PRAC 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Sample Essay

Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults Sample Essay

Making a definitive diagnosis for a patient who presents with depression symptoms is a difficult task. Nevertheless, that can be accomplished when the practitioner acknowledges the seriousness of the symptoms alongside establishing a suitable diagnosis criterion. Depression-related symptoms may be apparent in a patient who has bipolar1, bipolar 2, cyclothymic disorder, depressive disorder, and many more.  The paper seeks to assess the case of Stefanie, who visits a care center with depression symptoms and make a proper diagnosis for her.   In addition, the paper will entail three decisions made about the patient.

Decision One

I would settle on the cyclothymic disorder as the appropriate diagnosis for the patient based on her case and the symptoms. An adult is diagnosed with the cyclothymic disorder when he or she experiences multiple phases of indications of hypomania that sometimes go wrong with the hypomanic episode criterion combined with various episodes of depression symptoms that do not align with severe depressive disorder criterion (APA, 2013).  A closer glance at the concept of this author is that the person will undergo such experiences for two years or more. The presented symptoms align with those embodied by Stefanie because since she was a college student, she mentions having spent several sleepless nights for several years. According to the details given, the client mentions feeling “depressed” in a way, but she feels sad and empty. She claims the events are associated with bouts of exhaustion and a decreased capability to focus whenever she feels sad.

The client’s symptoms are in line with the cyclothymic disorder manifestations because she never mentioned any combined suicidal impulses or manic episodes that would cause the client to be diagnosed with Bipolar II hypomanic phase of Bipolar I depressed phase disorder. Given the available care options, it could be considered that treatment for the cyclothymic disorder is successful, presuming that the patient has significant clinical impairment or anxiety with depressive or hypomanic events of the condition, with extreme fluctuation of mood (Baldessarini, Vázquez & Tondo 2011). Based on this approach, the goal to care at present is to ensure the patient’s appropriate diagnosis, which will aid in the discovery of a suitable treatment or symptom control, and also a correct direction to clinical cooperation.

Decision Two

According to the details obtained in this situation, I decide to start Stefanie orally everyday on 10 mg Abilify. I agreed on this alternative because evidence has indicated that the mainline of action against cyclothymic disorder is mood stabilizers and anti-manic medications (Sadock, Sadock, and Ruiz, 2014). This medicine is suitable for Stefanie. Muneer (2016) suggests that Abilify has elements of being a partial agonist in pharmacodynamics, and it also works with selectivity. In addition, it is characterized by the control mechanism of the serotonin-dopamine function.  The reason I chose this medication is also that it as a longer half-life.  Muneer (2016), points out that this medication’s half-life is around 75 hours, which helps patients to manage treatment blood volumes even when they are unlikely to take it for a shorter amount of time.

This patient’s other treatment options include a three-month follow-up plan or starting her on Depakote 250 mg orally thrice a day. I perceived the options not appropriate for this case, and they should not be taken into consideration at present since there is no empirical evidence that supports the use of mood stabilizers in the management of symptoms of cyclothymic disorder.

Decision 3

Stefanie showed up at the care center four weeks later, and according to my anticipations, she said her mood was more stable and shared that she does not experience sadness as before due to the suggestion of this medication. Similarly, the impact of faintness that she endured in the first two weeks of Abilify treatment was reduced.

Decision Three

• At this moment, the choice for the

Currently, the patient is being cared for by maintaining her current 10 mg Abilify dose orally every day. This decision is focused on the presumption that the patient has reacted favorably to the drug and appears to handle it, as she mentioned in her recent visit. There is currently no prerequisite for adjusting the present dosage of Abilify according to her assessment report. According to the American Psychiatric Association (2013), after another four to eight weeks of treatment, the mental healthcare practitioner is required to carry out another thorough evaluation of possible elements leading to the condition and incorporate treatment plan changes on the likelihood that the individual still experiences marginal to no symptom change. The purpose of this approach is to guarantee that the individual is continually progressing and achieving euthymia.

At this point, the current therapeutic solutions entail choosing between increasing the Abilify dosage of the client to 15 mg once a day orally and stopping Abilify medicine. In case Stefanie presents relapse manifestations or withdrawal on the event the individual encounters serious and lethal side effects, it may be necessary to increase the dose.   While the result of the treatment was not disclosed during this discussion, with this drug, I expect that she can sustain a stabilized mood with no adverse consequences. The management of persons with mood disorders should be tailored towards the maintenance of euthymia.

Legal and Ethical Implications

The interplay between the patient and the healthcare provider as well as on the treatment plan, the physician needs to make a proper diagnosis, which will then result in the appropriate control of the disorder, or otherwise, the patient’s goal of treatment will not be accomplished.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Baldessarini, R. J., Vázquez, G., & Tondo, L. (2011). Treatment of cyclothymic disorder:

commentary. Psychotherapy & Psychosomatics, 80(3), 131-135.

Muneer, A. (2016). The treatment of adult bipolar disorder with aripiprazole: A systematic

review. Cureus, 8(4), e562.

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.