NURS 6630 Psychopharmacologic Approaches to Treatment
Walden University NURS 6630 Psycopharmacologic Approaches to Treatment-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NURS 6630 Psycopharmacologic Approaches to Treatment assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NURS 6630 Psycopharmacologic Approaches to Treatment
Whether one passes or fails an academic assignment such as the Walden University NURS 6630 Psycopharmacologic Approaches to Treatment depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NURS 6630 Psycopharmacologic Approaches to Treatment
The introduction for the Walden University NURS 6630 Psycopharmacologic Approaches to Treatment is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NURS 6630 Psycopharmacologic Approaches to Treatment
After the introduction, move into the main part of the NURS 6630 Psycopharmacologic Approaches to Treatment assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NURS 6630 Psycopharmacologic Approaches to Treatment
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NURS 6630 Psycopharmacologic Approaches to Treatment
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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NURS 6630 Psychopharmacologic Approaches to Treatment
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Case 1: The Man Whose Anti-Depressants Stopped Working
In the above case, the client is a 63-year old who shows signs of depression and anxiety. In order to successfully diagnose the condition, a psychiatrist nurse would need to ask certain questions depending on the tool they will intend to adopt. In the present case, and given the history of the patient, one would ask the following questions:
- How can you describe your sleep pattern for the last two weeks?
- Have you entertained suicidal ideations of late?
- Have you lost interest in anything that was initially enjoyable to you?
Asking these questions is important because of several reasons. The first reason is that they help a nurse to determine whether the common symptoms of depression are present in a patient. Moreover, these questions, specifically the third one, would help the nurse determine the level of impact that the symptoms have on the patient’s capacity to function. Lastly, they help a psychiatric mental health nurse practitioner determine how the symptoms affect a patient’s ability to maintain relationships with other people.
Social Screening
Screening a patient for depression may also entail asking for opinions from third parties. Given that the patient is married, the very first person to ask about the presence of certain depressive symptoms will be his wife. Studies have suggested that the involvement of family members in the holistic management of depression has improved the process (Zhang & Wudong, 2013). Hence, the nurse will ask the wife to reveal the functioning of the family- Do you think that your family has been functioning normally in the last 3 months? Also, studies have produced considerable evidence in support of the notion that impaired family functioning may lead to depression. Thus, by asking this question, the nurse practitioner will look to establish whether family functioning could have contributed to the patient’s condition.
In addition to the wife, the nurse will also question the patient’s children. These children can play an integral role in diagnostic process. The reason for using their subjective assessment to determine the existence of depression is founded on the fact that they may have noticed changes in their father’s behavior. Thus, in order to discover the existence of these changes, the nurse practitioner needs to ask them, “Is your father able to concentrate when holding conversations?” Asking this question enables a nurse to gauge the concentration levels of the patient with a view of determining whether the patient has difficulties in sustaining thoughts during conversations with his children.
Physical Exams and Diagnostic Tests
The diagnosis of depression takes many forms. The multidimensional approach to depression intends to eliminate another medical cause for the condition. Research works have indicated that physical examination plays a fundamental role in this diagnostic process (Ghaemi, 2013). For the present patient, and given his age, a nurse will order for physical examination on his neurological and endocrine systems. Specifically, the nurse will order for hypothyroidism and hyperthyroidism tests. Moreover, the patient will undergo central nervous system tumors tests and scans for head traumas.
In addition, further confirmatory tests may become necessary to differentially diagnose the condition. A diagnosis of depression may not be complete without a psychiatric evaluation of the patient. During this period, the patient will reveal their behavior patterns, feelings, thoughts, and symptoms. To successfully conduct the process, the mental health practitioner may ask the patient to fill in a questionnaire if they do not have the confidence to answer the questions in a face-to-face setting. Also, the mental health professional may enlist the services of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (Ghaemi, 2013). The DMS-5 allows the practitioner to confirm if the patient meets the criteria for depression diagnosis. These physical examinations and diagnostic tests are important as they will help the nurse practitioner to rule out other causes of the condition. In addition, they will allow the nurse to eliminate or even determine the presence of co-morbidity with other mental health conditions.
Differential Diagnosis of the Patient
The differential diagnosis of the patient’s condition will entail a broad range of conditions given his symptoms. However, the following three conditions are more likely to present with the condition: anxiety disorder, obstructive sleep apnea, and adjustment disorder with depressive mood due to marital problems. Out of the above conditions, anxiety disorder has the highest probability of presenting. During the preceding depressive episodes, anxiety was a constant as a symptom.
