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. Therapy for Clients With Comorbid Conditions Nursing Essay.

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

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 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. (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.

This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct. Therapy for Clients With Comorbid Conditions Nursing Essay.

 

 

ADDITIONAL INFORMATION 

Therapy for Clients With Comorbid Conditions

Introduction

The definition of comorbidity is “an interaction between two or more disorders that are present at the same time.” This can be confusing, especially when you’re trying to figure out how best to treat your client. If you have a client with both mental health and substance use issues, for example, should you treat their substance use disorder first? Or should you work on their mental health problems first?

There are three different comorbidity diagnoses that make it difficult for a client to get needed care:

The presence of comorbidity is a medical term that describes the presence of two or more diseases in the same person. Patients who have multiple health conditions are at risk for complications, delays in diagnosis and treatment, and lower quality of life.

The most common comorbid conditions include:

• Attention deficit hyperactivity disorder (ADHD) – ADHD is one of the most commonly diagnosed children’s psychiatric disorders with an estimated prevalence rate around 6%. It affects about 7% of adults worldwide (approximately 190 million people). Children with ADHD tend to exhibit symptoms such as distractibility, impulsivity and hyperactivity which vary from mild to severe levels depending on their age at onset (1). In addition to impairing school performance there may be behavioral problems such as aggression towards peers or teachers due to impulsive behavior resulting from difficulty concentrating on tasks required by school setting; these issues can lead up into adulthood when they become more difficult than ever before!

The first is medical comorbidity.

Medical comorbidity is the presence of two or more medical conditions in a patient. It can be challenging for clients to manage both their mental health and substance use disorders, especially when they are simultaneously being treated for different diseases.

Here are some examples of medical comorbidity:

• Diabetes and heart disease, which are common risk factors for developing depression;

• Severe arthritis pain that interferes with daily functioning;

• Painful conditions like asthma or arthritis (which often result in a loss of sleep);

• Depression symptoms caused by an underlying medical condition such as cancer or stroke (e.g., post-traumatic stress disorder).

The second is addiction comorbidity, which refers to clients with mental health disorders who also have an alcohol or substance use disorder.

Addiction comorbidity is a common condition that can make it difficult to treat your client with mental health disorders. It’s important to understand how this condition affects clients and how you can successfully manage it in your practice.

• Addiction comorbidity refers to clients with mental health disorders who also have an alcohol or substance use disorder. This may be the result of their symptoms, but it doesn’t necessarily mean they’re addicted—it just means that one disorder has been triggered by another.

• For example: A client who struggles with depression might have trouble sleeping because anxiety causes him or her not to feel safe at night and therefore keeps him or her awake all night long; this leads eventually into daytime drinking where he/she becomes dependent on alcohol for relief from those feelings of fearfulness (anxiety).

The third is chronic pain, which often occurs in tandem with mental health issues and substance use disorders.

The third is chronic pain, which often occurs in tandem with mental health issues and substance use disorders. Chronic pain is defined as continuous or intermittent pain that lasts longer than three to six months. Chronic pain can be caused by a variety of ailments, including arthritis, cancer, and fibromyalgia—and it’s no surprise that these conditions are more common than you might think.

Chronic pain can lead to depression and anxiety for clients who already have mental health problems; it also may trigger panic attacks for those who do not have previous experience with this type of disorder.

Takeaway:

As you can see, there are many different types of comorbidity. It can be difficult for clients with more than one diagnosis to get the right care. In addition, there are many different ways that people experience their illness and the symptoms they experience in relation to their comorbid conditions.

Conclusion

For clients with comorbid conditions, it can be very difficult to get the treatment they need. If you want to help these clients and their families, we hope you’ll consider our program. It’s designed specifically for them and includes services like individual therapy, couples counseling, family therapy, and case management.