 2017).

Decision Point Three Decision Selected Risperdal 1mg orally at HS will be continued Reason for Selection The decision to continue with the medication was because the desire result, and the actual result are in pari-passu. To change the current medication or tamper with the dosage may offset the patient and thereby destabilize the rate of her healing (Dean, 2017). The patient is still under assessment and close monitoring continue until the next appointment date. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Expected Results It is expected that the patient will increase in good mental stability and continue to maintain reduction in bipolar disorder symptom with the dosage of Risperdal 1mg at night (Robert et al., 2017). The patient is anticipated to having good sleep at night and well improve in her interaction with relatives and friends, with ability to concentrate on matters that concern her and carrier (Robert et al., 2017).

Differences between Expected outcome and Actual outcome The therapeutic decision is working in this patient in accordance to the expectation. The treatment agrees with the standard way of treatment of an Asian descendant, the starting procedural treatment for bipolar disorder to the maintaining of such patient that are been positive for CYP2D6.The side effect of drowsiness in the day and toxicity is agreement with Asian descent (Robert et al., 2017). The patient will have to be place on the same medication till the next visit for examination. The actual result is that the medication is achieving the therapeutic effect that is needed by the patient (Dean, 2017).

Ethical Considerations for Treatment plan Ethics demand that a patient should agree to treatment before it could be administering unto the patient. The law concerning patient’s preferences for treatment are overlook when the patient is in jeopardy of life threatening or severe psychiatric illness. Psychiatric advance directives are employing to make decision on the patient (Srivastava, 2011). When a practitioner treating a patient with bipolar is confronted with ethical conflicts of helping the patient to attain best result or their autonomy. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment. The autonomy will be the choice of the practitioner (Srivastava, 2011). The law clearly stipulate that practitioners should always carefully consider what moral weight should be given to the values of doing well and avoiding harm (U.S. Food and Drug Administration, 2017).

2 Conclusion Psychiatric nurses should assess the function of the client not only during admission even during remission period and plan for rehabilitation services since functioning is a complex and demanding task. However, it is very important to bring back the client to his fullest possible level to normal life by planning effective psychoeducation about illness, communication training and teaching problem solving skills to client and family. 1 Many drugs are available for the treatment of bipolar disorder, but the professional will have to carefully select a medication that will be the best treatment for the patient. It is worth knowing that genetics influences the absorption of drugs, metabolism, excretion, and distribution. In the case study the Asian woman with positive CYP2D6 will exhibit a certain side effect which will not be in a patient with negative CYP2D6 (Dean, 2017). Therefore, the dosage and frequent of dispensing of drugs be based on the genetic testing (National Alliance on Mental Illness, 2017). The treatment of bipolar disorders in Asian descent must be handled carefully and in accordance with the Food and Drug Administration set guidelines (U.S. Food and Drug Administration, 2017). In conclusion the safety of the patient and the life of family and friends should be the paramount concern of the practitioners. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

References American Psychiatric Association. (2017). 1 Treatment of Patients with Bipolar Disorder.

Retrieved from: 1http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf Dean, L. (2017). 1 Risperidone Therapy and CYP2D6 Genotype. Retrieved from:

1 https://www.ncbi.nlm.nih.gov/books/NBK425795/ Lee, S. Y., Martins, S. S., Keyes, K. M., & Lee, H. B. (2011). 1 Mental Health Service Use by Persons of Asian Ancestry With DSM-IV Mental Disorders in the United States. Psychiatric Services (Washington, D.C.), 62(10), 1180–1186.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698479/ Nami National Alliance on Mental Illness. (2017). 1 What Is Risperdal and What Does It Treat? Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Retrieved from: 1 https://www.nami.org/learn-more/treatment/mental-health-medications/risperidone (Risperdal).

Robert, M., Keck, P., & David Solomon, D. (2017). 1 Bipolar disorder in adults:Choosing maintenance treatment. Retrieved from: 1https://www.uptodate.org/contents/bipolar-isorder-in-adults-choosing-maintenance-treatment Srivastava, S. (2011). Ethics Commentary: Bipolar Disorder: 1 Ethical Considerations in the Treatment of Bipolar Disorder. Retrieved from:

1 https://focus.psychiatryonline.org/doi/abs/10.1176/foc.9.4.foc461?journalCode=foc Stahl, S. M. (2013). 1 Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

U.S. 1 Food and Drug Administration. (2017). 1 The Facts on Bipolar Disorder and FDA- Approved Treatments. Retrieved from: 1https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm530107.htm

