Assessing and Treating Bipolar Disorder
NURS 6630N Walden College
Bipolar Disorder Prognosis and Remedy
Introduction
Bipolar dysfunction is a psychological situation that impacts folks of all ages, each male and feminine. Clinicians ought to select one of the best therapy choices based mostly on the affected person’s traits. For instance, lithium is without doubt one of the simplest medicines used to deal with bipolar dysfunction. Clinicians must also inform sufferers concerning the risks of lithium (Malhi et al., 2017). Lengthy-term use of lithium has an impact on the kidney and thyroid techniques. Clinicians must also take into consideration varied moral points so as to keep away from lawsuits. Bipolar dysfunction therapy entails choosing the right treatment and monitoring the affected person as they take it.
First determination
The primary determination is to check the varied medicines accessible to find out the best choice. Lithium 300mg orally BID, Risperdal 1 mg orally BID, and Seroquel XR 100 mg orally HS are among the many accessible choices. Lithium 300mg orally BID is the only option among the many three medicines for treating bipolar dysfunction with manic episodes. Lithium is a generally used treatment to deal with bipolar dysfunction (Malhi et al., 2017). It reduces the severity and frequency of mania and bipolar despair. Clinicians additionally advise sufferers to take the treatment to keep away from future manic episodes (Stahl, 2013). One more reason for selecting the 300mg Lithium dosage is that it’s efficient in feminine sufferers. Clinicians start therapy with a low dose to watch sufferers and cut back the severity of pharmacokinetic and pharmacodynamic negative effects (Ketter et al., 2016). To keep away from negative effects, a kidney and thyroid system analysis is required earlier than prescribing the drug. The treatment is prescribed with the expectation that the affected person will cut back the frequency and severity of manic episodes. One other expectation is that lithium will suppress signs similar to irritable temper, poor sleep high quality, uncommon frequency of speaking, organized ideas, and diminished distractions (Malhi et al., 2017). The affected person ought to have a decrease Younger Mania Score Scale, in line with expectations. In response to a medical analysis, the Younger Mania Score Scale is at present at 22. For instance, the affected person ought to report a low frequency of temper modifications and irritability. After 4 weeks of taking the treatment, sufferers’ interactions with friends and members of the family enhance (Stahl, 2013). She must also be free to go about her each day actions, similar to working, consuming, sleeping, cooking, and doing house responsibilities. After 4 weeks, the affected person returns to the clinic. She claims that she has seen little enchancment since beginning the treatment. She admits, nonetheless, that she has not been taking the treatment constantly. The affected person nonetheless has 22 factors on the Younger Mania Score Scale. Because of this, she has made no progress. One of many causes for the shortage of progress is the drug’s inconsistent administration. One more reason might be the treatment’s low dosage.
Determination No. 2
The second choice is to extend the dosage to 450mg orally BID. Randomized managed trials present that rising the dosage is efficient as a result of it will increase the drug’s therapeutic capacity (Findling et al., 2019). The second determination entails educating the affected person on the significance of taking Lithium treatment regularly. It’s crucial to find out why the affected person will not be taking the treatment constantly whereas educating the affected person (Stahl, 2013). One other determination is that the affected person take the treatment and return to the clinic 4 weeks later. In response to the researchers, 4 weeks is sufficient time for the Lithium drug to suppress the signs of bipolar dysfunction. The affected person’s signs ought to have improved 4 weeks after receiving a better dose of the drug. The affected person remains to be exhibiting signs like bipolar despair, hyperactivity, temper modifications, and aggression (Findling et al., 2019). Different signs embrace poor sleep high quality, poor interplay with friends, and a lack of urge for food. Lithium is an efficient treatment for the therapy of bipolar dysfunction, permitting sufferers to enhance their each day interactions and participation in fundamental duties (Findling et al., 2019). Because of this, it’s anticipated that the signs can have considerably improved after 4 weeks. The expectation is primarily to help the affected person in taking part in each day actions and bettering their high quality of life. After 4 weeks, the affected person returned to the clinic. The affected person’s presentation indicated that the expectations had been considerably exceeded. One of many outcomes was that the affected person admitted to taking the treatment regularly after turning into conscious. The affected person was happy that she had acquired the schooling and that the treatment had relieved her signs. One of many affected person’s enhancements was a discount in bipolar dysfunction, an enchancment in sleep high quality, urge for food, a lower in hyperactivity, and the power to take part in each day actions. As well as, the affected person’s Younger Mania Score Scale rating decreased. The affected person acquired 11 factors on the size, indicating a 50% enchancment in signs. The affected person additionally reported a weight acquire, which was anticipated. Weight acquire is a typical aspect impact of lithium therapy for bipolar dysfunction. One of many variations between the end result and the expectations is that the affected person solely improved by 50%. The distinction might be resulting from time, and if the affected person continues to take the drug for one more 4 weeks, she is going to enhance fully. – PhD Dissertation Writing Providers USA
Third determination
