NURS 6630: Psychopharmacologic Approaches to Treatment of Psychopathology | Week 11

As a psychiatric mental health nurse practitioner, you will frequently work with clients who have comorbid conditions. For instance, you may treat a 19-year-old male with Down syndrome and increasing violent behaviors; a middle-aged female with schizophrenia, diabetes, and poor renal function; or an older adult with a mental disorder, stage I Alzheimer’s disease, and chronic obstructive pulmonary disease (COPD). In cases like these, you must draw from foundational knowledge of pathophysiology and collaborate with other healthcare providers to ensure optimal safely and efficacy of psychopharmacological therapies for clients.

This week, as you study therapy for patients with comorbid conditions, you examine psychopharmacologic approaches to treatment for clients across the lifespan.

Final Exam

This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for clients across the lifespan:

• Therapy for Clients with Pain and Sleep/Wake Disorders
• Therapy for Clients with Impulsivity, Compulsivity, and Addiction
• Therapy for Clients with ADHD
• Therapy for Clients with Dementia
• Therapy for Clients with Comorbid Conditions

Learning Objectives – NURS 6630: Week 11 Nursing Therapy for Clients With Comorbid Conditions

Students will:

• Assess psychopharmacologic approaches to treatment for clients across the lifespan

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 Materialssection 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. (2014a). Stahl’s illustrated violence: Neural circuits, genetics and treatment. New York, NY: Cambridge University Press.

To access the following chapter, click on the Illustrated Guides tab and then the Violence tab.

• Chapter 3, “Treatment of Violence and Aggression”

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

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

Review the following medications:

For Alzheimer’s disease

• donepezil
• galantamine
• memantine
• rivastigmine

For Parkinson’s disease with dementia

• rivastigmine

Crocker, A. G., Prokić, A., Morin, D., & Reyes, A. (2014). Intellectual disability and co-occurring mental health and physical disorders in aggressive behaviour. Journal of Intellectual Disability Research, 58(11), 1032–1044. doi:10.1111/jir.12080

Erickson, S. C., Le, L., Zakharyan, A., Stockl, K. M., Harada, A. M., Borson, S., & … Curtis, B. (2012). New-onset treatment-dependent diabetes mellitus and hyperlipidemia associated with atypical antipsychotic use in older adults without schizophrenia or bipolar disorder. Journal of the American Geriatrics Society, 60(3), 474–479. doi:10.1111/j.1532-5415.2011.03842.x

Hulvershorn, L. A., Schroeder, K. M., Wink, L. K., Erickson, C. A., & McDougle, C. J. (2015). Psychopharmacologic treatment of children prenatally exposed to drugs of abuse. Human Psychopharmacology, 30(3), 164–172. doi:10.1002/hup.2467

Malhotra, A. K., Zhang, J., & Lencz, T. (2012). Pharmacogenetics in psychiatry: Translating research into clinical practice. Molecular Psychiatry, 17(8), 760–769. doi:10.1038/mp.2011.146

Substance Abuse and Mental Health Services Administration. (2013). Substance abuse treatment for persons with co-occurring disorders: A treatment improvement protocol. Treatment Improvement Protocol (TIP) Series 42. Rockville, MD: Author. Retrieved from http://store.samhsa.gov/shin/content//SMA13-3992/SMA13-3992.pdf

Document: Final Exam Study Guide (PDF)

Optional Resources

Stahl, S. M. (2014a). Stahl’s illustrated violence: Neural circuits, genetics and treatment. New York, NY: Cambridge University Press.

To access the following chapters, click on the Illustrated Guides tab and then the Violence tab.

• Chapter 1, “Which Individuals Will Become Violent or Aggressive?”
• Chapter 2, “Neurobiology and Genetics of Violence and Aggression”

Final Exam:

This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for clients across the lifespan:

• Therapy for Clients with Pain and Sleep/Wake Disorders
• Therapy for Clients with Impulsivity, Compulsivity, and Addiction
• Therapy for Clients with ADHD
• Therapy for Clients with Dementia
• Therapy for Clients with Comorbid Conditions

By Day 7

Complete the Final Exam. Prior to starting the exam, you should review all of your materials. There is a 2-hour time limit to complete this 76-question exam. You may only attempt this exam once. NURS 6630: Week 11 Nursing Therapy for Clients With Comorbid Conditions.

ADDITIONAL INFO 

Nursing Therapy for Clients With Comorbid Conditions

Introduction

If you’re a client with multiple conditions, it’s important to know that nursing therapy can help you manage your condition and improve your overall health. In this post, we will explore the most common comorbidities that affect people with chronic diseases.

CHF

CHF is a disease of the heart muscle. It can be caused by a variety of factors, including high blood pressure and heart valve problems. CHF also occurs in people with coronary artery disease (CAD).

CHF is usually treated with medications that reduce blood pressure, increase blood flow to the heart muscle, and improve oxygen delivery to cells throughout your body.

COPD

• COPD is a disease that affects the lungs and airways.

• It can be caused by smoking, exposure to harmful chemicals, and other factors.

COPD can be hard to diagnose because it doesn’t show up on many tests or symptoms. It’s also common for people with COPD to have more than one condition at once.

Hemophilia

Hemophilia is a bleeding disorder caused by a lack of clotting factor VIII. Clotting factors are proteins that help blood to clot and restore normal function after injury. If a person has too little or no clotting factor, there will be excessive bleeding from cuts, wounds and other injuries.

Clients with hemophilia may experience bruising more easily than those without the condition; they may also have trouble healing cuts quickly because they do not produce enough of the appropriate type of platelets (which help form clots). In addition, people with hemophilia may develop infections due to prolonged use of antibiotic medicines or other treatments prescribed by their doctor.

Diabetes Mellitus

Diabetes mellitus is a chronic condition that can cause several health problems. The most common type of diabetes is type 1, an autoimmune disease. Type 2 diabetes is caused by lifestyle factors such as obesity and lack of exercise.

Diabetes mellitus affects the body’s ability to regulate blood sugar levels and produces both short-term effects such as fatigue, blurred vision and frequent urination as well as long-term complications such as heart disease or stroke.

Treatment for both types of diabetes involves medication (insulin) administered daily to keep glucose levels in check so that they remain near normal despite fluctuations in food intake or activity level (resting energy expenditure).

Hepatitis C

Hepatitis C is a viral infection that can cause inflammation of the liver. It’s spread through blood-to-blood contact, such as through sharing needles or having sex with someone who has it. Symptoms include fatigue, nausea, vomiting and jaundice. Treatment options include interferon therapy and antiviral drugs such as ribavirin (an oral medication).

Takeaway:

The take away from this is that it is important to understand the client’s comorbid condition. This will help you to tailor your care plan and treatment plans based on their specific needs.

Conclusion

It is important to remember that clients with comorbid conditions have unique challenges, so it’s important that you are well-versed in their management and how to effectively manage their symptoms. It also means you should be prepared for the possibility of a long-term treatment plan when working with your clients.