Patient with Comorbid Addiction 6330

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SafeAssign Originality Report

DNRS-6630A-4/NURS-6630F-4/NURS-6630N-4/NURS-6630C-4/DNRS-6630-4-Approaches to Treatment-2021-Winter-QTR-Term-wks-1-thru-11-(11/29/2021-02/13/2022)-PT27•SafeAssign DraftsView Originality Report - Old Design

Monique MoiseTotal Score:

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High risk53%Submission UUID: 2f1e4001-bbfc-e8c6-1a46-f7c204d28114Total Score

Total Number of Reports

1

Highest Match

53 % Submission_Text.html

Average Match

53 %

Submitted on

02/04/22 10:11 PM EST

Average Word Count

1,150 Highest: Submission_Text.html

highRisk Created with Sketch.

Attachment 153%Word Count: 1,150 Submission_Text.html

• Institutional database (16) 44%
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• Internet (1) 9%
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    homeworkhelpermath

• Top sources (3)
  • 11

    Student paper

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    homeworkhelpermath

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    Student paper

• Excluded sources (0)

  I

  1

  The patient, Mrs Maria Perez, is a 53 years old Puerto Rican female.

  2

  She has had an alcohol problem since her father's death in her late teens.

  3

  Since her 20's, she has always struggled with alcohol, and she was always involved with alcoholics. She also reports that she has had more difficulties maintaining her sobriety for the past two years since the Rising Star casino was opened near her home. She mentioned that she enjoys taking a drink or two while gambling because it helps calm down during high-stakes games.

  4

  Over the past two years, her cigarette smoking has also increased.

  She is worried that the negative effects of smoking might affect her health.

  3

  She reported that she has attempted to quit drinking, but when gambling, she always feels that she should get “high” for her to rom the act of “even out.” She has also noticed that when she drinks alcohol, her smoking reduces, but she always enjoys smoking while playing at slot machines.

  She also mentioned that her drinking has made her gain weight and that she currently weighs 122 lbs.

  5

  She is also concerned that she had borrowed $50,000 from her retirement account to pay her gambling debut her husband doesn't know.

  6

  On performing the mental status exam, she is alert and oriented to person, place, time, and event.

  7

  She is appropriately dressed for the weather, and her speech is clear, coherent, and goal-directed.

  She does not maintain eye contact during the clinical interview.

  8

  She does not display any noteworthy gestures, mannerisms, or tics.

  9

  Her affect and self-reported mood are appropriate to the conversation content.

  10

  She does not have visual or auditory hallucinations, nor does she have a paranoid or delusional thought process.

  5

  Her judgment and insight are grossly intact, but her impulse control is impaired.

  11

  She denies having homicidal or suicidal ideations.

  Decision #1

  12

  My first decision is to administer an Antabuse (disulfiram) 250 mg orally every day.

  Disulfiram is a benzodiazepine, and it acts by decreasing the sensitivity of ethanol.

  It inhibits the enzyme acetaldehyde dehydrogenase, which is a hepatic enzyme in the alcohol metabolism oxidative pathway, thus converting acetaldehyde to acetate (Williams, 2019).

  This results in unpleasant effects such as headache, nausea, chest pain, blurred vision, and anxiety, some of the classic symptoms of alcohol hangover.

  I did not choose naltrexone injection 380 mg intramuscularly in the gluteal region and acamprosate 666mg orally thrice a day because disulfiram has a higher efficacy for preventing relapse in alcoholism compared to naltrexone and acamprosate.

  Also, the naltrexone dosage for alcoholism is 50 mg daily for adults (Zhou, 2019).

  By giving the patient disulfiram, I aimed to decrease the non-pleasant side effects of disulfiram.

  An alcoholic on disulfiram is unlikely to experience unpleasant symptoms upon smoking.

  Ethical considerations that may influence this treatment option include autonomy and non-maleficence.

  Non-maleficence will ensure that the medication will not cause any harm to the patient.

  In autonomy, the patient also has the right to decide the new treatment option.

  All information regarding the new medication should be communicated to the patient.

  This will impact the treatment plan because the patient will be able to make an informed choice.

  Decision #2

  13

  After four weeks, the client returned to the clinic, and she was complaining of fatigue, sedation, and a metallic taste in her mouth.

  The symptoms were not going away.

  11

  She also reported that she only had one drink five days after starting to take the medication, and she thought that she would die.

  2

  She reported that she would feel like her heart was pounding right out of her chest and that her face was all red.

  She reported that she continues to visit the casino, but she does spend much money as she used to.

  She also mentioned that her cigarette smoking was increasing.

  14

  My second decision is to continue the current dose of Antabuse and begin Wellbutrin XL 150 mg orally daily.

  Wellbutrin XL is an antidepressant, but it can also be used for the cessation of smoking (Antidepressants, 2021).

  Fatigue and sedation are common complaints about people taking Antabuse.

  15

  The best approach would be to change the drug administration time to the evening.

