Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder.

 

Having bipolar disorder is a severe mental illness that may enormously impact a person’s quality of life. According to the National Alliance on Mental Illness (NAMI), it is estimated that more than 10 million individuals in the United States are affected by bipolar disorder, according to the National Alliance on Mental Illness (NAMI). It may occur at any age, although it is more prevalent in those over 25 years old. It is estimated that 4.4 percent of the population suffers from bipolar illness. There are now 2.8% of females and 2.9% of males suffering from bipolar illness at any one point in time (Reiser et al., 2017). The severity of your bipolar illness may increase if you don’t get treatment immediately. Patients with bipolar illness and those who care about them may benefit from treatment that includes medication and counseling. One patient with bipolar disorder is profiled in this study, their therapy choices, rationales for each, and moral quandaries encountered throughout treatment.

This case study features a 26-year-old Asian lady who suffers from bipolar type 1 disorder. She spent 15 days in the hospital after a severe attack of manic depression. Throughout the test, they seemed to be engrossed in intense mental exertion. While some individuals like sleeping, others despise it. She received a score of 22 on the Young Mania Rating Scale, the maximum achievable (YMRS). After being taken to the hospital two weeks before this encounter, she was given lithium. The patient’s BMI, which indicates obesity, and her medical history, may influence the medication administered. Due to the genetic variations between Asians and Caucasians, it will be crucial to consider the CYP2D6*10 allele while administering antipsychotic medication to him.

Decision 1: Seroquel 100 XR mg at night

Seroquel (quetiapine) is a second-generation dibenzothiazepine antipsychotic medication licensed to treat major depressive disorder and schizophrenia. The medication may be taken immediately or in the form of an extended-release (XR) tablet (IR). Both drugs have similar bioavailability. On the other hand, a 5-hour peak plasma concentration of XR enables daily dosing. The medication is metabolized mainly in the liver, with just a trace of metabolism occurring at the CYP2D6 enzyme (Lopez-Muoz et al., 2017).

Quetiapine seems to be associated with fewer adverse events than other antipsychotic medicines. Whether administered alone or in conjunction with other treatments for bipolar illness in adolescents, medication had a substantial effect on the outcome. Due to the patient’s discontinuation of lithium two weeks before admission, the hospital stay was judged unnecessary. To prevent a recurrence, it is suggested that you gradually decrease your lithium dosage over at least four weeks before discontinuing. If the patient has undesirable weight gain due to the lithium, her health may be compromised due to her high BMI. Risperdal has been linked to diabetes and impaired glucose tolerance due to the patient’s obesity, among other undesirable effects that may have a substantial impact on the patient’s quality of life. Because studies have shown that combining this medicine with another is more beneficial than monotherapy, using it alone in this case study is not recommended.

Expected Outcome

If the patient’s insanity symptoms improve within four weeks of being discharged from the clinic, they should be permitted to return. She should be allowed to unwind and sleep regularly. Her Young Mania Rating Scale score will decrease by at least 50%. (YMRS). Two possible adverse effects include weight gain and intestinal problems.

Ethical Considerations Impact on Treatment Plan

As a nurse, you must safeguard your patients’ health and well-being. As a result, the patient’s participation in therapeutic decision-making is critical (Reiser et al., 2017). Before making a selection, it is critical to have an open and candid conversation with the patient about all possible therapeutic options and their benefits and drawbacks.

Decision 2: Discontinue Seroquel and begin taking Geodon 40 mg daily. BID, with a 500-calorie meal

Quetiapine should be stopped after the first intervention and replaced with another antipsychotic drug. The patient suffered from weight gain, dry mouth, and constipation, among other adverse effects. Among the numerous alternatives, it is vital to begin employing Geodon, a medicine licensed in 2004 to treat manic episodes in persons with bipolar illness. According to studies, Geodon may be beneficial in treating acute manic episodes. A favorable result may be reached as the therapy does not induce weight gain, which is essential in making it accep

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