Week 5 Discussion Tree Assignment

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Week 5 Discussion Tree Assignment

Practicum: Decision Tree

The Case Study: A young Woman with Depression

Decision #1: Differential Diagnosis

Decision:

Bipolar I; Predominantly mood-related symptoms including difficulty in sleeping presentation.

Reason for Making Decision:

Stefanie is a Puerto Rico young woman aged 32-years-old exhibiting symptoms that include difficulty in sleeping. However, Stefanie can go with minimal sleep for a few days, but the next day, she does not seem fatigued. Furthermore, after three days with minimal sleep, Stefanie crashes and has a good night sleep. Stefanie has been distinguished to be alright for a few days and then she will experience a similar issue with sleep.

Following APA (2013) the DSM-5 criteria for Bipolar I, individuals suffering from Bipolar disorder exhibit persistent pattern of having difficulty in sleeping, feeling depressed, and high energy. The DSM-5 criteria include a 7 days duration criteria for bipolar I (American Psychiatric Association, 2013). These criteria are essential in identifying a patient with a high likelihood of Bipolar I condition. Basing on the symptoms types, Stefanie has enough symptoms of difficulty in sleeping but does not seem to be fatigued the next day. Additionally, Stefanie has had this problem for years.

Basing on these, it is important that more inquiries concerning Stefanie’s her workload, and academic demand be made (Ducharme et al. 215). Furthermore, it is also essential to establish whether the young woman has another condition that could clarify these symptoms better, as well as that, take place simultaneously as Bipolar I.  Week 5 Discussion Tree Assignment .The collected information from Stefanie through the Conners’ Rating Scale-Revised [CRS-R], should then be applied under the DSM-5 guidelines, to support Bipolar I diagnose.

Anticipated Result with this Decision:

The ultimate goal of this decision is towards beyond reasonable doubt establishing that the young Woman has no other conditions that clarify these symptoms better, as well as that, take place simultaneously as Bipolar I (American Psychiatric Association, 2013). Moreover, to be able to explain better to Stefanie that her persistent pattern of sleeping difficulty being exhibited by her is due to Bipolar I.  Additionally, this decision will ascertain that Stefanie is appropriately diagnosed beside treated for Bipolar I, in case confirmed by the DSM-5 diagnostic standard.

Difference Between What I Expected to Achieve with Decision #1 and the Decision Results:

After the patient returns after four weeks, I did not expect to achieve any other results, since the CRS-R is also an examination tool that supports evaluation of whether adults have Bipolar I (Ducharme et al. 215). Thus I expected similar results of Bipolar I, predominantly difficulty in sleeping presentation.

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Decision #2: Treatment Plan for Psychotherapy

Decision:

            Begin Latuda 40 mg orally daily, Lamictal 100 mg orally daily and commence psychotherapy using a psychodynamic approach

Reason for Making Decision:

Latuda 40 mg is an atypical antipsychotic medication used to treat mood/mental disorders such as depression associated with Bipolar disorder through helping the patient to think to take part in everyday activity, think clearly and feel less nervous. This medication may also improve sleep and energy level. It has a high ability to restore the balance of certain natural brain substances supporting Stefanie have enough sleep (American Psychiatric Association, 2013). Additionally, Lamictal 100 mg is a mood stabilizing anticonvulsant used in the maintenance and treatment of bipolar disorder to delay depression. FDA approved it as a first therapy since it has lithium for bipolar disorder maintenance. Psychotherapy using psychodynamic approach is essential for offering Stefanie partial relief. Week 5 Discussion Tree Assignment .

For the fact that Begin Latuda 40 mg orally daily, Lamictal 100 mg orally daily medication has caused the young woman to experience improved sleep, it is advisable that she commence Psychotherapy using psychodynamic approach. The reason is that she is experiencing the side effects of the drug.

Anticipated Result with this Decision:

I do anticipate that the medication is taken correctly as recommended will support Stefanie towards increasing her ability to sleep. Furthermore, I do anticipate that it will support her to organize her tasks as well as enhancing her listening work. Through Psychotherapy using psychodynamic, I do anticipate that her sleep will eventually improve.

Difference Between What I Expected to Achieve with Decision #2 and the Decision Results:

After the patient returns after four weeks, I did not expect to achieve any other results, because Latuda 40 mg, Lamictal 100 mg has several side effects that include seizures, agitation, fever, and trouble in swallowing among others. These side effects are mild besides to some individuals; they do fade in a few weeks as well as months after treatment when well managed.

Decision #3: Treatment Plan for Psychopharmacology

Decision:

Add a small dose of immediate release Latuda and Lamictal in the early afternoon, besides augmenting family Psychotherapy using a psychodynamic approach.

Reason for Making Decision:

Basing on Stefanie medical condition in addition to the treatment response, she can maintain her attention throughout the morning classes. This is an indication that, there is a need to adjust her dose to zero down on the dose that appropriately fits her condition. As a consequence, there is necessitating adding a small dose of immediate to help her sleep well at night.

Anticipated Result with this Decision:

The decision made will ascertain that the appropriate dosage that fits Katie condition is achieved by adding a small dose of immediate release Latuda and Lamictal at night; which wills her sleep significantly. Week 5 Discussion Tree Assignment .On the other side, although Psychotherapy using psychodynamic approach will not address Stefanie difficulty in sleeping symptoms, I anticipate that it will champion her family towards addressing more practical concerns, including how to appropriately support Stefanie in her daily duties.

Difference Between What I Expected to Achieve with Decision #3 and the Decision Results:

I did not expect to achieve any other results, as the small dose of immediate release Latuda 40 mg, Lamictal at night; should have significantly improved her sleep (Ducharme et al. 215). I also expected that, through besides augmenting family Psychotherapy using psychodynamic, the family would collaborate as a team towards a shared purpose of understanding and addressing the unique challenges experienced by Stefanie, besides concrete ways of supporting her with the symptoms.

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Ethical Considerations Impacts on Treatment Plan and Communication with clients and Families:

The treatment plan can be impacted by the conflict between telling the truth and doing good since I can be tempted to withhold information from the client and family concerning her utmost underlying Psychotherapy needs and the probable psychodynamics. This is championed by the fact that disclosing everything right away; I can run the risk of making the patients never to return and hence not receiving adequate treatment (Malekpour, Hadi &Aghababaei, 2015). Week 5 Discussion Tree Assignment .

 

References

American Psychiatric Association [APA]. (2013). American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Association.

Ducharme, S., Price, B. H., Larvie, M., Dougherty, D. D., & Dickerson, B. C. (2015). Clinical approach to the differential diagnosis between behavioral variant frontotemporal dementia and primary psychiatric disorders. American Journal of Psychiatry, 172(9), 827-837.

Malekpour, M., Hadi, S., & Aghababaei, S. (2015). The effectiveness of Family, Child and Family-Child Based Intervention on ADHD Symptoms in Iranian Students with ADHD. International Journal of Psychological Studies, 7(2). doi:10.5539/ijps.v7n2p31

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.

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.

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/05/mm/decision_tree/index.html

 

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? Week 5 Discussion Tree Assignment .
  • 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. Week 5 Discussion Tree Assignment.