Assignment One: Short Answer Assessment Essay

 Assignment One: Short Answer Assessment Essay

1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?

For a patient presenting with major depressive disorder and a history of alcohol abuse, I would combine a medication that treats alcohol dependence with one antidepressant for the depressive disorder. I would administer Naltrexone and Sertraline. Both Naltrexone and Sertraline are FDA-approved for treating alcohol use disorder and major depressive disorders, respectively. The two medications have low side effects, and the patient is expected to experience the resolution of symptoms within 8-12 weeks (McHugh & Weiss, 2019). The contraindicated drugs include MOIs due to side effects such as insomnia, dizziness, and drowsiness.

2. List 4 predictors of late-onset generalized anxiety disorder.

According to Mohlman (2020), late-onset Generalized Anxiety Disorder is one of the most common psychiatric impairments for adults aged 65 and above. The condition is, however, caused by different modifiable factors, including environmental and personal factors, and thus is preventable. The predictors of late-onset generalized disorder gender (GAD prediction is higher in females), having a pre-existing chronic mental or physical disorder, a recent experience of adverse life events, and lack of appropriate parental care and presence of adverse events during childhood.

3. List 4 potential neurobiology causes of psychotic major depression.

The potential neurobiology causes of psychotic major depression include;

The disrupted neurodevelopment of widespread brain systems due to the exposure to early life stress is a major potential cause of psychotic major depression (DeRosse & Barber, 2021). The disruptions often affect the emotion and reward function, which play a major role in the emergence and severity of psychosis.

Genetic predisposition- individuals with altered neurotransmission and neuroplasticity, resulting from polymorphism, are associated with a higher psychotic major depression risk (Croarkin, 2018).

The alteration of neuronal networks affecting the cortical area’s output coordination is also a major causative factor of psychotic major depression (Giotakos, 2020).

The decrease in plasma-derived brain neurotrophic factor levels is also a potential neurobiological cause of psychotic major depression (Croarkin, 2018)

4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.

According to Zimmerman et al. (2018), the symptoms required for an episode of major depression according to the DSM-5 include;

• Persistent insomnia and hypersomnia almost every day for two weeks
• Lack of interest in earlier pleasurable activities
• A consistently depressed mood
• Indecisiveness and a decreased ability to concentrate
• Loss of energy and fatigue
• Suicidal thoughts, behaviors, and thoughts of death
• Changes in appetite leading to either weight gain or weight loss. The body weight can change up to 5%
• A feeling of worthlessness and excess/inappropriate guilt
• Loss of self-esteem and confidence.

5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

Insomnia is a condition whereby an individual finds it difficult to initiate or maintain sleep, wakes up indefinitely, and cannot go back to sleep. It is associated with various mental health disorders. The classes of drugs that can be used to precipitate insomnia include:

• Statins is a class of drugs that are used to treat high cholesterol levels and help reduce a patient’s risk of cardiovascular diseases. Examples of statins include Fluvastatin, Lovastatin, and Rosuvastatin.
• Corticosteroids is a class of medications that are used to treat inflammations by overworking the cortisol hormone, thus disrupting the body’s sleep-wake patterns. Examples of corticosteroids include prednisone and cortisone.
• Beta-blockers. Beta-blockers are a group of medications used to treat arrhythmias and hypertension. Beta-blockers reduce the body’s secretion of the melatonin hormone, which regulates sleep, thus causing insomnia (Conley et al., 2022). Examples of beta-blockers include Atenolol and Sotalol.
  

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References

Conley, S., Jeon, S., Breazeale, S., O’Connell, M., Hollenbeak, C. S., Jacoby, D. & Redeker, N. S. (2022). Symptom Cluster Profiles Among Adults with Insomnia and Heart Failure. Behavioral Sleep Medicine, 1-12. https://doi.org/10.1080/15402002.2022.2060226

Croarkin P. E. (2018). Indexing the neurobiology of psychotic depression with resting state connectivity: Insights from the STOP-PD study. EBioMedicine, 37, 32–33. https://doi.org/10.1016/j.ebiom.2018.10.010

DeRosse, P., & Barber, A. D. (2021). Overlapping neurobiological substrates for early-life stress and resilience to psychosis. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 6(2), 144-153. https://doi.org/10.1016/j.bpsc.2020.09.003

Giotakos O. (2020). Neurobiology of emotional trauma. Psychiatric 31(2), 162–171. https://doi.org/10.22365/jpsych.2020.312.162

McHugh, R. K., & Weiss, R. D. (2019). Alcohol Use Disorder and Depressive Disorders. Alcohol Research: Current Reviews, 40(1), arcr.v40.1.01. https://doi.org/10.35946/arcr.v40.1.01

