ASSESSING AND TREATING PATIENTS WITH BIPOLAR DISORDER
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ASSESSING AND TREATING PATIENTS WITH BIPOLAR DISORDER
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
• Ostacher, M. J., & Hsin, H. (2016). The use of antiepileptic drugs in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 93–98). Elsevier.
• Perlis, R. H., & Ostacher, M. J. (2016a). Bipolar disorder. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 48–60). Elsevier.
• Perlis, R. H., & Ostacher, M. J. (2016b). Lithium and its role in psychiatry. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 86–92). Elsevier.
• Traeger, L., Brennan, M. M., & Herman, J. B. (2016). Treatment adherence. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 20–26). Elsevier.
• American Psychiatric Association. (2010b). Practice guideline for the treatment of patients with bipolar disorder Links to an external site. (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.pdf
• Chen, R., Wang, H., Shi, J., Shen, K., & Hu, P. (2015). Cytochrome P450 2D6 genotype affects the pharmacokinetics of controlled-release paroxetine in healthy Chinese subjects: Comparison of traditional phenotype and activity score systems. European Journal of Clinical Pharmacology Links to an external site., 71(7), 835–841. https://doi.org/10.1007/s00228-015-1855-6
• Hirschfeld, R. M. A. (n.d.). Guideline watch: Practice guideline for the treatment of patients with bipolar disorder Links to an external site. (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch.pdf
• Vitiello, B. (2013). How effective are the current treatments for children diagnosed with manic/mixed bipolar disorder? CNS Drugs Links to an external site., 27(5), 331–333. https://doi.org/10.1007/s40263-013-0060-3
MEDICATION RESOURCES
• U.S. Food & Drug Administration. (n.d.). Drugs@FDA: FDA-approved drugs Links to an external site.. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm
Note: To access the following medications, use the Drugs@FDA resource. Type the name of each medication in the keyword search bar. Select the hyperlink related to the medication name you searched. Review the supplements provided and select the package label resource file associated with the medication you searched. If a label is not available, you may need to conduct a general search outside of this resource provided. Be sure to review the label information for each medication as this information will be helpful for your review in preparation for your Assignments.
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
REQUIRED MEDIA
• Doc Snipes. (2022, February 14). Bipolar disorder assessment and diagnosis Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=onKHtQWkNaU
Note: The approximate length of this media piece is 1 hour and 5 minutes
OPTIONAL RESOURCES
• Mostafavi, A., Solhi, M., Mohammadi, M., Hamedi, M., Keshavarzi, M., & Akhondzadeh, S. (2014). Melatonin decreases olanzapine induced metabolic side-effects in adolescents with bipolar disorder: A randomized double-blind placebo-controlled trial. Acta Medica Iranica Links to an external site., 52(10), 734–739. http://acta.tums.ac.ir/index.php/acta
TO PREPARE FOR THIS ASSIGNMENT:
• Review this week’s Learning Resources, including the Medication Resources indicated for this week.
• Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring bipolar therapy.
THE ASSIGNMENT: 5 PAGES
For this assignment, you will write a 5–6-page paper on the topic of bipolar and bipolar and related disorders. You will create this guide as an assignment; therefore, a title page, introduction, conclusion, and reference page are required. You must include a minimum of 3 scholarly supporting resources outside of your course provided resources.
In your paper, you will choose one of the following diagnoses: Bipolar I, Bipolar II, Cyclothymic Disorder, Substance/Medication-Induced Bipolar and Related Disorder, Bipolar and Related Disorder Due to Another Medical Condition. Your paper will include discussion for your chosen diagnosis of bipolar and related disorder on the following:
• Prevalence and Neurobiology of your chosen disorder
• Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria
• Discuss special populations and considerations (children, adolescents, pregnancy/post-partum, older adult, emergency care) for your chosen bipolar and related disorder; demonstrating critical thinking beyond basics of HIPPA and informed consent with discussion of at least one for EACH category: legal considerations, ethical considerations, cultural considerations, social determinants of health
• Discuss FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder
• Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring
• Provide 3 examples of how to write a proper prescription that you would provide to the patient or transmit to the pharmacy.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center Links to an external site.provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.
BY DAY 7
Submit your Assignment.
SUBMISSION INFORMATION
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1. To submit your completed assignment, save your Assignment as WK5Assgn_LastName_Firstinitial
2. Then, click on Start Assignment near the top of the page.
3. Next, click on Upload File and select Submit Assignment for review.
Rubric
NURS_6630_Week5_Assignment_Rubric
NURS_6630_Week5_Assignment_Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeWrite a 5–6-page paper on the topic of bipolar and bipolar related disorders: • Prevalence • Neurobiology 20 to >17.0 pts
Excellent Point range: 90–100
Discussion includes Prevalence and Neurobiology of chosen bipolar and related disorder. 17 to >15.0 pts
Good Point range: 80–89
Discussion is vague regarding Prevalence and Neurobiology of chosen bipolar and related disorder. 15 to >13.0 pts
Fair Point range: 70–79
Discussion is missing one section for Prevalence and Neurobiology of chosen bipolar and related disorder. 13 to >0 pts
Poor Point range: 0–69
Discussion is inaccurate or missing more than one section for Prevalence and Neurobiology of chosen bipolar and related disorder.
