Bipolar disorder is a unique disorder that causes shifts in mood and energy, which results in depression and mania for patients. Proper diagnosis of this disorder is often a challenge for two reasons: 1) patients often present as depressive or manic but may have both; and 2) many symptoms of bipolar disorder are similar to other disorders. Misdiagnosis is common, making it essential for you to have a deep understanding of the disorder’s pathophysiology. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with bipolar disorder.

BACKGROUND INFORMATION

The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. 

Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?”

She weights 110 lbs. and is 5’ 5” 

SUBJECTIVE

Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” 

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. 

Genetic testing reveals that she is positive for CYP2D6*10 allele. 

Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. 

The endocrine system includes eight major glands throughout the body which affect such things as growth and development, metabolism, sexual function, and mood (National Institutes of Health). Some of the most commonly diagnosed endocrine disorders include hypothyroidism, diabetes, and Hashimoto’s disease. Not surprisingly, treating any one endocrine disorder may have effects on other body systems or their functions. As an advanced practice nurse, treating patients who may suffer from endocrine disorders requires an acute understanding of the structure and function of the endocrine system. Additionally, a solid understanding of patient factors and behaviors will assist in developing the best drug therapy plans possible to treat your patients. Some of most commonly diagnosed endocrine disorders include

This week, you differentiate the types of diabetes and examine the impact of diabetes drugs on patients. You also evaluate alternative drug treatments and patient education strategies for diabetes management.

Reference: National Institutes of Health. (n. d.). National Institute of Diabetes and Digestive and Kidney Disorders. Endocrine diseases. Retrieved July 3, 2019 from https://www.niddk.nih.gov/health-information/endocrine-diseases

Learning Objectives

Students will:

• Differentiate types of diabetes
• Evaluate the impact of diabetes drugs on patients
• Evaluate alternative drug treatments and patient education strategies for diabetes management

Discussion: Diabetes and Drug Treatments

Photo Credit: [Mark Hatfield]/[iStock / Getty Images Plus]/Getty Images

Each year, 1.5 million Americans are diagnosed with diabetes (American Diabetes Association, 2019). If left untreated, diabetic patients are at risk for several alterations, including heart disease, stroke, kidney failure, neuropathy, and blindness. There are various methods for treating diabetes, many of which include some form of drug therapy. The type of diabetes as well as the patient’s behavior factors will impact treatment recommendations.

For this Discussion, you compare types of diabetes, including drug treatments for type 1, type 2, gestational, and juvenile diabetes.

Reference: American Diabetes Association. (2019). Statistics about diabetes. Retrieved from http://diabetes.org/diabetes-basics/statistics/

To Prepare

• Review the Resources for this module and reflect on differences between types of diabetes, including type 1, type 2, gestational, and juvenile diabetes.
• Select one type of diabetes to focus on for this Discussion.
• Consider one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Then, reflect on dietary considerations related to treatment.
• Think about the short-term and long-term impact of the diabetes you selected on patients, including effects of drug treatments.

By Day 3 of Week 5

Post a brief explanation of the differences between the types of diabetes, including type 1, type 2, gestational, and juvenile diabetes. Describe one type of drug used to treat the type of diabetes you selected, including proper preparation and administration of this drug. Be sure to include dietary considerations related to treatment. Then, explain the short-term and long-term impact of this type of diabetes on patients. including effects of drug treatments. Be specific and provide examples. Atleast 4 reffereneces needed

 
1 postsRe: Topic 4 DQ 2

In addition to establishing universal coverage and shared responsibility, the Affordable Care Act sets federal standards for health insurers offering products in both the individual and small-group markets, as well as employer-sponsored health benefit plans, Rosenbaum S. (2011).

The law has 3 primary goals, according the Healthcare.gov:

1. Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level (FPL). Note: If your income is above 400% FPL, you may still qualify for the premium tax credit in 2021.
2. Expand the Medicaid program to cover all adults with income below 138% of the FPL. (Not all states have expanded their Medicaid programs.)
3. Support innovative medical care delivery methods designed to lower the costs of health care generally.

The Affordable Care Act was designed to reduce the cost of health insurance coverage for people who qualify. The law includes premium tax credits and cost-sharing reductions to help lower expenses for lower-income individuals and families. Premium tax credits lower your health insurance bill each month. It was developed to make health insurance more affordable, to initiate consumer protection, and to increase the number of people covered by health insurance.
Nurses can support the health of families and communities by serving as an important resource in providing information on how to access the health insurance coverage that the Affordable Care Act (ACA) offers.

Using 200-300 APA format with references to support the discussion 

 What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law? 

Concisely define evidenced based practice, the evolution of EBP and how barriers to EBP can be overcome. Briefly give an example of a compelling clinical question that piques your interest.

• Length: A minimum of 300 words, not including references
• Citations: At least one high-level scholarly reference in APA format from within the last 5 years

 Directions

1. Please review the infographic as way to guide you in getting started with your assignment: Developing an Assignment with Integrity (Links to an external site.)
2. View a short tutorial with tips for completing this assignment: Healthcare Policy Assignment Tutorial (Links to an external site.)
3.  (Links to an external site.)This assignment will be in the format of a PowerPoint presentation (Bullet points may be used).
4. You are educating your peers through this presentation regarding a federal bill you believe may be of interest to nurses.
5. Go to https://www.govtrack.us/congress/bills/subjects/health/6130 (Links to an external site.)
6. Choose a health-related federal bill of interest. Read through the bill and develop a summary in your own words. Include the bill number and name.
7. Here is a link to our U.S. legislative process (bill to law) for review, if needed: https://www.congress.gov/legislative-process (Links to an external site.)
8. For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft Office 365 Training (Links to an external site.) may be helpful.
9. Include the following information in your presentation
   • Title slide (Your name, NR451, session, Healthcare Policy assignment)
   • Bill name and number (indicate either H.B. or S.B.)
   • Bill summary (in your own words)
   • Address how this bill might impact professional nursing practice standards if passed? If not passed?
   • How might the bill impact your own nursing practice?
   • How might you communicate your concerns about or support for this bill based on nursing practice, standards, or patient outcomes?
   • How might this bill impact your community?
   • References slide to include the Bill source in APA format.
   • No more than 12 slides

  Template

There is no required form or template for this assignment. Please use PowerPoint best practices throughout your presentation.

Best Practices

The following are best practices in preparing this presentation.

• Review directions and rubric thoroughly prior to beginning assignment.
• Watch the short video tutorials on tips for completing the assignment and on developing a PowerPoint. Incorporate graphics, clip art, or photographs to increase interest.
• Make slides easy to read with short bullet points and large font.
• Please see the grading criteria and rubrics on this page.
• Please use your browser’s File setting to save or print this page.

Scholarly Sources and Citations

• Cite all sources on the appropriate slides with (author, year) as well as on the Reference slide.
• Spell check for spelling and grammar errors prior to final submission.