Assessing And Treating Clients With Impulsivity, Compulsivity, And Addiction
PLEASE PAY ATTENTION TO THE CASE STUDY, SAMPLE ESSAY (the way the instructor wants us to answer the decisions), CHAPTER 14
ZERO PLAGIARISM
FIVE REFERENCES
The Assignment
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 stop to complete the following:
Decision #1
Which decision did you select?
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
Decision #2
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
Decision #3
Why did you select this decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Note: Support your rationale with a minimum of three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.
Edit question’s body
Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female
Puerto Rican female
BACKGROUND
Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.”
SUBJECTIVE
Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health.
She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.
Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money.
MENTAL STATUS EXAM
The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.
Diagnosis: Gambling disorder, alcohol use disorder
Decision Point One
Select what the PMHNP should do:
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.pngNaltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.pngAntabuse (Disulfiram) 250 mg orally daily
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.pngCampral (Acamprosate) 666 mg orally three times/day
Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female
Puerto Rican female
Decision Point One
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.pngNaltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection
· Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling)
· Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned
· Decision Point Two
· Select what the PMHNP should do next:
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.pngAdd on Valium (diazepam) 5 mg orally TID/PRN/anxiety
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.pngRefer to a counselor to address gambling issues
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.pngAdd on Chantix (varenicline) 1 mg orally BID
·
Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female
Puerto Rican female
Decision Point One
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.pngAntabuse (Disulfiram) 250 mg orally every morning
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Mrs. Perez reports to your office complaining of sedation, fatigue and a “metallic taste” in her mouth, which “seems to be going away.” She also reports that she had just one drink about 5 days after starting the drug and thought that she would “die.” She reports that her face was red, and she felt that her heart would “pound right out of my chest.”
· Mrs. Perez also reports that she continues to visit the casino, but has not been spending as much money when she does go. She has noticed that her cigarette smoking is increasing
· Decision Point Two
· Select what the PMHNP should do next:
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.pngContinue current dose of Antabuse and begin Campral (acamprosate) 666 mg orally BID
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.pngContinue current dose of Antabuse and refer to counseling for ongoing gambling issues
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.pngContinue current dose of Antabuse and begin Wellbutrin (bupropion) XL 150 mg orally daily
·
Co-morbid Addiction (ETOH and Gambling) 53-year-old Puerto Rican Female
Puerto Rican female
Decision Point One
https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.pngCampral (acamprosate) 666 mg orally TID
RESULTS OF DECISION POINT ONE
· Client returns to clinic in four weeks
· Mrs. Perez states that she has noticed that she has been having suicidal ideation over the past week, and it seems to be getting worse
· Clientis She is also reporting that she is having “out of control” anxiety
· Select what the PMHNP should do next:
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.pngEducate Mrs. Perez on the side effects of Campral and add Valium (diazepam) 5 mg orally TID to address anxiety symptoms
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.pngDiscontinue Campral and begin Antabuse (disulfiram) 250 mg orally daily
·
· https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.pngDecrease Campral to 666 mg orally BID
Looking for a Similar Assignment? Order now and Get 10% Discount! Use Coupon Code “Newclient”
