Assessing and Treating Clients with Bipolar Disorder

Introduction

Bipolar disorder is attributed to the instability in the emotions of a person and may occur as a result of the genes of the patient. Stahl et al. (2019) record that other than the genetic possibility, the occurrence of a bipolar disorder may be blamed on the neurons or biological operation of the organs of the patient. Typically, bipolar disorder arises in the changes in the moods of patients frequently. A patient with bipolar disorder could be difficult to get the best diagnosis since the patient may have varying depressive moods and the diagnosis may be made wrongly to be other health conditions such as depression. A patient with bipolar disorder may, therefore, be seen to have symptoms similar to other health issues. This paper seeks to discuss the treatment for a patient who is diagnosed with bipolar disorder.

Decision Point 1

The three options that are there for selection to help in treating the patient are Begin Lithium 300 mg orally Bid, Begin Risperdal 1 mg orally, or Begin Seroquel XR 10o mg orally at HS. The choice that is selected for the patient to use to treat the health concern is Begin Lithium 300 mg orally Bid.

Decision Rationale

Begin Lithium 300 mg orally Bid is selected for use by the patient for the management of the change in moods. The patient is reported to have swings in his moods and the use of this medication will help in the management of the frequent changes in his moods. This medication is therefore selected with the need for the treatment of the patient by handling the symptoms that are recorded due to bipolar disorder (Landersdorfer et al., 2017). The medication is expected to help in the management of the change in moods since it acts on the neurotransmitters and hence allowing for management of the moods that a patient may have.

Desired Treatment Goals

 The manic symptoms that are recorded are as well expected to be reduced by the use of this medication. As such, this medication is selected to ensure that the exaggerated moods of the patient are managed. Gozutok et al. (2019) add that the use of this medication is as well important for treating issues of anxiety and issues of having loud speaking.

Outcomes of the decision

After four weeks the patient is brought back to the healthcare facility for follow up and is found that the patient has not fully been compliant with the use of the medication since there are instances that he used the medication and in other instances did not use the medication. The patient is reported to have had no change in his condition.

Decision Point 2

The selected option for this case is the use of Begin Seroquel XR 100 mg orally at HS. The patient should have had an increase in the dose for the medication but there must be a change of medication. Other than the increase in the dosage, the patient must be educated on the importance of compliance with the use of the medication

Decision Rationale

The use of this medication is because it will help in the process of determination of the easy ways of management of mood changes in the health setting. Thus, there is an ease in the process of patient care to ensure that one can eliminate the process of change. These efforts that are taken into account are expected to help in ensuring that cases of mood changes are managed effectively as opined by Garriga et al. (2017). This medication is as well of importance in the process of management of the working of the neurotransmitters.

Desired Treatment Goals

Outcomes

The outcomes that are attained with the use of this medication are seen after four months when the patient makes a visit to the healthcare facility and it found that the patient has had an addition of weight. The patient as well points out that he has had an incidence of dry mouth and instance of constipation. The positive response found in this case is that there is an improvement in the mania condition since there is a reduction in the occurrences. The patient indicates that there has been a rise in instances where he has a good mood. The complaint presented by the patient is that the medication has had an extensive case of side effects. There is a need therefore for handling the side effect that is seen in the use of this medication to ensure that it does not affect the quality of well-being of the patient. There is a need as well for handling the issues of education of the patient on the healthcare measures that should be put into an account at all times for the best aspect of health that should be taken into account. The education as well should be in line with the need for having a better understanding of the challenges that are faced in the process of decision making and the need for compliance to the use of the medication.

Decision Point 3

The decision that is made in this case concerning the need for having a better direction of care that allows for the patients to be well informed of the best healthcare direction needed. There is a need as well for ensuring that the healthcare providers can reach out to the patients to ensure that the side effects of the medication are is handled. As such, the decision will be useful for the determination of the option that is attained concerning the side effects and the healing and making a comparison of the best option to be made. The choice, in this case, is to discontinue Seroquel and go back to Lithium.  

Decision Rationale

The reasons for discontinuing the use of Seroquel and go back to Lithium is because the use of Seroquel has resulted in side effects that may not be preferable and can be avoided. As alluded by Yatham and Kesavan (2017), the use of lithium 300 mg orally daily allows for the patients to have effective management of the issue of bipolar disorder and has fewer side effects as compared to the use of Seroquel.

Desired Treatment Goals

The use of this medication will be of importance in that it allows for the reduction of issues of noncompliance with the effective education of patients. The patient will have to receive education on the issues of compliance with the use of medication and the necessary options that should be handled concerning the process of care for patients. The patient as well should be informed of the expectation with the adherence to the use of the medication. This will be a motivation for the patient to adhere to the medication and get the best health standards.

Patient Outcome

The expectation for the use of this medication was to have a better health standard for the patient. When the patient comes to the healthcare facility for follow up after four weeks, it is found that the patient has a change in mood and that the condition of the patient has become better and that the quality of life of the patient has improved. The process ensured that there is an improvement in the quality of health and that the issue of manic moods is managed.

Ethical and Legal Consideration

In the process of provision of care and the treatment plan for patients, one must consider the ethical standards. First, the process of care mustn’t be affected by the condition that is in place and that the use of the medication should not affect the health of the patient. The healthcare providers as well should act in a way to ensure that the process of care for patients is genuine and that there is the avoidance of any issues of poor health. This includes the kind of medication that is to be used and the dosage that is to be given to the patient. It is the importance that they are in linewith the require protocols of management of issues of bipolar disorder.

