2 separate discussions
It is anticipated that the initial discussion post should be in the range of 250-300 words. Response posts to peers have no minimum requirement, but must demonstrate topic knowledge and scholarly engagement with peers. Substantive content is imperative for all posts. All discussion prompt elements for the topic must be addressed. Please proofread your response carefully for grammar and spelling. Do not upload any attachments unless specified in the instructions. All posts should be supported by at least one scholarly resource, ideally from the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.
First topic
· Your patient is a 36-year-old woman with bipolar disorder and anxiety. She has been stable on a combination of fluoxetine and olanzapine for two years. She is morbidly obese at 340 pounds at 5’5” in height, has type II diabetes, hypertension, and hyperlipidemia. She has concerns about her weight and has tried numerous ‘fad diets’ to no avail. She explains she has lost, at most, 15 pounds and has been able to keep it off for three months.
· She has three children, one of which is severely disabled, and a husband who has a terminal diagnosis. She expresses worry that her weight will impact her ability to care for her disabled child when her husband dies. She reports she eats out frequently due to her children’s busy schedules. She is a stay-at-home mother but gets little exercise and performs no regular physical activity.
· She reports feelings of shame that she can no longer orgasm on the rare occasions her husband has the energy and desire to be intimate.
Questions:
· What would be your approach to managing this patient’s weight concern? (Discuss at least two aspects of your approach and stay within the PMHNP scope of practice). Please support your answer with research-based evidence.
· What would be our approach to the sexual side effects she is experiencing?
· If you suggested additional medication, look up your state’s prescribing laws. Are PMHNP’s able to prescribe the medication you recommended? (STAY WITHIN THE PMHNP scope of practice)
· Please include the subjective and objective information in this post.
All responses must by supported by correct APA 7th edition formatted citations and references.
Second discussion
Answer the following questions:
1. Which antipsychotics are considered first-generation, and why are they used less often than second-generation antipsychotics? Are second-generation antipsychotics more effective?
2. Compare and contrast the following conditions: Tardive Dyskinesia, Acute Dystonia, Athetosis, and Tics.
Responses need to address all components of the question, demonstrate critical thinking and analysis, and include peer-reviewed journal evidence to support the student’s position.
Please be sure to validate your opinions and ideas with in-text citations and corresponding references in APA format.