Pharmacologic Agents for the Patient
The usage of certain pharmacological agents has proven essential in the management of major depressive disorders. In the present case, the psychopharmacological therapy that the nurse can formulate for the patient includes a selective serotonin reuptake inhibitor (sertraline) or a serotonin-norepinephrine reuptake inhibitor (venlafaxine). If the therapy consists of Sertraline, then the patient should be given an initial dose of 50 mg orally once per day (Stahl, 2014). This will be followed by a maintenance dose of between 50-200 mg depending on the maximum effective and safe dose for the patient. However, if the pharmacotherapy comprises venlafaxine, the patient will be started on Effexor XR at 75 mg once daily (Stahl, 2014). Upon monitoring, the dosage could be increased by 75 mg up to 225 mg maximum, contingent upon the patient’s reaction to the same. The mechanisms of action of the two and how they quickly achieve their peak plasma concentration levels make them prime candidates for the therapy.
However, whereas the patient responded well to Sertraline, the mechanism of actions of the two drugs above would make Effexor XR to be more effective. Whereas the two drugs target the inhibition of the re-absorption of serotonin, Effexor XR additionally targets the reabsorption of norepinephrine (Stahl, 2013). Both norepinephrine and serotonin play fundamental roles in the transmission of feel-good messages between cells in the brain. Thus, inhibiting the reuptake of norepinephrine and serotonin makes Effexor XR preferable based on mechanism of action alone.
Effect of Ethnicity on Effector XR
Studies have shown that the dosage of Effector XR may be manipulated according to the ethnicity of a patient. The enzyme CYP2D6 catalyzes the conversion of venlafaxine to its active metabolite O-desmethylvenlafaxine (ODV). The enzyme above has a functional variant known as CYP2D6*1 and nonfunctional variants called CYP2D6*4 and CYP2D6*4 that are prevalent in Caucasian ethnicities (Dean, 2015). Hence, given that the patient is of this ethnicity, he is a poor metabolizer of the drug. According to a study by the Pharmacogenetics Working Group of the Royal Dutch Association for the Advancement of Pharmacy (KNMP), the necessary data for the calculation of dose adjustment for poor metabolizers was insufficient. However, the FDA asserted that there are no varied dosing regimens for either poor or extensive metabolizers (Dean, 2015), which implies that the dosage for the present patient could be adjusted to 150% of the normal dose.
Lessons Learned
The analysis of this case has revealed fundamental lessons to the nurse. The case has shown that major depressive disorders are recurrent in nature. Moreover, the periods between subsequent episodes shorten as the recurrences occur. Thus, one needs to be keen as they manage patients with the condition. Secondly, the case study has revealed that if the treatment regimen is not properly done, then a patient runs the risk of becoming resistant to anti-depressants. This implies that at a certain period, it will become impossible to treat such a patient. Therefore, the nurse will make sure that they prescribe maintenance doses for patients at the third recurrence even with remission. This will ensure that the probability of a relapse reduces significantly for the nurse’s patients.
In the above case, the client is a 63-year old who shows signs of depression and anxiety. In order to successfully diagnose the condition, a psychiatrist nurse would need to ask certain questions depending on the tool they will intend to adopt. In the present case, and given the history of the patient, one would ask the following questions:
How can you describe your sleep pattern for the last two weeks?
Have you entertained suicidal ideations of late?
Have you lost interest in anything that was initially enjoyable to you?
Asking these questions is important because of several reasons. The first reason is that they help a nurse to determine whether the common symptoms of depression are present in a patient. Moreover, these questions, specifically the third one, would help the nurse determine the level of impact that the symptoms have on the patient’s capacity to function. Lastly, they help a psychiatric mental health nurse practitioner determine how the symptoms affect a patient’s ability to maintain relationships with other people.
Social Screening
Screening a patient for depression may also entail asking for opinions from third parties. Given that the patient is married, the very first person to ask about the presence of certain depressive symptoms will be his wife. Studies have suggested that the involvement of family members in the holistic management of depression has improved the process (Zhang & Wudong, 2013). Hence, the nurse will ask the wife to reveal the functioning of the family- Do you think that your family has been functioning normally in the last 3 months? Also, studies have produced considerable evidence in support of the notion that impaired family functioning may lead to depression. Thus, by asking this question, the nurse practitioner will look to establish whether family functioning could have contributed to the patient’s condition.
In addition to the wife, the nurse will also question the patient’s children. These children can play an integral role in diagnostic process. The reason for using their subjective assessment to determine the existence of depression is founded on the fact that they may have noticed changes in their father’s behavior. Thus, in order to discover the existence of these changes, the nurse practitioner needs to ask them, “Is your father able to concentrate when holding conversations?” Asking this question enables a nurse to gauge the concentration levels of the patient with a view of determining whether the patient has difficulties in sustaining thoughts during conversations with his children.