Determination #three is to maintain taking the treatment, Lithium 450mg orally BUD, as a result of it’s working properly for the affected person. In response to analysis, it takes a number of weeks for lithium to make a big distinction in a person. The one aspect impact is weight acquire, which is a typical aspect impact (Ketter et al., 2016). Altering the drug could also be dangerous to the affected person’s well being as a result of it could end in weight reduction. Dropping pounds is dangerous to the affected person’s well being as a result of it impairs their physique’s performance. Because of this, it’s crucial to stay with the drug and change it to handle weight after treating bipolar dysfunction. Lithium 450mg is a helpful treatment as a result of it prevents future manic and depressive episodes (Stahl, 2013). It’s also used as upkeep remedy for long-term therapy. The drug is efficient as a result of it regulates temper by appearing on the mind and central nervous system. Through the drug prescription for one more 4 weeks, you will need to notify the affected person about different negative effects in the course of the long-term administration of the drug. Sufferers ought to take Eight-12 glasses of water to keep away from lithium from affecting the thyroid or kidney operate (Ketter et al., 2016). The affected person must also keep away from exceeding regular salt ranges. Through the prescription, it was additionally essential to examine the extent of lithium focus within the affected person. The reason being that Lithium is metabolized otherwise in feminine sufferers in comparison with male sufferers (Stahl, 2013). Due to this fact, the dosage will be diminished as soon as the affected person improves considerably to keep away from antagonistic results. The expectation is that the affected person will manifest a 100 % enchancment in varied signs after 4 weeks. For instance, I anticipated the affected person to report higher high quality of sleeping, improved interplay with different folks and a discount in temper modifications. Analysis exhibits that the administration of Lithium for a number of weeks is efficient within the therapy of the bipolar dysfunction (Ketter et al., 2016). It’s also beneficial for sufferers with signs similar to delusions, hallucinations, hyperactivity, lack of sleep, and racing ideas. The end result of the therapy is that the affected person recorded a 100 % enchancment in signs. When the affected person returned to the clinic, the expressed their pleasure that that they had skilled higher high quality of sleep with no hallucinations. The affected person additionally participated in each day actions with out hyperactivity, temper modifications, and racing ideas. The expectations of the therapy had been met. Nevertheless, a decrease dosage of the drug will be prescribed or a distinct drug for therapeutic upkeep functions to stop the reoccurrence of the signs.
Moral Issues and Remedy
Moral concerns are essential throughout therapy to reinforce the standard of therapy and forestall lawsuits. One of many moral concerns in the course of the therapy is to coach the affected person concerning the results of Lithium medicine (Stahl, 2013). For instance, the antagonistic results of Lithium is including weight. The reason is crucial to discard therapeutic false impression. A affected person can be entitled to details about modifications in treatment or dosage and causes for the modifications. One other consideration is to get the knowledgeable consent of the affected person relating to therapy (Muir et al., 2019). The affected person ought to comply with obtain therapy and adjust to the therapy targets. Remedy of psychological situations additionally requires confidentiality. All of the details about the affected person must be saved confidential. Clinicians danger authorized implications if they don’t adjust to the privateness and confidentiality necessities within the therapy of psychological situations. Clinicians ought to observe the human rights of a affected person. Regardless of the medical situation of the affected person, it’s important to keep away from any violation of human rights or dignity. Healthcare suppliers must also present care whereas observing justice and equity (Muir et al., 2019). Equity means caring for all sufferers with none bias. Consequently, clinicians are suggested to keep away from any battle of curiosity similar to offering care to sufferers with whom they produce other relations (Stahl, 2013). For instance, a PMHNP could be unethical for caring for a member of the family. Moreover, PMHNP must be prepared to supply care to sufferers throughout emergencies. If a clinician fails to supply care, he could be deemed unethical (Muir et al., 2019). Due to this fact, the varied moral concerns are important to enhance the standard of therapy of psychological well being sufferers.
Conclusion
Remedy of bipolar requires a sequence of selections. A sequence of selections helps in monitoring the enhancements in a affected person. Lithium is without doubt one of the greatest medicines used to deal with bipolar problems. Through the prescription, you will need to educate a affected person about the necessity to take the treatment constantly. Sufferers must also adhere to the therapy to make sure higher outcomes. PMHNP ought to contemplate varied moral points that have an effect on the therapy of psychological situations similar to bipolar dysfunction. Remedy of the bipolar dysfunction is efficient when PMHNP select one of the best treatment among the many accessible selections and assess the outcomes for acceptable modifications.
References
Findling, R. L., McNamara, N. Okay., Pavuluri, M., Frazier, J. A., Rynn, M., Scheffer, R., … & Rowles, B. M. (2019). Lithium for the upkeep therapy of bipolar I problems: a double-blind, placebo-controlled discontinuation examine. Journal of the American Academy of Little one & Adolescent Psychiatry, 58(2), 287-296.
Ketter, T. A., Miller, S., Dell’Osso, B., & Wang, P. W. (2016). Remedy of bipolar dysfunction: Assessment of proof relating to quetiapine and lithium. Journal of Affective Problems, 191, 256-273.
Malhi, G. S., Gessler, D., & Outhred, T. (2017). Using lithium for the therapy of bipolar dysfunction: suggestions from medical apply pointers. Journal of Affective Problems, 217, 266-280.
Muir, H. J., Coyne, A. E., Morrison, N. R., Boswell, J. F., & Constantino, M. J. (2019). Moral implications of routine outcomes monitoring for sufferers, psychotherapists, and psychological well being care techniques. Psychotherapy, 56(four), 459.
Stahl, S. M. (2013). Stahl’s important psychopharmacology: Neuroscientific foundation and sensible purposes (4th ed.). New York, NY: Cambridge College Press.
