An Asian american Woman With Bipolar Disorder Essay.

Posted: November 6th, 2022

An Asian american Woman With Bipolar Disorder Essay.

Examine Case Study: An Asian American Woman With Bipolar 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.

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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?
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 academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

Begin Risperdal 1 mg orally BID

The decision selected for this patient is beginning Risperdal 1 mg orally twice a day.

I selected this decision because Risperdal is considered to be the best treatment choice for bipolar disorder. It is an atypical antipsychoticthat stabilizes the brain, improving moods, thoughts and behavior of the patients. It is also approved by the US Food and Drug Administration and is also used to manage irritability associate with bipolar disorder (Stahl, 2013).

By prescribing this medication, I was hoping to manage her moods and bring them back to normal by eliminating the changes. I also expected the client to have normal sleeping patterns since she complained of hating sleep. Moreover, I sought to have the client adjust her behavior to normal. As such, she is expected to verbalize the changes experienced within four weeks of treatment. She should be able to concentrate and express herself without ambiguity as the medication works to balance her brain substances (Stahl, 2013).

The difference between the actual outcomes and the expected results after four weeks include lethargy and sedation. The client appeared calm and sluggish probably following the side effects of Risperdal medication. The client’s mother reports that she has been lethargic and sedated since about a week after the last office visit.

Decision #2

Decrease Risperdal to 1mg at HS at bedtime

I selected this decision because; the client appeared to be intolerant to the high dosage administrated initially. As such, the reduction of the strength will help alleviate the lethargy and sedation side effects and help the client improve her symptoms. Clients with Korean descent are positive for CYP2D6*10 allele which increases the vulnerability to Risperdal side effects at higher dosages (Dean, 2017).

With this decision, I was hoping to eliminate the sedative impacts of Risperdal at 1mg BID. I was also seeking to reduce the lethargic feeling associated with the side effects. Moreover, I expected the client to demonstrate improvements in her thoughts and behaviors. This is because, the Risperdal to 1mg at HS at bedtime prescribed has reduced strength that is tolerable to patients and hence presents less side effects and more positive outcomes of the symptoms (Stahl, 2013).

The difference between the expected and the actual outcome was that the lethargic and sedation had reduced but not eliminated completely.  The young mania Young Mania Rating Scale had also reduced from 22 to 16. This demonstrated a positive change in the treatment. It also indicates that she tolerates the drug and hence that presented the optimum dosage for her recovery having eliminated symptoms by 25%.

Decision #3

Continue at same dose of Risperdal and reassess in 4 weeks

The reason for selecting this decision is because the client has shown positive improvement of bipolar symptoms. Being a Korean with positive for CYP2D6*10 allele, she might take longer to clear the medication in the blood causing side effects if the dosage was to be increased (Lee et al., 2011).

The patient was expected to completely recover from the continuation of the medication without side effects (American Psychiatric Association, 2017).

There was no difference observed from the expected during the reassessment of the client. She demonstrated positive outcomes.

Ethical Considerations

The ethical considerations that might impact treatment and communication include the cultural background of the client and how they perceive medication and treatment of mental disorders. As such, autonomy ethical principle should be employed to ensure respect for the client’s dignity.