Running Head: Bipolar Therapy a Client of Korean Descent 2

Running Head: Bipolar Therapy a Client of Korean Descent 2

 

Bipolar Therapy a Client of Korean Descent 2

 

 

 

 

 

Bipolar Therapy a Client of Korean Descent

Silifat Jones-Ibrahim

NURS 6630

A 22-year old Korean woman who presents herself for a 21-day hospitalization for the onset of acute mania has bipolar, but she doesn’t agree. She has a fantastic mood, sleeps 5 hours, claiming that sheets too, alert, oriented to people time and event. Genetic testing reveals that she is positive for the CYP2D6*10 allele. The purpose of her treatment is to help her resume her daily duties, reduce the unrest, and reduce destructive behaviors.

Desicion#1 begins Risperdal 1mg orally BID, for this is a typical antipsychotic that has verified to be extremely useful in the running of bipolar disorders. It does so by trying to effect a rebalance in serotonin and dopamine, thus ensuing in moral behavior. Because the patient had bipolar mix-up, Risperdal occurs to be the best alternate, also seeing that it is readily reachable (Culpepper, 2014). In the previous treatment, the patient happened to avoid lithium. So, it wouldn’t be a smart choice to start lithium 300mg because the probabilities of the patient not obeying to treatment are high. It leaves Risperdal as the most excellent decision in this situation. Likely Result, in four weeks on treatment, the patient is projected to display immense improvement. The patient would be relaxing and be able to conduct her actions of everyday life with slight or no trouble (John & Antai-Otong, 2016). It also expects that the patient’s self-destructive practices and tension would reduce and will reply to her atmosphere and public connections positively (Fang et al., 2017).

Likely Results and Real Result after four weeks, the patient returned to the clinic escorted by a parent. They, yet, settled that the patient’s self-destructive practices had expressively reduced. The client’s mother clarified that the client had been sluggish for about a week after the last appointment.

Decision#2 reducing Risperdal to 1mg HS; this is for the patient’s improvement in the second visit, it was evident that Risperdal was effective in achieving therapeutic goals of treatment. Nevertheless, the unwanted side effects were the key worries. It is then wise to cut the dosing to deal with the side effects rather than change to a new drug. Reducing the dose to one mg HS would be the best substitute that will aid to lessen the critical influence of the side effects (Culpepper, 2014). Giving the patient backing to adjust to an alternative dose of the same medicine will also advance their devotion, belief, and understanding to cooperate in attaining the treatment goals—likely Result (John & Antai-Otong, 2016). Reducing the dose to one mg HS will cut the quantity of Risperdal accrued in the body and following side effects of lethargy and sedation. By this, I expect that the client will record some constructive improvement concerning reduced self-destructive activities, ease in acting operations of daily life, and thinking patterns (Fang et al., 2017). I also expect that the client will have slight incidents of lethargy and sedation.

Likely results and real results. After four weeks, the client came back to the hospital. She was less sedated, less sluggish, and displayed massive development in signs. The new mania score gage had also reduced from 22 to 16, an illustration that there was more than a 25% decrease in symptoms. (John & Antai-Otong, 2016)

Decision #3 carry on with the same dose of 1 mg HS. Because of the first visit, it was clear that the client has decent development in the relation of decreasing self-destructive actions and handling of the medicines’ side effects. Continuing this dose and reexamining the client after four weeks will contribute to the attainment of the active goals for both the client and the present mental health physician. The first dosage of 1 mg BID had turned out to be detrimental to the patient’s wellbeing (Fang et al., 2017). Likely Results within four weeks, the patient will record massive improvement by reducing self-destructive actions. Also, she will report very slight or no side effects from Risperdal. She will have a decent state of mind, behavior, and moral thinking outlines. Risperdal is FDA approved for managing bipolar signs and has confirmed to be extremely useful with controllable side effects.

Likely Results and Real Results, the patient has some noteworthy progress and very minimal side effects of lethargy and sedation. The analysis proved that Risperdal had effectively helped to attain the vital treatment goals in the whole path of treatment. Given the pharmacodynamics and pharmacokinetics of Risperdal, these are indeed the results that must anticipate. Subsequently, the customer is for positive for the CYP2D6*10 allele; Risperdal might be clearing at a measurable sum resulting in higher than usual points in the blood (Fang et al., 2017). Instead, a mental physician must reflect, giving the patient some of the best accessible choices for handling to maximize the supports of treatment (Ratheesh et al., 2017).

The weakening of vision and decision that is always considered by mania and temper events may render a patient as not able to provide informed consent nor incapable of making rational conclusions concerning their treatment. Also, some medical exhibitions, such as delusional thinking and irritability, might be peril in the dangerous therapeutic alliance that exists between a client and a mental healthcare provider. It notes that, due to the reverting-remitting nature of the bipolar disorder, there are instances where a patient might feel well and question the need to continue with treatment (Ratheesh et al., 2017). These places the treatment goals laid by the mental healthcare provider in conflict with the patient’s autonomy to make decisions.

 

References

Culpepper, L. (2014). The diagnosis and treatment of bipolar disorder: decision-making in primary care. The primary care companion for CNS disorders, 16(3).

Fang, F., Wang, Z., Wu, R., Calabrese, J. R., & Gao, K. (2017). Is there a ‘weight neutral’ second-generation antipsychotics for bipolar disorder?. Expert review of Neurotherapeutics, 17(4), 407-418.

John, R. L., & Antai-Otong, D. (2016). Contemporary Treatment Approaches to Major Depression and Bipolar Disorders. Nursing Clinics, 51(2), 335-351.

Ratheesh, A., Cotton, S. M., Davey, C. G., Adams, S., Bechdolf, A., Macneil, C., & McGorry, P. D. (2017). Ethical considerations in preventive interventions for bipolar disorder. Early intervention in psychiatry, 11(2), 104-112.

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