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Insomnia & Mental Illnesses Health Case Study

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Insomnia & Mental Illnesses Health Case Study

Description

Insomnia is one of the most common medical conditions you will encounter as a PMHNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). Due to the interconnected psychopathology, it is important that you, as the PMHNP, understand the importance of the effects some psychopharmacologic treatments may have on a patientàmental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.

Reference: Abbott, J. (2016). Whatàthe link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-l…

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patientàhealth needs.

Case: An elderly widow who just lost her spouse.

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husbandàdeath. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:

  • Metformin 500mg BID
  • Januvia 100mg daily
  • Losartan 100mg daily
  • HCTZ 25mg daily
  • Sertraline 100mg daily

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86

BY DAY 3 OF WEEK 7

Post a response to each of the following:

  • List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
  • Identify people in the patientàlife you would need to speak to or get feedback from to further assess the patientàsituation. Include specific questions you might ask these people and why.
  • Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
  • List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
  • List two pharmacologic agents and their dosing that would be appropriate for the patientàantidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.
  • For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
  • Include any èeck points(i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

Read a selection of your colleagues’ responses.

BY DAY 6 OF WEEK 7

Respond to at least two of your colleagues on two different days in one of the following ways:

  • If your colleagues0osts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
  • If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective. Read a selection of your colleagues2esponses and respond to at least two of your colleagues on two different days.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!

I hope all this helps and below is the rest of the announcement.

Week 7 Assignment Study Guide-

To make it easier for everyone I have picked some meds you can use depending on what the letter of your last name starts with. Please use these If you can not find an otherwise assigned medication .

Last name starts with :

A-H

I-P – Use Zyprexa (Olanzapine)

Q-Z

Areas of importance you should address, but are not limited to, are:

  • Title page
  • Description of the Psychopharmacological medication agent including brand and generic names and appropriate FDA indication uses
  • Any supporting, valid and reliable research for non-FDA uses
  • Drug classification
  • The medication mechanism of action
  • The medication pharmacokinetics
  • The medication pharmacodynamics
  • Mechanism of Action
  • Appropriate dosing, administration route, and any considerations for dosing alterations
  • Considerations of use and dosing in specific specialty populations to consider children, adolescents, elderly, pregnancy, suicidal behaviors, etc.
  • Definition of Half-life, why half-life is important, and the half-life for your assigned medication
  • Side effects/adverse reaction potentials
  • Contraindications for use including significant drug to drug interactions
  • Overdose Considerations
  • Diagnostics and labs monitoring
  • Comorbidities considerationsa
  • Legal and ethical considerations
  • Pertinent patient education considerations
  • Reference Page

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.

LEARNING RESOURCES

Required Readings

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.

  • amisulpride
  • aripiprazole
  • asenapine
  • brexpiprazole
  • cariprazine
  • chlorpromazine
  • clozapine
  • flupenthixol
  • fluphenazine
  • haloperidol
  • iloperidone
  • loxapine
  • lumateperone
  • lurasidone
  • olanzapine
  • paliperidone
  • perphenazine
  • pimavanserin
  • quetiapine
  • risperidone
  • sulpiride
  • thioridazine
  • thiothixene
  • trifluoperazine
  • ziprasidone
Explanation & Answer:
2 pages
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