20 pts
This criterion is linked to a Learning Outcome• Discuss the differences between your chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria. 20 to >17.0 pts
Excellent Point range: 90–100
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria. 17 to >15.0 pts
Good Point range: 80–89
Discussion includes the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM version older than DSM 5 TR criteria. 15 to >13.0 pts
Fair Point range: 70–79
Discussion is vague in differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria and/or missing discussion presentation of symptoms according to DSM 5 TR criteria or older version of DSM. 13 to >0 pts
Poor Point range: 0–69
Discussion is inaccurate or does not include the differences between chosen disorder and one other bipolar and related disorders in relation to the diagnostic criteria including presentation of symptoms according to DSM 5 TR criteria or older version of DSM.
20 pts
This criterion is linked to a Learning Outcome• Discuss special populations and considerations (children, adolescent, pregnancy/post-partum, older adult, emergency care) for your chosen bipolar and related disorder-be specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health. 20 to >17.0 pts
Excellent Point range: 90–100
Special Populations and Considerations are discussed and specific, not general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health. 17 to >15.0 pts
Good Point range: 80–89
Special Populations and Considerations are discussed not specific, but general and address at least one for EACH category demonstrating critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health. 15 to >13.0 pts
Fair Point range: 70–79
Special Populations Considerations are discussed not specific, but general and missing 1-2 of EACH category and does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health. 13 to >0 pts
Poor Point range: 0–69
Special Populations Considerations are vaguley or not discussed, not specific, is inaccurate and/or general and missing 3+ or more of or none of EACH category, inaccurate discussion and/or does not demonstrate critical thinking beyond basics of HIPPA and informed consent: legal considerations, ethical considerations, cultural considerations, social determinants of health.
20 pts
This criterion is linked to a Learning Outcome• Discuss FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for your chosen bipolar and related disorder • Of the medication treatment options for your chosen disorder discuss side effects, FDA approvals and warnings. What is important to monitor in terms of labs, comorbid medical issues with why important for monitoring. 15 to >13.0 pts
Excellent Point range: 90–100
Discussion includes FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues with why important formonitoring. 13 to >11.0 pts
Good Point range: 80–89
Discussion includes vague FDA and/or clinical practice guidelines approved pharmacological treatment options in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is vague discussion regarding side effects, FDA approvals and warnings. Paper includes vague discussion what is important to monitor in terms of labs, comorbid medical issues with why important for monitoring. 11 to >9.0 pts
Fair Point range: 70–79
Discussion includes pharmacological treatment options but not aligned with FDA approved and/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is missing elements for discussion regarding side effects, FDA approvals and warnings. Paper includes what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring. 9 to >0 pts
Poor Point range: 0–69
Discussion inaccurate and/or missing pharmacological treatment options but not aligned with FDA approved and/or clinical practice guidelines in relation to acute and mixed episodes vs maintenance pharmacological treatment for chosen bipolar and related disorder; Of the medication treatment options chosen for the disorder there is inaccurate or no elements for discussion regarding side effects, FDA approvals and warnings. Paper does not include what is important to monitor in terms of labs, comorbid medical issues but does not discuss why important for monitoring.
15 pts
This criterion is linked to a Learning OutcomeProvides three examples of how to write a proper prescription that would be provided to patient and/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature. 15 to >13.0 pts
Excellent Point range: 90–100
Provides three examples of how to write a proper prescription that would be provided to patient and/or transmitted to pharmacy. Prescription contains date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature. 13 to >11.0 pts
Good Point range: 80–89
Provides three examples of how to write a proper prescription that would be provided to patient and/or transmitted to pharmacy. Prescription is missing 1-2 elements of the following; date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature. 11 to >9.0 pts
Fair Point range: 70–79
Provides two examples of how to write a proper prescription that would be provided to patient and/or transmitted to pharmacy. Prescription is missing 3 of the following: date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature. 9 to >0 pts
Poor Point range: 0–69
Provides one example of how to write a proper prescription that would be provided to patient and/or transmitted to pharmacy. Prescription is missing 4+ or is inaccurately written for date, medication and strength, amount to be taken, route to be taken, frequency, indication, quantity, refills; providers signature.
15 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—Paragraph development and organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. 5 to >4.0 pts
Excellent Point range: 90–100
Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.5 pts
Good Point range: 80–89
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time….Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. 3.5 to >3.0 pts
Fair Point range: 70–79
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment is vague or off topic. 3 to >0 pts
Poor Point range: 0–69
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided.
5 pts
This criterion is linked to a Learning OutcomeWritten Expression and Formatting—English writing standards: Correct grammar, mechanics, and punctuation; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources; Paper is 5-6 pages not counting title page and reference page. 5 to >4.0 pts
Excellent Point range: 90–100
Uses correct grammar, spelling, and punctuation with no errors; Includes title page and reference page with a minimum of 3 scholarly supporting resources outside of course provided resources. Paper is 5-6 pages not counting title page and reference page. 4 to >3.5 pts
Good Point range: 80–89
Contains a few (one or two) grammar, spelling, and punctuation errors; includes the following: title page and reference page. Only contains 2 scholarly supporting resources outside of course provided resources. Paper is 4 pages not counting title page and reference page. 3.5 to >3.0 pts
Fair Point range: 70–79
Contains several (three or four) grammar, spelling, and punctuation errors; missing one of the following; title page or reference page; only contains 1 scholaraly supporting resources outside of course provided. Paper is 3 pages or exceeds to page 7 not counting title page and reference page. 3 to >0 pts
Poor Point range: 0–69
Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding; missing the following; title page and reference page; contains no scholaraly supporting resources outside of course provided resources. Paper is 2 pages or exceeds 8 pages not counting title page and reference page.
5 pts
Total Points: 100
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