  16

  The metallic taste in her mouth is also another side effect of the drug, but it will decrease or may go away fully as time passes.

  11

  When a person takes Antabuse, they also experience symptoms such as nausea, vomiting, tachycardia, and flushing.

  The ethical considerations that could impact my treatment plan and communication with the patient include autonomy and respect.

  No matter the patient's condition, she should be treated and communicated with respect.

  In autonomy, the patient has a right to refuse my medication choice, which might negatively impact my treatment plan.

  Decision #3

  17

  After four weeks, the client returned to the clinic, and she reported that the side effects of the Antabuse had gone, and she was feeling much better.

  11

  She also reported that she is still smoking, but it had dropped to only a couple of cigarettes a day.

  She mentioned that she still visits the casino, but she does not spend a lot money as she used to.

  14

  My third decision is to maintain the current dosage of each medication and refer her to counseling for her gambling.

  16

  There are no drugs approved by the FDA for the treatment of gambling addiction, and counseling should be the mainstay for managing this disorder.

  11

  Wellbutrin takes as long as 12 weeks to exert its full therapeutic effect.

  Therefore, there is no indication to increase Wellbutrin dosage.

  11

  In addition to Wellbutrin, cognitive behavioral therapy can also be used to help Mrs Perez stop smoking. Although there are a lot of controversies in the literature regarding how long a client should be maintained on an Antabuse, eight weeks will be too soon to consider discontinuation.

  6

  The ethical considerations that may impact this decision include non-maleficence and informed consent.

  When the patient has been fully informed of why the timing of the Antabuse should be changed to the evening, in non-maleficence, the drugs should not cause harm to the patient (Azheri, 2018).

  The patient should be informed of all these with respect.

  Conclusion

  In conclusion, disulfiram can be used to stop alcoholism by decreasing the sensitivity of ethanol.

  It produces unpleasant effects such as headache, nausea, chest pain, blurred vision, and anxiety, but these symptoms go away as time passes.

  In addition to using Antabuse in the treatment of alcoholism, behavioral therapy can also be used to change drinking behavior through counseling.

  Wellbutrin XL is an antidepressant, but it can also be used for the cessation of smoking.

  11

  In addition to Wellbutrin, cognitive behavioral therapy can also be used to help Mrs Perez stop smoking.

  6

  The various ethical considerations that impact the treatment plan and communication to a patient include respect, informed consent, autonomy, and non-maleficence.

  Source Matches (30)
  • 1Student paper81%

    Student paper

    The patient, Mrs Maria Perez, is a 53 years old Puerto Rican female.

    Original source

    The assignment is about a 53-year-old Puerto Rican female, Mrs maria Perez

  • 2Student paper70%

    Student paper

    She has had an alcohol problem since her father's death in her late teens.

    Original source

    The client admits that she has had alcohol problems since the death of her father in her late teens

  • 3homeworkhelpermath73%

    Student paper

    Since her 20's, she has always struggled with alcohol, and she was always involved with alcoholics. She also reports that she has had more difficulties maintaining her sobriety for the past two years since the Rising Star casino was opened near her home. She mentioned that she enjoys taking a drink or two while gambling because it helps calm down during high-stakes games.

    Original source

    She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home While gambling, she “enjoys a drink or two” to help calm her during high-stakes games

  • 4Student paper66%

    Student paper

    Over the past two years, her cigarette smoking has also increased.

    Original source

    She is also concerned about the negative aspect of cigarette smoking on her health which has increased in the past two years

  • 3homeworkhelpermath65%

    Student paper

    She reported that she has attempted to quit drinking, but when gambling, she always feels that she should get “high” for her to rom the act of “even out.” She has also noticed that when she drinks alcohol, her smoking reduces, but she always enjoys smoking while playing at slot machines.

    Original source

    She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines

  • 5Student paper75%

    Student paper

    She is also concerned that she had borrowed $50,000 from her retirement account to pay her gambling debut her husband doesn't know.

    Original source

    The patient is also very concerned because she has borrowed over $50,000 from her retirement account to pay off her gambling debts that her husband does not know about

  • 6Student paper89%

    Student paper

    On performing the mental status exam, she is alert and oriented to person, place, time, and event.

    Original source

    On performing a mental status exam, he is alert and oriented to person, place and time

  • 7Student paper87%

    Student paper

    She is appropriately dressed for the weather, and her speech is clear, coherent, and goal-directed.

    Original source

    She has dressed appropriately dressed for the weather, speech is clear, coherent, and goal-directed

  • 8Student paper71%

    Student paper

    She does not display any noteworthy gestures, mannerisms, or tics.

    Original source

    The patient did not showcase any noteworthy tics, gestures, or mannerisms

  • 9Student paper94%

    Student paper

    Her affect and self-reported mood are appropriate to the conversation content.

    Original source

    Her affect is appropriate to the conversation content and self-reported mood

  • 10Student paper64%

    Student paper

    She does not have visual or auditory hallucinations, nor does she have a paranoid or delusional thought process.

