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NURS 4430 Module 3: Disorders With Behavioral Components

NURS 4430 Module 3: Disorders With Behavioral Components

NURS 4430 Module 3: Disorders With Behavioral Components

Mental health and substance abuse disorders can affect individuals across the life span. While these illnesses are common, recurrent, and serious, they are often treatable and many people do recover (SAMHSA, 2020). Mental disorders involve changes in thinking, mood, and/or behavior such that these changes can and do affect how individuals relate to others and how they make choices.

Behavioral disorders that give rise to impulsivity and substance abuse represent one area of expertise for which a psychiatric nurse practitioner (PNP) may prescribe pharmacologic treatments. Furthermore, understanding the underlying mechanisms that result in these behavioral disorders will be an important component of any treatment plan. Not surprisingly, PNPs may observe the coexistence of both a mental health and a substance use disorder (SAMHSA, 2020). Such co-occurring disorders or comorbidities present additional challenges for PNPs in assessing, treating, and providing care to their patients. NURS 4430 Module 3: Disorders With Behavioral Components

As you engage with the content for this module, reflect on how you might assess, treat, and provide care for patients presenting with behavioral disorders. While some disorders may have a direct treatment plan, others may require additional assessment considerations and pharmacologic interventions.

Reference:
Substance Abuse and Mental Health Services Administration. (2020). Mental health and substance use disorders. https://www.samhsa.gov/find-help/disorders

What’s Happening This Module?

Module 3, Disorders With Behavioral Components, is a 2-week module. During Week 10, you will continue to apply your assessment and therapy skills as you assess and treat patients suffering from impulsivity, compulsivity, and addiction. In Week 11, you will review treatment plans and concepts related to the treatment of patients with dementia/Alzheimer’s and comorbid states. You will also complete your Final Exam for the course.

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What do I have to do?     When do I have to do it?    
Review your Learning Resources. Days 1–7, Weeks 10–11
Assignment: Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction Submit your Assignment by Day 7 of Week 10.
Final Exam Complete Final Exam by Day 7 of Week 11.

Go to the Weekly Content

Week 10: Therapy for Patients With Impulsive/Substance Use Disorders (SUD)

Impulsivity and compulsivity have a wide range of clinical presentations and often overlap with many other psychiatric disorders. Some individuals act without forethought and have difficulty saying “no” to certain things, such as using illicit drugs or spending money, whereas other individuals engage in compulsive behaviors with undesirable consequences. In some cases, these impulsive and compulsive behaviors also fuel issues with addiction. To effectively assess and treat patients, you must understand how these disorders differ as well as how their symptoms impact patients and their families. NURS 4430 Module 3: Disorders With Behavioral Components

This week, as you examine therapies for individuals with impulsivity, compulsivity, and addiction, you explore the assessment and treatment of patients with these disorders. You also consider ethical and legal implications of these therapies.

Learning Objectives

Students will:

  • Assess patient factors and history to develop personalized therapy plans for patients with impulsivity, compulsivity, and addiction
  • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for impulsivity, compulsivity, and addiction
  • Synthesize knowledge of providing care to patients presenting for impulsivity, compulsivity, and addiction
  • Analyze ethical and legal implications related to prescribing therapy for patients with impulsivity, compulsivity, and addiction
Learning Resources

Required Readings

Kelly, J. E., & Renner, J. A. (2016). Alcohol-Related disorders. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

Renner, J. A., & Ward, N. (2016). Drug addiction. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 163–182). Elsevier.

  • Substance Abuse and Mental Health Services Administration. (1999). Treatment of adolescents with substance use disorders: Treatment improvement protocol series, no. 32. http://www.ncbi.nlm.nih.gov/books/NBK64350/
    • Chapter 1, “Substance Use Among Adolescents”
    • Chapter 2, “Tailoring Treatment to the Adolescent’s Problem”
    • Chapter 7, “Youths with Distinctive Treatment Needs”
  • University of Michigan Health System. (2016). Childhood trauma linked to worse impulse control. Journal of Psychosocial Nursing & Mental Health Services, 54(4), 15.Grant, J. E., Odlaug, B. L., & Schreiber, L. N. (2014). Pharmacological treatments in pathological gambling. British Journal of Clinical Pharmacology, 77(2), 375–381. https://doi.org/10.1111/j.1365-2125.2012.04457.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. https://doi.org/10.1002/hup.2467
  • Loreck, D., Brandt, N. J., & DiPaula, B. (2016). Managing opioid abuse in older adults: Clinical considerations and challenges. Journal of Gerontological Nursing, 42(4), 10–15. https://doi.org/10.3928/00989134-20160314-04
  • Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual Diagnosis, 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439
  • Sanches, M., Scott-Gurnell, K., Patel, A., Caetano, S. C., Zunta-Soares, G. B., Hatch, J. P., Olvera, R., Swann, A. C., & Soares, J. C. (2014). Impulsivity in children and adolescents with mood disorders and unaffected offspring of bipolar parents. Comprehensive Psychiatry, 55(6), 1337–1341. https://doi.org/10.1016/j.comppsych.2014.04.018

Medication Resources

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

  • naltrexone (revia/vivitrol)
  • naloxone
  • acamprosate
  • disulfiram

Required Media

Case Study: A Puerto Rican Woman with Comorbid Addiction

Note: This case study will serve as the foundation for this week’s Assignment.