Physical Exams and Diagnostic Tests
The diagnosis of depression takes many forms. The multidimensional approach to depression intends to eliminate another medical cause for the condition. Research works have indicated that physical examination plays a fundamental role in this diagnostic process (Ghaemi, 2013). For the present patient, and given his age, a nurse will order for physical examination on his neurological and endocrine systems. Specifically, the nurse will order for hypothyroidism and hyperthyroidism tests. Moreover, the patient will undergo central nervous system tumors tests and scans for head traumas.
In addition, further confirmatory tests may become necessary to differentially diagnose the condition. A diagnosis of depression may not be complete without a psychiatric evaluation of the patient. During this period, the patient will reveal their behavior patterns, feelings, thoughts, and symptoms. To successfully conduct the process, the mental health practitioner may ask the patient to fill in a questionnaire if they do not have the confidence to answer the questions in a face-to-face setting. Also, the mental health professional may enlist the services of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria (Ghaemi, 2013). The DMS-5 allows the practitioner to confirm if the patient meets the criteria for depression diagnosis. These physical examinations and diagnostic tests are important as they will help the nurse practitioner to rule out other causes of the condition. In addition, they will allow the nurse to eliminate or even determine the presence of co-morbidity with other mental health conditions.
Differential Diagnosis of the Patient
The differential diagnosis of the patient’s condition will entail a broad range of conditions given his symptoms. However, the following three conditions are more likely to present with the condition: anxiety disorder, obstructive sleep apnea, and adjustment disorder with depressive mood due to marital problems. Out of the above conditions, anxiety disorder has the highest probability of presenting. During the preceding depressive episodes, anxiety was a constant as a symptom.
Pharmacologic Agents for the Patient
The usage of certain pharmacological agents has proven essential in the management of major depressive disorders. In the present case, the psychopharmacological therapy that the nurse can formulate for the patient includes a selective serotonin reuptake inhibitor (sertraline) or a serotonin-norepinephrine reuptake inhibitor (venlafaxine). If the therapy consists of Sertraline, then the patient should be given an initial dose of 50 mg orally once per day (Stahl, 2014). This will be followed by a maintenance dose of between 50-200 mg depending on the maximum effective and safe dose for the patient. However, if the pharmacotherapy comprises venlafaxine, the patient will be started on Effexor XR at 75 mg once daily (Stahl, 2014). Upon monitoring, the dosage could be increased by 75 mg up to 225 mg maximum, contingent upon the patient’s reaction to the same. The mechanisms of action of the two and how they quickly achieve their peak plasma concentration levels make them prime candidates for the therapy.
However, whereas the patient responded well to Sertraline, the mechanism of actions of the two drugs above would make Effexor XR to be more effective. Whereas the two drugs target the inhibition of the re-absorption of serotonin, Effexor XR additionally targets the reabsorption of norepinephrine (Stahl, 2013). Both norepinephrine and serotonin play fundamental roles in the transmission of feel-good messages between cells in the brain. Thus, inhibiting the reuptake of norepinephrine and serotonin makes Effexor XR preferable based on mechanism of action alone.
Effect of Ethnicity on Effector XR
Studies have shown that the dosage of Effector XR may be manipulated according to the ethnicity of a patient. The enzyme CYP2D6 catalyzes the conversion of venlafaxine to its active metabolite O-desmethylvenlafaxine (ODV). The enzyme above has a functional variant known as CYP2D6*1 and nonfunctional variants called CYP2D6*4 and CYP2D6*4 that are prevalent in Caucasian ethnicities (Dean, 2015). Hence, given that the patient is of this ethnicity, he is a poor metabolizer of the drug. According to a study by the Pharmacogenetics Working Group of the Royal Dutch Association for the Advancement of Pharmacy (KNMP), the necessary data for the calculation of dose adjustment for poor metabolizers was insufficient. However, the FDA asserted that there are no varied dosing regimens for either poor or extensive metabolizers (Dean, 2015), which implies that the dosage for the present patient could be adjusted to 150% of the normal dose.
Lessons Learned
The analysis of this case has revealed fundamental lessons to the nurse. The case has shown that major depressive disorders are recurrent in nature. Moreover, the periods between subsequent episodes shorten as the recurrences occur. Thus, one needs to be keen as they manage patients with the condition. Secondly, the case study has revealed that if the treatment regimen is not properly done, then a patient runs the risk of becoming resistant to anti-depressants. This implies that at a certain period, it will become impossible to treat such a patient. Therefore, the nurse will make sure that they prescribe maintenance doses for patients at the third recurrence even with remission. This will ensure that the probability of a relapse reduces significantly for the nurse’s patients.
Also Read:
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