Evidence-based nursing is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. It is not about developing new knowledge or validating existing knowledge, but rather translating existing evidence so that it can be applied to clinical decision making. This process starts with formulating a sound PICO question. PICO is a format for developing a good clinical research question prior to starting a review or research. It is a mnemonic used to describe the four elements of a sound clinical foreground question. 

Scenario:

A 17-year-old African American woman, just diagnosed with hepatitis B, has been taking acetaminophen for headaches. Her mother has heard that acetaminophen can cause liver problems, and she asks you if her daughter should continue taking the drug for her headaches, considering her hep-b diagnosis.

Answer the following questions in essay format about the scenario above:

1. What is evidence-based nursing practice and why is it important?
   1. What is the PICO process?
   2. Formulate a well defined clinical question that will yield the most relevant and best evidence.
   3. Describe the background of the question
   4. Present the question using PICOT format
   5. Indicate what will be the best study to answer the clinical question.

Write an argumentative essay on the following topic. Take your position and support with the evidence and reasons. Evidence includes facts, data, and quotes. Evidence should be supported. 

• Do you think that technology is helping over society more or harming it more? In what ways?

           Follow an APA format. Write a five-paragraph essay. At-least, include two citations. do not forget to include References on a separate page. 

 

Healthcare organizations are like any other business in that there are teams of people to be guided to meet the organization’s goals. Groups require leaders, and the leaders must lead effectively for successful outcomes. Unfortunately, not every unit manager or department head is good at leading necessarily. 

Transformational leadership and high-performance

 Nursing education includes learning how to think critically, problem-solving, and when and who to delegate tasks to ensure the most efficient work completion. Nurse managers benefit from honing those skills when leading a team. Nurse managers are in the complicated position of advocates for their team members and patients and representatives of higher management and the organization (Asiri et al., 2016). That said, nurse managers have a lot of responsibility, and it simply is not reasonable for any manager to expect to control and manage every detail of their unit. Being a good manager means being good at empowering others to step and lead (Asiri et al., 2016). When lower-level members of a team are empowered and given reasonable autonomy to perform their job functions without being under intense scrutiny, their achievements grow in connection to the organization, and the investment grows for that person. When an individual is investing in their work, they tend to have more commitment to it, connecting purpose to their roles as team members (Asiri et al., 2016). A healthcare organization with invested and committed team members is an organization with quality care outcomes (Asiri et al., 2016).

Leadership influence on the nursing workforce

The transformational leadership style is the preferred and most successful leadership style in the healthcare industry (Alloubani et al., 2019). Transformational leaders exhibit how much they value their team and everyone on the team by seeking team involvement in decision-making and recognizing each contribution (Fischer, 2016). The transformational team leader encourages personal growth for its team, showing interest in the people’s well-being on the team. Team members recognized and shown concern for as individuals are team members that feel cared for and part of the organization’s family. Team members will give back what they receive in quality work that results in improved patient outcomes and work-life satisfaction (Fischer, 2016).

References

Alloubani, A., Akhu-Zaheya, L., Abdelhafiz, I. M., & Almatari, M. (2019). Leadership styles’ influence on the quality of nursing care. International Journal of Health Care Quality Assurance, 32(6), 1022-1033. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.1108/IJHCQA-06-2018-0138

Asiri, S. A., Rohrer, W. W., Al-Surimi, K., Da’ar, O. O., & Ahmed, A. (2016). The association of leadership styles and empowerment with nurses’ organizational commitment in an acute health care setting: a cross-sectional study. BMC Nursing, 15(38), n.d. Retrieved from https://doi.org/10.1186/s12912-016-0161-7

Fischer, S. A. (2016). Transformational leadership in nursing: a concept analysis. Journal of Advanced Nursing, 72(11), 2644-2653. Retrieved from https://doi.org/10.1111/jan.13049

  

Scenario: Family
An 83, year old woman is recovering from pneumonia. She has Alzheimer’s disease and has become increasingly hostile and unmanageable in the home setting. Her 65, year old daughter is distraught about the idea of placing her mother in a long term care facility but feels she is not able to care for her.

Directions:
Part 1:
• The post must be at least 200 – 300 words in length
• What is your role in this situation?
• How might you help the daughter with her decision?
• What information would you give the daughter?

Scenario: Family
A 78, year old man is a retired banker whose wife died several years ago. He is able to perform all ADLs but needs help with meal preparation and transportation. He lives in a deteriorating neighborhood and no longer feels safe. He does not want to live with family members or completely give up his independence.

Directions:
Part 1:
• The post must be at least 200 – 300 words in length
• What housing options would be appropriate for him? Why?
• What advantages would such housing options offer over living alone?

Scenario: Exercise
You are checking blood pressures at a senior citizen health fair. After you check the blood pressure of an older woman, she asks you about starting an exercise program. She has not been exercising, but some of her friends have told her that she should start to exercise regularly.

Directions:
Part 1:
• The post must be at least 200 – 300 words in length
• What recommendations do you give her?
• What precautions do you include in your recommendations?

Scenario: Safety
A 77, year old woman is hospitalized for management of her diabetes. She has a history of functional urinary incontinence and poor vision from the diabetes. The nursing staff observes her climbing over the side rails on numerous occasions at night en route to the bathroom. She is quite agitated during this time. The nursing assistant requests that you obtain an order for a body restraint at night to prevent her from falling out of bed.

Directions:
Part 1:
• The post must be at least 200 – 300 words in length
• Should this patient be restrained to prevent injury?
• Would you request the order for a body restraint? Why, or why not?
• What other information is relevant to this case?
• What nursing interventions could be tried before considering a restraint?