Optional Resources

  • Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., Cinose, E., Di Iorio, G., Di Nicola, M., & Di Giannantonio, M. (2014). Pharmacological treatments in gambling disorder: A qualitative review. Biomed Research International, 2014. https://doi.org/10.1155/2014/537306

Assignment: Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

Impulsivity, compulsivity, and addiction are challenging disorders for patients across the life span. Impulsivity is the inclination to act upon sudden urges or desires without considering potential consequences; patients often describe impulsivity as living in the present moment without regard to the future (MentalHelp.net, n.d.). Thus, these disorders often manifest as negative behaviors, resulting in adverse outcomes for patients. For example, compulsivity represents a behavior that an individual feels driven to perform to relieve anxiety (MentalHelp.net, n.d.). The presence of these behaviors often results in addiction, which represents the process of the transition from impulsive to compulsive behavior.

In your role as the psychiatric nurse practitioner (PNP), you have the opportunity to help patients address underlying causes of the disorders and overcome these behaviors. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with impulsivity, compulsivity, and addiction.

Reference: MentalHelp.net. (n.d.). Impaired decision-making, impulsivity, and compulsivity: Addictions’ effect on the cerebral cortex. https://www.mentalhelp.net/addiction/impulsivity-and-compulsivity-addictions-effect-on-the-cerebral-cortex/

To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients requiring therapy for impulsivity, compulsivity, and addiction.

The Assignment: 5 pages

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. 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.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

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.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

By Day 7

Submit your Assignment.

Submission and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK10Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 10 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 10 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK10Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

  • Week 10 Assignment Rubric
Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 10 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 10

To participate in this Assignment:

Week 11: Therapy for Patients With Dementia/Alzheimer’s and Comorbid States

As a psychiatric nurse practitioner, you will frequently work with patients across the life span who may also have comorbid conditions. For instance, you may treat a 16-year-old female with Down syndrome and increasing violent behaviors; a middle-aged male with schizophrenia, diabetes, and poor lung function; or an older adult with a mental disorder, Stage 1 Alzheimer’s disease, and chronic heart disease (CHD). In cases like these, you must draw from foundational knowledge of pathophysiology and collaborate with other healthcare providers to ensure optimal safety and efficacy of psychopharmacologic therapies for patients. NURS 4430 Module 3: Disorders With Behavioral Components

This week, as you examine therapy for patients with dementia/Alzheimer’s and comorbid states, you review psychopharmacologic approaches to treatment for these patients across the life span. You will also complete your Final Exam.

Learning Objectives

Students will:

  • Assess psychopharmacologic approaches to treatment for patients across the life span

Learning Resources

Required Readings 

  • Gatchel, J. R., Wright, C. L., Falk, W. E., & Trinh, N. (2016). Dementia. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 149–162). Elsevier.
  • Angermeyer, M. C., Matschinger, H., & Schomerus, G. (2013). Attitudes towards psychiatric treatment and people with mental illness: Changes over two decades. The British Journal of Psychiatry, 203(2), 146–151. https://doi.org/10.1192/bjp.bp.112.122978
  • Bui, Q. (2012). Antidepressants for agitation and psychosis in patients with dementia. American Family Physician, 85(1), 20–22Crocker, 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. https://doi.org/10.1111/jir.12080
  • Dingfelder, S. F. (2009). Stigma: Alive and well. Monitor on Psychology, 40(6), 56-59. https://doi.org/10.1037/e542802009-028
  • Erickson, S. C., Le, L., Zakharyan, A., Stockl, K. M., Harada, A. M., Borson, S., Ramsey, S. D., & 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. https://doi.org/10.1111/j.1532-5415.2011.03842.x
  • Jenkins, J. H. (2012). The anthropology of psychopharmacology: Commentary on contributions to the analysis of pharmaceutical self and imaginary. Culture, Medicine and Psychiatry, 36(1), 78–79. https://doi.org/10.1007/s11013-012-9248-0
  • Malhotra, A. K., Zhang, J., & Lencz, T. (2012). Pharmacogenetics in psychiatry: Translating research into clinical practice. Molecular Psychiatry, 17(8), 760–769. https://doi.org/10.1038/mp.2011.146

Medication Resources

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments.

  • donepezil
  • galantamine
  • memantine
  • rivastigmine

Optional Resources

Rothman, D. J. (1994). Shiny, happy people: The problem with “cosmetic psychopharmacology.” New Republic, 210(7), 34–38.

Final Exam

This exam will cover the following topics, which relate to psychopharmacologic approaches to treatment for patients across the life span:

    • Therapy for Patients With Substance Dependence
    • Therapy for Patients With Impulsivity, Compulsivity, and Substance Use Disorder
    • Therapy for Patients With ADHD
    • Therapy for Patients With Dementia/Alzheimer’s
    • Therapy for Patients With Pathophysiology and Psychiatric Comorbidities

Prior to starting the exam, you should review all of your materials. There is a 2.5-hour time limit to complete this 50-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.

By Day 7

Submit your Final Exam by Day 7.

Submission Information

Submit Your Exam by Day 7

To submit your Final Exam:

  • Week 11 Final Exam

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