Download Cyclothymia PowerPoint Presentation and more Assignments Health sciences in PDF only on Docsity! Cyclothymia Student Name Chamberlain University: Nurse Practitioner track NR568 - Advanced Pharmacology for Adult- Gerontology Primary Care Nurse Practitioner Date Patient history Ashley ➢ 28-year-old female ➢ Chief Complaint – mood swings, anxious and down a lot but has periods of feeling better. ➢ HPI: Affecting her motivation levels ➢ Missing deadlines at work. ➢ Her partner also notes that she has had little motivation with helping maintain their house and that they are fighting more often. ➢ New symptoms noticed over the last 3-6 months Patient Treatment Plan ► Psychotherapy ► Cognitive Behavioral Therapy (CBT) ► Medications: ► Mood stabilizer ► Lamotrigine ► First line for patients who are anxious-depressive more than not ► Lithium can be added in conjunction with Lamotrigine if symptoms do not improve (Bielecki & Gupta, 2022). State & Federal Regulations in Pennsylvania ➢ Pennsylvania ➢ APN’s can prescribe Schedule II-V medications including psychiatric medications ➢ As allowed by their collaborative agreement (Chapter 21. State Board of Nursing, 2021). ➢ Federal ➢ 2010 Affordable Care Act ➢ Insurances must cover behavioral treatment, mental/behavioral inpatient services and treatment for substance use disorder. ➢ Insurance plan cannot turn you down or raise your rates due to your mental illness (Department of Health and Human Services, 2023). State & Federal Regulations in Pennsylvania ➢ Ashley will have access to the mental health resources needed ➢ Her insurance will cover any therapy/treatment ➢ Her insurance rates will not change or be take away due to her diagnosis ➢ She will be able to utilize community resources and find the best treatment fit for her. Community Resources ➢ Within Philadelphia area: ➢ Department of Behavioral Health and Intellectual Disability Services ➢ Available 24/7 at 215-686-4420 ➢ Philadelphia Crisis line – 215-685-6440 (City of Philadelphia, 2023) ➢ Friends Hospital ➢ Established in 1813 by the Quakers ➢ Provides inpatient treatment for Adolescents, general adult, and older adults ➢ Involuntary or Voluntary ➢ Provides the option for long-term residential treatment ➢ Provides services specific to LGBTQ+ patients (Friends Hospital, 2023). ➢ To schedule a confidential assessment, the patient can call their admission’s department at 215-831-2600 Legal or Ethical Considerations ► Potential Legal issues ► Prescribing or ordering outside the restrictions of collaborative agreement ► Patient suicidal comments/ideations not acted on ► Potential Ethical issues ► Patient suicidal comments/ideations not acted on ► Patient confidentiality Legal or Ethical Considerations ► Follow up ► Will be contingent on medication therapy. ► Typically, monthly until stable on medication therapy ► Routine liver and renal function testing (Rosenthal & Burchum, 2021) ► Ensure patient makes appointments ► If missed or canceled, reach out to patient or emergency contact ► If concerned for wellbeing, can ask local law enforcement to do a wellness check ► As PCP – how to mitigate risks in providing care for behavioral health concerns? ► Stay up to date on EBP ► Ensure proper handoff regarding patient information with any transition of care