 

Bipolar Disorder

Introduction

In this paper, we examine the case study regarding bipolar disorder in Asian American Woman. A number of Asian American woman face this disorder. Conferring suicide in numerous Asian societies is viewed as a corrupt and insolent act to one’s folks and predecessors. Numerous Asian American women with despondency will express uninvolved self-destructive musings when addressed delicately. The Bipolar disorder refers to outrageous emotional instability through honest to goodness comes about for ordinary living of patients and their gatekeepers. The brain as ordinary primarily involves pharmacotherapy and solid treatment. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Regardless, countless shows a defective response to treatment and still experience the evil impacts of unending scenes, symptoms and poor social working. Both psychiatric and physical comorbid issue visits, especially personality issue, substance misuse, cardiovascular diseases, and diabetes. The multidisciplinary composed exertion of specialists is required to join all ability with a particular true objective to finish awesome consolidated treatment. A couple of audits have exhibited promising effects of composed treatment programs for patients with bipolar issue. We also present an ethical consideration to the decision regarding Bipolar disorder (Tondo L, 2013).

Decision 1.

My Decision

My first decision is to begin “Risperdal one mg orally Bis In Die (BID)”

 

Reason

Risperdal, whose logical name is risperidone, is a moment era or atypical antipsychotic whose utilizations incorporate treatment of the bipolar issue. It attempts to rebalance the dopamine and serotonin and along these lines enhancing inclination, considering and conduct. Since the patient was determined to have bipolar confusion, Risperdal is the best alternative considering the accessible prescriptions. In the past treatment, the patient defaulted in lithium. Thus it may not be a smart thought to start lithium 300 mg as chances are the patient may not go along. Seroquel XR might be a decent alternative yet its reactions may incorporate putting on of weight and obstruction (Martha Sajatovic, 2006). It may not be gotten well by the patient who defaulted in utilizing lithium that is the comparable reaction in stoppage. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Hope to Achieve

Inside the initial four weeks, patient ought to have the capacity to progress. The manifestations should diminish essentially incorporating a change in the state of mind. The patient ought to have the capacity to begin having great rest and getting a charge out of it. Risperdal is a powerful solution for adjusting mental action ought to have the capacity to re-establish rational soundness in the way the patient considers and responds to matters (Fountoulakis, 2014). The self-destructive practices should diminish, and also tension responds to matters. The self-destructive practices should diminish and also tension.

Real and Expected Outcomes

Following four weeks, the patient went to the doctor’s facility, and she was calmed and dormant. Truly, her mother needed to escort her and help her into the workplace. It accounted for that these indications ejected following one week of the drug. It is in opposition to the foreseen consequences of lessened bipolar side effects.

It was normal that the patient will have enhanced the state of mind and appropriate considering (Stahl, 2013). The distinction in the outcomes is because of the reactions of the medication. A high measure of Risperdal in the blood prompts sedation. The way that the patient is of Korean plunge and positive for “CYP2D6*10 allele” implies that she might not have quick freedom of Risperdal from the blood promoting aggregation.

Decision 2.

My Decision

My second decision is to reduce the “Risperdal to one mg at HS.”

Reason

The second visit does not demonstrate that the Risperdal 1 mg orally BID has neglected to work; it just gives the reactions. It is savvy to change the dose to deal with the symptoms instead of end the medicine for another. Changing Risperdal to 2 mg at HS may, in any case, turn out to be a great deal, and the reactions may not sufficiently oversee. A choice to change back to lithium is as yet not great as the patient still has a demeanor towards it (Chen R, 2015). Moreover, it may befuddle the patient and make her vibe that all medicine is terrible. Helping her adapt to an alternate dose of a similar medication will support her trust in drugs and comprehend that it is about the direction of the measurements. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Hope to Achieve

As said before, Risperdal effective in adjusting dopamine and serotonin in the brains and subsequently treating mind-set, conduct, and thought issues. The reactions have credited to the amassing of Risperdal in the blood of the patient. Diminishing the measurements to Risperdal 1 mg at HS will guarantee there is no collection of the medication in the blood of the patient as the body will have the capacity to discharge it effectively.

