NURS 6630 week 5 Assignment: Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder

NURS 6630 week 5 Assignment: Case Study: An Asian American Woman. Diagnosis-Bipolar Disorder

Introduction Bipolar disorder is a condition that is chronic with the onset of adulthood or adolescence, and it is associated with illegal drug use and anxiety issues (Muneer, 2015). Muneer (2015) study classified bipolar in type 1 or type 2; DSM- 5 defines type 1 as bipolar patients with experiences of significant depression and manic incidents while type 2 as significant depression occurrences with reoccurring hypomanic periods. The author noted that bipolar condition is one of the leading reasons for disability globally, with increased risk of suicide among mental health patients due to feelings of hopelessness with thoughts of death.There are no current biomarkers for bipolar diagnosis, and providers must rely on the patient's history, presenting symptoms, and mental health exam protocols to make the appropriate diagnosis. This article aims to describe appropriate pharmacotherapy and decision for treating the patient with bipolar disorder. A twenty-six-year-old Asian American female presents for follow-up appointment post 21 days if inpatient hospitalization with the onset of mania episode (Laureate Education, 2020). According to Laureate Education (2020), Patients diagnosed with type 1 bipolar disorder and ordered a Lithium prescription upon discharge but confesses to stopping to take Lithium two weeks ago after release. Besides, after arriving in the office, the patient busy playing with stuff on top of the desk while changing the chair's sitting sides from one to another, stating "she does not believe she has bipolar" but likes talking, cooking, and dancing. The patient is also alert and oriented, oddly dressed in evening gown, rapid and pressured speech, reports good mood, and sleeping five hours every night although verbalizes hating sleeping because it is not fun and denies hallucinations and suicidal thoughts. Lastly, patient genetic testing revealed she is positive for the CYP2D6 *10 allele.

3 Decision # 1 My first decision is ordering and restarting Lithium 300 mg orally BID because the patient reported no side or adverse effects of Lithium after hospital discharge but stopped taking Lithium because she thinks she does not have bipolar disorder (Laureate Education, 2020). According to Volkmann et al. (2020), Lithium is the treatment of choice for bipolar patients used for over seventy years and preferred for maintenance drug therapy. The authors noted that Lithium has been used during initial treatments of the bipolar condition and prevents bipolar relapses during acute events for depression, mania, and some mood illnesses. Besides, Lithium is preferred for treating patients with a high risk of suicide, preventing new manic episodes while stabilizing the moods. The study recommended baseline patient exam, thyroid hor