Week 5: Bipolar Disorders

I am finally doing everything right. I stayed up all night studying for my final exams and even managed to clean out my closet and order a whole new bedroom from the Internet. I know I will ace all my exams. Nothing can go wrong like they did a few months ago. I was so low and was sleeping all the time. I did not think I would ever be happy again, but now I know I can do anything.

Jessica, age 22

Bipolar disorder is relatively rare with around only 3% of the population diagnosed with one of them. Although being relatively rare in terms of lifetime prevalence, bipolar disorder is burdensome to the individual and health care system because of its early onset, severity, and chronic nature. The average age of onset is around 25 and affects men and women equally. The importance of evidence-based intervention for treatment in persons with bipolar disorder cannot be underestimated. Unstable mood can result in repeat chronic hospitalizations. Developing a good rapport and relationship with the client can make a difference in the course, symptom management, and stability of the person with bipolar disorder.

This week, you will once again become “cCaptain of the Sship” as you take full responsibility for a client with a bipolar disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs and community support, and recommending follow-up plans. You will use the decision tree format to justify your rationale for diagnosis, pharmacological treatment, and psychotherapy of a patient with a mental illness. You also will evaluate the results of your Fitzgerald University Exit Comprehensive Exam and, based on those results, develop a plan of action to prepare for the certification exam.

Learning Resources

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

• Standard 13 “Collaboration” (pages 78-79)

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

• Chapter 8, “Mood Disorders” (pp. 347–386)

Note: This is review from the Learning Resource in Week 2.

• Chapter 13, “Acute and Maintenance Treatment of Bipolar and Related Disorders”

• “Bipolar and Related Disorders”

Stahl, S. M. (2014). Prescriber’s Guide: Stahl’s Essential Psychopharmacology (5th ed.). New York, NY: Cambridge University Press.

 

Note: All Stahl resources can be accessed through the Walden Library using the link below. This link will take you to a login page for the Walden Library. Once you log in to the library, the Stahl website will appear. http://ezp.waldenulibrary.org/login?url=http://stahlonline.cambridge.org/

 

To access information on specific medications, click on The Prescriber’s Guide, 5th Ed. tab on the Stahl Online website and select the appropriate medication.

Marsee, K., & Gross, A. F. (2013). Bipolar disorder or something else? Current Psychiatry, 12(2), 43–49. Retrieved from http://www.mdedge.com/currentpsychiatry/article/66320/bipolar-disorder/bipolar-disorder-or-something-else

Required Media

Laureate Education (Producer). (2017d). A young woman with depression [Multimedia file]. Baltimore, MD: Author.

Optional Resources

Malhi, G. S., McAulay, C., Gershon, S., Gessler, D., Fritz, K., Das, P., & Outhred, T. (2016). The lithium battery: Assessing the neurocognitive profile of lithium in bipolar disorder. Bipolar Disorders, 18(2), 102–115. doi:10.1111/bdi.12375

Samalin, L., de Chazeron, I., Vieta, E., Bellivier, F., & Llorca, P. (2016). Residual symptoms and specific functional impairments in euthymic patients with bipolar disorder. Bipolar Disorders, 18(2), 164–173. doi:10.1111/bdi.12376

Assignment 1: “Captain of the Ship” Project – Bipolar Disorders

Bipolar disorders are severe disorders of mood that include both depressive episodes and expansive, grandiose, or manic episodes. During these times, the person may engage in activities with little awareness of the consequences because of accompanying psychosis. A diagnosis of bipolar disorder includes periods of mania or hypomania and periods of depression where the mood is down, hopeless, and suicidal. The neurovegetative symptoms of bipolar depression can be incapacitating. It is also important to differentiate the psychosis of bipolar disorder from schizophrenia.

In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a bipolar disorder.

Students will:

• Recommend psychopharmacologic treatments based on therapeutic end points for clients with bipolar disorders
• Recommend psychotherapy based on therapeutic end points for clients with bipolar disorders
• Identify medical management needs for clients with bipolar disorders
• Identify community support resources for clients with bipolar disorders
• Recommend follow-up plans for clients with bipolar disorders

To prepare for this Assignment:

• Select an adult or older adult client with a bipolar disorder that you have seen in your practicum.

In 3-4 pages, write a treatment plan for your client. In which you do the following:

• Describe the HPI and clinical impression for the client.
• Recommend psychopharmacologic treatments and describe specific and therapeutic end points for your psychopharmacologic agent. (This should relate to HPI and clinical impression.).
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
• Identify medical management needs, including primary care needs, specific to this client.
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK5Assgn1+last name+first initial.(extension)” as the name.
• Click the Week 5 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 5 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn1+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 5 Assignment 1 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment 1 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 1

Assignment 2: FHEA Exam Follow-up

In Week 3 you completed the Fitzgerald University Exit Comprehensive Exam and you should have received your results. This exam is an example of the certification exam you may be required to take in order to be licensed as a PMHNP in your state. Your results from the exam may reflect how you would do in the actual certification exam.

In this Assignment, you will develop a plan of action to address any areas of the exam where you may have scored less than acceptable.

Students will:

• Develop plan of action for certification exam preparation

To prepare for this Assignment:

• Develop plan of action for certification exam preparation

In 1 page:

Based on your results from the FHEA Exam, develop a plan of action, including an academic study plan, which will help you maintain your areas of strength and address the areas that need improvement, and help you prepare for the Certification Exam. Address each area of the exam including:

• Foundations of Advanced Practice Nursing
• Independent Practice Competencies
• Professional Role and Policy

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

• Please save your Assignment using the naming convention “WK5Assgn2+last name+first initial.(extension)” as the name.
• Click the Week 5 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
• Click the Week 5 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
• Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK5Assgn2+last name+first initial.(extension)” and click Open.
• If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
• Click on the Submit button to complete your submission.

Grading Criteria

To access your rubric:

Week 5 Assignment 2 Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 5 Assignment 2 draft and review the originality report.

Submit Your Assignment by Day 7

To submit your Assignment:

Week 5 Assignment 2

Assignment 3: Practicum: Decision Tree

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

• Evaluate clients for treatment of mental health disorders
• Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point stop to complete the following:

• • Decision #1: Differential Diagnosis
    • 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?
  • Decision #2: Treatment Plan for Psychotherapy
    • 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: Treatment Plan for Psychopharmacology
    • 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 and their family.

Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

By Day 7 of Week 7

Submit your Assignment.

Making Connections

This week, you once again became “captain of the ship” as you took full responsibility for a client with a bipolar disorder by recommending psychopharmacologic treatment and psychotherapy, identifying medical management needs, community support, and recommending follow-up plans. You used the decision tree format to justify your rationale for diagnosis, pharmacological treatment, and psychotherapy of a patient with a mental illness. You also evaluated the results of your Fitzgerald University Exit Comprehensive Exam and, based on those results, developed a plan of action to help you prepare for the certification exam.

Next week, you will explore evidence-based treatment methods for clients with anxiety disorders. You will complete a midterm exam and analyze reimbursement rates for treatment of mental health disorders.

To go to the next week:

Week 6