Neurocognitive Disorders Essay Discussion Paper
Neurocognitive Disorders
Neurocognitive disorders are described as impaired mental functioning caused by other medical problems. It may be caused by a traumatic brain injury, dementia, alcohol use, a degenerative condition, or some other illness or infection. It may be minor or serious. Mr. Charles Wingate, a 76-year old man in the case study demonstrates manifestations of a neurocognitive disorder. This paper seeks to draw three decisions about this patient’s diagnosis and treatment. An illustration of the ethical considerations that could have an effect on this client’s care and communication will also be provided Neurocognitive Disorders Essay Discussion Paper.
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Decision One: Major neurocognitive disorder with Lewy bodies
Mr. Wingate matches the diagnostic criteria for the neurocognitive disorder, which is associated with a decline in his level of performance linked to various cognitive realms, according to the DSM-5 criteria. He needs assistance in most tasks, including settling bills and primary care, indicating that he has a mental disorder (American Psychiatric Association, 2013). The DSM-5 criteria point out that cognitive disabilities affect a patient’s ability to perform all everyday tasks. There are no symptoms of delirium, which may be the source of the disorder. Any indication of Alzheimer’s disease must be confirmed and should be carried out based on a genetic makeup that necessitates genetic examination and family background (Sheikh & Galvin, 2018).
Mr. Wingate has minor apathy that fades with time; however, there are no signs of three or more behavioral indications that could lead to the diagnosis of frontotemporal neurocognitive impairment. This could be related to feelings of compassion or remorse, nutritional administrative capabilities, or recognizable decline.
The client’s linguistic skills were not impaired. He was good at identifying items, finding words, managing grammar, and fabricating speech. He has erratic thinking and indications of Parkinsonism, which induces perceptual impairment and is a sign of a severe neurocognitive disorder with Lewy bodies (Sheikh & Galvin, 2018).
Decision 2: Start Ramelteon 8 mg before bedtime
Ramelteon is important for resolving the client’s sleep problem. Additionally, this drug does not cause addiction or abuse. Olanzapine and Rivastigmine are both effective but are recommended in this situation. Dry mouth, fatigue, drowsiness, memory loss, diarrhea, dizziness, and weight loss have all been attributed to rivastigmine Neurocognitive Disorders Essay Discussion Paper.
Ramelteon is intended to overcome the problem of sleep problems. However, the client can experience insomnia, fatigue, dizziness, and headaches.
The client came back with his son to the clinic after one month. The client uses the drug before going to bed, however, he does not wake up until about 9 a.m. He used to get up around 7 or 8 a.m. He has fallen twice in the night when going to the toilet. He has been advised not to drink too many liquids in order to have a good night’s sleep. He also mentioned morning headaches and body weakness. Dreadful nightmares have persisted, and the son claims that he is enacting his dreams. As a result, the medication failed to solve the problem of dream-enacting, which may have been caused by the small dose.
Decision 3: Start Clonazepam 0.25 orally at bedtime
The client has developed dizziness and has fallen several times as a result of this. There are reports of dizziness and headaches, which may be Ramelteon’s side effects. Despite the fact that this medication is proven to be safe and efficient, Mr. Wingate believes it has more adverse implications than beneficial impacts attributable to the above adverse effects. Falling in the elderly is a problem that requires urgent attention because it has been linked to a slew of health problems.
Restricting fluid intake might not be the safest choice since it can lead to dehydration, which can lead to dizziness and raise the likelihood of falling (Schroeck et al., 2018)Neurocognitive Disorders Essay Discussion Paper. Ambien has the same impact as Ramelteon, although there is little proof that it successfully treats sleep disorders. Melatonin would not be useful, because Ramelteon is also a melatonin 1 and 2 receptor agonist. It would have the same adverse effects
To manage the sleep issue, switching the medication to Clonazepam 0.25mg is a smart choice. Because of its long half-life, it ought to be started at a low dose and gradually raised. Side effects should be explained to the client.
Ethical considerations
Certain ethical concerns can have an effect on the treatment plan as well as communication with the client and relatives. In this case, the ideals of confidentiality, nonmaleficence, and beneficence are crucial. Beneficence together with non-maleficence advocates for therapeutic service that does no damage to the patient (Roberts & Dunn, 2019). Conversely, communication has an impact on the principle of confidentiality, which needs consent when sharing any sensitive information with another individual. As a result, prior to any information sharing, consent must be obtained.
Conclusion
It is crucial to follow the principles of confidentiality, nonmaleficence, and beneficence while handling a patient like this. This is because they all have an impact on the treatment plan implemented. Nonmaleficence and beneficence have an effect on the care plan because they are linked to issues of confidentiality and safety Neurocognitive Disorders Essay Discussion Paper.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author. https://www.psychiatry.org/psychiatrists/practice/dsm
Roberts, L., & Dunn, L. (2019). Ethical considerations in psychiatry. The American Psychiatric Association Publishing Textbook of Psychiatry. https://doi.org/10.1176/appi.books.9781615371501.lr07
Sheikh, M., & Galvin, J. (2018). Neurocognitive disorders with Lewy bodies. The American Psychiatric Association Publishing Textbook of Neuropsychiatry and Clinical Neurosciences. https://doi.org/10.1176/appi.books.9781615372423.sy21
Schroeck, J. L., Ford, J., Conway, E. L., Kurtzhalts, K. E., Gee, M. E., Vollmer, K. A., & Mergenhagen, K. A. (2016). Review of safety and efficacy of sleep medicines in older adults. Clinical Therapeutics, 38(11), 2340-2372. https://doi.org/10.1016/j.clinthera.2016.09.010
Explore evidence-based psychotherapy and psychopharmacologic treatment for neurocognitive disorders. You will complete your final Decision Tree as you rationalize and justify your diagnosis and treatment of a patient with a mental health disorder.
Examine the client case study and, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.
- Evaluate clients for treatment of mental health disorders
- Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders.
Examine Case 3: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment Neurocognitive Disorders Essay Discussion Paper.
Case 3 Neurocognitive Disorders: https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6670/08/mm/decision_tree/index.html
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At each Decision Point, stop to complete the following:
- Decision #1: Differential Diagnosis
- 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: Treatment Plan for Psychotherapy
- 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: Treatment Plan for Psychopharmacology
- 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?
- Also include how ethical considerations might impact your treatment plan and communication with clients and their family Neurocognitive Disorders Essay Discussion Paper.
Resources:
Acadia Pharmaceuticals. (2017). Transform the treatment of Parkinson’s disease psychosis with NUPLAZID. Retrieved from https://www.nuplazidhcp.com/?gclid=CIHS5auvwtMCFQkaaQodrU0FGQ
- “Neurocognitive Disorders”
- Chapter 63, “Delirium”
- Chapter 64, “Neurocognitive Disorder Due to Alzheimer’s Disease”
- Chapter 65, “Frontotemporal Neurocognitive Disorder”
- Chapter 66, “Vascular Neurocognitive Disorder”
- Chapter 67, “Neurocognitive Disorder Due to Parkinson’s Disease”
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
- Chapter 21, “Neurocognitive Disorders” (pp. 694–741)
Neurocognitive Disorders Essay Discussion Paper