    Original source

    She denies Visual and auditory hallucinations or delusional, or paranoid thoughts

  • 5Student paper100%

    Student paper

    Her judgment and insight are grossly intact, but her impulse control is impaired.

    Original source

    Her insight and judgment are grossly intact, but her impulse control is impaired

  • 11Student paper86%

    Student paper

    She denies having homicidal or suicidal ideations.

    Original source

    She currently denies suicidal or homicidal ideations

  • 12Student paper79%

    Student paper

    My first decision is to administer an Antabuse (disulfiram) 250 mg orally every day.

    Original source

    The first decision chosen was to administer Antabuse (disulfiram) 250 mg orally every evening

  • 13Student paper93%

    Student paper

    After four weeks, the client returned to the clinic, and she was complaining of fatigue, sedation, and a metallic taste in her mouth.

    Original source

    However, after four weeks, the client returned to the clinic complaining of fatigue, sedation, and a metallic taste in her mouth

  • 11Student paper76%

    Student paper

    She also reported that she only had one drink five days after starting to take the medication, and she thought that she would die.

    Original source

    She also reports that she had just one drink about five days after starting the drug and thought that she would die

  • 2Student paper71%

    Student paper

    She reported that she would feel like her heart was pounding right out of her chest and that her face was all red.

    Original source

    However, she reports that her face was red and said that her heart would pound right out of her chest

  • 14Student paper83%

    Student paper

    My second decision is to continue the current dose of Antabuse and begin Wellbutrin XL 150 mg orally daily.

    Original source

    Decision 2- to continue the current dose of Antabuse and begin Wellbutrin XL 150 my daily

  • 15Student paper94%

    Student paper

    The best approach would be to change the drug administration time to the evening.

    Original source

    the best approach would be to change the administration time to the evening

  • 16Student paper68%

    Student paper

    The metallic taste in her mouth is also another side effect of the drug, but it will decrease or may go away fully as time passes.

    Original source

    The “metallic” taste in Mrs Perez’s mouth is also another side effect that lessens and may fully go away with the passage of time

  • 11Student paper70%

    Student paper

    When a person takes Antabuse, they also experience symptoms such as nausea, vomiting, tachycardia, and flushing.

    Original source

    When a person taking Antabuse ingests alcohol, they will probably experience flushing, tachycardia, nausea, and vomiting

  • 17Student paper79%

    Student paper

    After four weeks, the client returned to the clinic, and she reported that the side effects of the Antabuse had gone, and she was feeling much better.

    Original source

    After four weeks, the client returns to the clinic and reports the side effects of Antabuse are gone and she is feeling much better

  • 11Student paper79%

    Student paper

    She also reported that she is still smoking, but it had dropped to only a couple of cigarettes a day.

    Original source

    She still says that she is still smoking but states that it has dropped to only a couple of cigarettes a day

  • 14Student paper84%

    Student paper

    My third decision is to maintain the current dosage of each medication and refer her to counseling for her gambling.

    Original source

    Maintain current dosage of each medication and refer to counseling for her gambling

  • 16Student paper80%

    Student paper

    There are no drugs approved by the FDA for the treatment of gambling addiction, and counseling should be the mainstay for managing this disorder.

    Original source

    There are no FDA approved treatments for gambling addiction, so the mainstay of treatment for this disorder is counseling

  • 11Student paper71%

    Student paper

    Wellbutrin takes as long as 12 weeks to exert its full therapeutic effect.

    Original source

    Recall that it could take as long as 12 weeks for this medication to exert its full therapeutic effect

  • 11Student paper74%

    Student paper

    In addition to Wellbutrin, cognitive behavioral therapy can also be used to help Mrs Perez stop smoking. Although there are a lot of controversies in the literature regarding how long a client should be maintained on an Antabuse, eight weeks will be too soon to consider discontinuation.

    Original source

    Cognitive-behavioral principles can also be employed to help Mrs Perez to stop smoking, in addition to the bupropion Although controversy exists in the literature regarding how long to maintain a client on Antabuse, eight weeks is probably too soon to consider discontinuation

  • 6Student paper63%

    Student paper

    The ethical considerations that may impact this decision include non-maleficence and informed consent.

    Original source

    Examples of the ethical considerations that will influence my decision include informed consent and respect

  • 11Student paper77%

    Student paper

    In addition to Wellbutrin, cognitive behavioral therapy can also be used to help Mrs Perez stop smoking.

    Original source

    Cognitive-behavioral principles can also be employed to help Mrs Perez to stop smoking, in addition to the bupropion

  • 6Student paper70%

    Student paper

    The various ethical considerations that impact the treatment plan and communication to a patient include respect, informed consent, autonomy, and non-maleficence.

    Original source

    The ethical considerations in caring for a patient with a lack of sleep include non-maleficence, autonomy, respect, and informed consent