By changing the measurements, the patient should begin being less quieted and less dormant. The patient ought to likewise begin encountering a change in the disposition, have legitimate practices and also think well. It is the work of Risperdal when taken in the correct amounts. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Real and Expected Outcomes

Following four weeks, the patient went to, and she was less calmed and less lazy. Also, the Young Mania Rating Scale had diminished from 22 to 16. The patient revealed herself that she was not encountering whatever other reactions. These outcomes are fundamentally the same as the foreseen comes. Indeed, the reactions cleared very quicker than it thought and this the main distinction and fortunately in the positive bearing. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment. The outcomes are comparative because similarly as specified before, Risperdal is a powerful solution for bipolar turmoil (Miklowitz, 2012). The reactions couldn’t utilize as a reason for dumping the medication for this situation.

Decision 3.

My Decision

My third decision is to “continue at the same dose of the Risperdal.”

Reason

Now, the patient is reacting great to the present prescription. It is more prudent to endure with the dose as the evaluation keeps on taking note of any requirement for changing the medicine in any capacity. Besides, Risperdal I mg orally BID officially turned out to be heinous by the patient’s framework. Going back toward it, prompt the symptoms saw before. Changing to Latuda then again is not appropriate since FDA just affirms it for the treatment of bipolar 1. The patient’s condition is not steady with bipolar 1.

The medication is additionally extremely costly and may not be moderate to the patient. In this manner, it is insightful to proceed with a similar measurement of Risperdal and just change when it is vital.

Hope to Achieve

Since a patient has reacted decidedly to the treatment by Risperdal, it is normal that nonstop utilization of this medication will bring about much further lessening of the bipolar manifestations. The principal moment yielded a more than twenty-five rate diminishment in side effects; in this way, the lessening ought to be around 50% by the fourth week (Vitiello, 2013). The patient ought to have great rest, an enhanced state of mind, ordinary conduct and legitimate manner of thinking. The symptoms experienced in the main measurements not anticipate that would happen once more.

Real and Expected Outcomes

As indicated by exhortation given after the third choice, the ordinary outcomes will be that the patient will accomplish a critical dynamic lessening of the side effects. It will prompt the cure of bipolar issue if the Risperdal keeps on working adequately at this measurement. These are comparative outcomes to those expected when the dose was directing. Given consistency in the pharmacodynamics and pharmacokinetics, these ought to be the outcomes, and the objectives of treatment will accomplish.

Ethical Consideration

In healthcare, the ethical considerations assume a major part in treatment arrange. When managing patients having bipolar confusion, moral contemplations come midway to the way the PMHNP approaches the treatment. For the most part, the patient is temperamental rationally, and in this manner, the PMHNP needs to know the best approach to introduce any data to them and an opportunity.

For this situation, moral contemplations influenced the way the patient was directed to keep utilizing Risperdal in an alternate measurement after the first had caused sedation and dormancy (Roger D. Weiss, 2011). While picking between the medications to utilize, moral contemplations were at the center since a few medications are known for certain reactions to various drops of individuals. For example, Seroquel XL is known for stoppage and drying of mouth. The patient had whined of comparable reactions when she utilized lithium in her past medicine. Moral contemplations request that the PMHNP considers the long haul impacts this may realize; like harm of the teeth. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

Conclusion

The bipolar issue is a dubious condition to analyze due to the numerous indications that look like manifestations for another mental issue. In the treatment of this condition, due contemplations should make with regards to the reactions of the medications utilized. Moral contemplations are likewise fundamental to the treatment anticipate bipolar confusion given the mental flimsiness of the patient. There are drugs known for the treatment of bipolar issue; in any case, the PMHNP should know about which tranquilize is appropriate and the measurement for each particular bipolar issue persistent. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment.

 

References

Chen R, W. H. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology.

Fountoulakis, K. N. (2014). Bipolar Disorder: An Evidence-Based Guide to Manic Depression. Springer.

Martha Sajatovic, M. S. (2006). Risperidone in the treatment of bipolar mania. Neuropsychiatr Dis Treat. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment

Miklowitz, D. J. (2012). Integrated Group Therapy for Bipolar Disorder and Substance Abuse. The American Journal of Psychiatry.

Roger D. Weiss, H. S. (2011). Integrated Group Therapy for Bipolar Disorder and Substance Abuse. Guilford Press.

Stahl, S. M. (2013). Stahl’s Essential Psychopharmacology: Neuroscientific Basis and Practical Applications. Cambridge University Press.

Tondo L, I. G. (2013). Suicidal behaviour in bipolar disorde. CNS Drugs.

Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder. CNS Drugs. Assessing and Treating Clients with With Bipolar Disorder Case study Assignment