Mohlman, J. (2020). Neurocognitive predictors of long-term outcome in CBT for late-life generalized anxiety disorder. Journal of Anxiety Disorders, 74, 102246. https://doi.org/10.1016/j.janxdis.2020.102246

Zimmerman, M., Balling, C., Chelminski, I., & Dalrymple, K. (2018). Understanding the severity of depression: which symptoms of depression are the best indicators of depression severity? Comprehensive Psychiatry, 87, 84-88. https://doi.org/10.1016/j.comppsych.2018.09.006

Assignment 1: Short Answer Assessment
As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

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To Prepare
Review the Learning Resources for this week.
Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.
Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health.
To complete:
Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
List 4 predictors of late onset generalized anxiety disorder.
List 4 potential neurobiology causes of psychotic major depression.
An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

Rubric Detail

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Name: NURS_6630_Week8_Assignment1_Rubric
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List View
Excellent

Point range: 90–100 Good

Point range: 80–89 Fair

Point range: 70–79 Poor

Point range: 0–69
In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why. Be specific. What it is the timeframe that the patient should see resolution of symptoms?
12 (16%) – 13 (17.33%)
The response accurately and clearly explains in detail the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.

The response accurately and clearly details which drugs are contraindicated with specific examples.

The response accurately and clearly explains in detail the timeframe that the patient should see resolution of symptoms.
11 (14.67%) – 11 (14.67%)
The response accurately explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.

The response accurately identifies which drugs are contraindicated with specific examples.

The response accurately explains the timeframe that the patient should see resolution of symptoms.
10 (13.33%) – 10 (13.33%)
The response inaccurately or vaguely explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse.

The response inaccurately or vaguely identifies which drugs are contraindicated with inaccurate or vague examples.

The response inaccurately or vaguely explains the timeframe that the patient should see resolution of symptoms.
0 (0%) – 9 (12%)
The response inaccurately and vaguely explains the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse, or is missing.

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The response inaccurately and vaguely identifies which drugs are contraindicated with inaccurate examples, or is missing.

The response inaccurately and vaguely explains the timeframe that the patient should see resolution of symptoms, or is missing.
List four predictors of late onset generalized anxiety disorder.
12 (16%) – 13 (17.33%)
The response accurately and clearly lists in detail four predictors of late-onset generalized anxiety disorder.
11 (14.67%) – 11 (14.67%)
The response accurately lists four predictors of late-onset generalized anxiety disorder.
10 (13.33%) – 10 (13.33%)
The response inaccurately or vaguely lists four predictors of late-onset generalized anxiety disorder.
0 (0%) – 9 (12%)
The response inaccurately and vaguely lists four predictors of late-onset generalized anxiety disorder, or is missing.
List four potential neurobiology causes of psychotic major depression.
12 (16%) – 13 (17.33%)
The response accurately and clearly lists in detail four potential neurobiology causes of psychotic major depression.
11 (14.67%) – 11 (14.67%)
The response accurately lists four potential neurobiology causes of psychotic major depression.
10 (13.33%) – 10 (13.33%)
The response inaccurately or vaguely lists four potential neurobiology causes of psychotic major depression.
0 (0%) – 9 (12%)
The response inaccurately and vaguely lists four potential neurobiology causes of psychotic major depression.
An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least five symptoms required for the episode to occur. Be specific.
12 (16%) – 13 (17.33%)
The response accurately and clearly explains in detail at least five symptoms for the episode of major depression to occur.

Specific examples provided fully support the response.
11 (14.67%) – 11 (14.67%)
The response accurately explains at least five symptoms for the episode of major depression to occur.

Specific examples provided support the response.
10 (13.33%) – 10 (13.33%)
The response inaccurately or vaguely explains at least five symptoms for the episode of major depression to occur.

Specific examples provided inaccurately or vaguely support the response.
0 (0%) – 9 (12%)
The response inaccurately and vaguely explains at least five symptoms for the episode of major depression to occur, or is missing.

Specific examples provided do not support the response, or is missing.
List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
12 (16%) – 13 (17.33%)
The response accurately and clearly lists in detail 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.

Examples provided fully support the response provided.
11 (14.67%) – 11 (14.67%)
The response accurately lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.

Examples provided support the response provided.
10 (13.33%) – 10 (13.33%)
The response inaccurately or vaguely lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia.

Examples provided inaccurately or vaguely support the response provided.
0 (0%) – 9 (12%)
The response inaccurately and vaguely lists 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia, or is missing.

Examples provided do not support the response provided, or is missing.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation
5 (6.67%) – 5 (6.67%)
Uses correct grammar, spelling, and punctuation with no errors.
4 (5.33%) – 4 (5.33%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
3.5 (4.67%) – 3.5 (4.67%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
0 (0%) – 2 (2.67%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.