DELIVER WITHIN 6 HRS

#775865 Topic: Part 2 - Assignment: Assessing and Treating Clients with With Bipolar Disorder Number of Pages: 2 (Double Spaced) Number of sources: 1 Writing Style: APA Type of document: Research Paper Academic Level:Master Category: Nursing ATTACHEMENTS; Order_Files_775826_1.docx (HAS THE INSTRUCTIONS WHAT NEED TO BE DONE AT 2 PAGES) Finished_Order_775826_3.docx (THE OTHER PART OF THE ASSIGNMENT WHICH IS PART OF THIS.) Included here is part 1 of this assignment. the writer already did a good job. The writer needs to use correct information on POINT TWO DECISION AND POINT THREE DECISION . The writer's introduction is good, DECISION POINT ONE IS GOOD, AND THE CONCLUSION IS GOOD. You are supposed to work on the information herein for "POINT TWO DECISION AND POINT THREE DECISION" Decision Point Two Discontinue Risperdal and start Lithium sustained release 300 mg orally BID RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Client no longer lethargic after the end of the first week Client has a slight decrease in her Young Mania Rating Scale (from 22 to 19) Client reports that her sleep is again decreasing, but that overall, she is happy Decision Point Three Increase Lithium SR to 450 mg orally BID Guidance to Student Recall that the client is of Korean descent and is positive for CYP2D6*10 allele. As a result, she may be demonstrating slower clearance of Risperdal from her system, resulting in higher than normal levels of Risperdal in the blood, resulting in sedation. The client responded well to the discontinuation of Risperdal and after about a week of drug cessation, she was no longer lethargic /sedate. However, in the following 3 weeks, she had experienced increased symptoms, although a slight improvement in YMSR score was noted. The PMHNP could make no changes at this time and allow the lithium to remain at its current dose for an additional 4 weeks and reassess. Conversely, the PMHNP can increase the lithium to 450 mg orally BID and then reassess in 4. The additional milligrams may hasten mood stabilization. Risperdal 0.5 mg orally BID may be appropriate if the clients� symptoms are worsening, however, the PMHNP would need to have the client return to the office sooner than 4 weeks for an interim visit to assess effects of drug and presence of somnolence/lethargy. Remember decision Two will have The Selected Decision: Reason for Selection Expected Results Disparities between the Expected Results and the Actual Results Remember decision Three will have The Selected Decision: Reason for Selection Expected Results Disparities between the Expected Results and the Actual Results