Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment

Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment

Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

To prepare for this Assignment:
• Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.
The Assignment
Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client.Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.
• At each decision point stop to complete the following Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment:
o Decision #1
§ Which decision did you select?
§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.
§ What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
§ Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

BUY A PLAGIARISM-FREE PAPER HERE

o Decision #2
§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.
§ What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
§ Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
o Decision #3
§ Why did you select this decision? Support your response with evidence and references to the Learning Resources.
§ What were you hoping to achieve by making this decision?Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment. Support your response with evidence and references to the Learning Resources.
§ Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
• Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three ( 3) academic resources. While you may use the course text to support your rationale, it will not count toward the resource re

SEE ATTACHED CASE STUDY.

Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

 To prepare for this Assignment:

  • Review this week’s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy.

The Assignment

Examine Case Study: An Elderly Hispanic Man With Major Depressive Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

  • At each decision point stop to complete the following:
    • Decision #1
      • Which decision did you select?
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
    • Decision #2
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment
    • Decision #3
      • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
      • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
      • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
  • Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three ( 3)  academic resources. While you may use the course text to support your rationale, it will not count toward the resource re

Assignment: Assessing and Treating Adult and Geriatric Clients With Mood Disorders

Advances in genetics and epigenetics have changed the traditional understanding of mood disorders, resulting in new evidence-based practices. Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment.In your role as a psychiatric mental health nurse practitioner, it is essential for you to continually educate yourself on new findings and best practices in the field. For this Assignment, you consider best practices for assessing and treating adult and geriatric clients presenting with mood disorders.

Learning Objectives

Students will:

  • Assess client factors and history to develop personalized plans of antidepressant therapy for adult and geriatric clients
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in adult and geriatric clients requiring antidepressant therapy
  • Evaluate efficacy of treatment plans
  • Analyze ethical and legal implications related to prescribing antidepressant therapy to adult and geriatric clients

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

 

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

 

Note: To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

  • Chapter 6, “Mood Disorders”

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press.

 

Note: To access the following medications, click on the The Prescriber's Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

 

Review the following medications:

  • amitriptyline
  • bupropion
  • citalopram
  • clomipramine
  • desipramine
  • desvenlafaxine
  • doxepin
  • duloxetine
  • escitalopram
  • fluoxetine
  • fluvoxamine
  • imipramine
  • ketamine
  • mirtazapine
  • nortriptyline
  • paroxetine
  • selegiline
  • sertraline
  • trazodone
  • venlafaxine
  • vilazodone
  • vortioxetine

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: Retrieved from Walden Library databases.

Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389. Retrieved from https://www.researchgate.net/profile/Marie_Asberg/publication/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change/links/09e41513f85c708fee000000.pdf

 

Required Media

Laureate Education. (2016g). Case study: An elderly Hispanic man with major depressive disorder [Interactive media file]. Baltimore, MD: Author.

 

Note: This case study will serve as the foundation for this week’s Assignment.

 

 

Adult/Geriatric Depression
Hispanic Male With MDD

 

Decision Point One

 

Begin Effexor XR 37.5 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Client reports that there is no change in depressive symptoms at all

Decision Point Two

 

Increase dose to 75 mg of Effexor XR orally daily

 

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client reports an improvement in depressive symptoms
  • Montgomery- Asberg Depression Rating Scale (MADRS) decreased from 51 to 38 (25% reduction)Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment

Decision Point Three

 

Continue same dose of medication

 

Guidance to Student
At this point, the PMHNP would have two choices to discuss with the client- the current dose of drug can be maintained if the client is feeling better and is not offering any complaints of side effects. The dose can also be increased at this point, but the PMHNP must counsel client regarding the possibility of side effects. The use of an augmenting agent is not appropriate at this time as we have not reached a maximum dose with Effexor (in fact, 75 mg is still a relatively small dose), displaying primarily SSRI properties only (recall that at lower doses, Effexor exerts a greater effect on serotonergic receptors than norepinephrine at low doses).Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment

 

Adult/Geriatric Depression
Hispanic Male With MDD

 

Decision Point One

 

Begin zoloft 25 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Reports a 25% decrease in symptoms
  • Client is concerned over the new onset of erectile dysfunction

Decision Point Two

 

Decrease dose to 12.5 mg orally daily

 

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Erectile dysfunction has subsided
  • Depressive symptoms have worsened

Decision Point Three

 

Change to Paxil 20 mg orally daily

 

Guidance to Student
Increasing dose back to 25 mg orally daily may be appropriate as there is no guarantee that the side effect will return. If it does return at 25 mg orally daily, then the PMHNP should consider changing to another drug. Changing to Paxil 20 mg may also be appropriate at this point, as not all SSRIs have the same side effect profile. Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment.Changing to an SNRI would not be appropriate at this point as the issue is not that the client has not responded to SSRI therapy, rather, he has had a negative side effect to one drug in the class.

 

Adult/Geriatric Depression
Hispanic Male With MDD

 

Decision Point One

 

Begin Effexor XR 37.5 mg orally daily

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • Client reports that there is no change in depressive symptoms at all

Decision Point Two

 

Increase dose to 75 mg of Effexor XR orally daily

 

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client reports an improvement in depressive symptoms
  • Montgomery- Asberg Depression Rating Scale (MADRS) decreased from 51 to 38 (25% reduction)Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment

Decision Point Three

 

Continue same dose of medication

 

Guidance to Student
At this point, the PMHNP would have two choices to discuss with the client- the current dose of drug can be maintained if the client is feeling better and is not offering any complaints of side effects.Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment. The dose can also be increased at this point, but the PMHNP must counsel client regarding the possibility of side effects. The use of an augmenting agent is not appropriate at this time as we have not reached a maximum dose with Effexor (in fact, 75 mg is still a relatively small dose), displaying primarily SSRI properties only (recall that at lower doses, Effexor exerts a greater effect on serotonergic receptors than norepinephrine at low doses). Assessing and Treating Adult and Geriatric Clients with Mood Disorders Assignment