NURS 6630 Week 5 Assignment – Step-by-Step Guide

The first step before starting to write the NURS 6630 Week 5 Assignment: Assessing And Treating Patients With Bipolar Disorder, it is essential to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. It is also important to identify the audience of the paper and its purpose so that it can help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, you should review its use, such as writing citations and referencing the resources used. You should also review how to format the title page and the headings in the paper.

How to Research and Prepare for NURS 6630 Week 5 Assignment

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify the list of keywords from your topic using different combinations. The first step is to visit the university library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last words and go through each to check for credibility. 

Ensure that you obtain the references in the required format, for example, in APA, so that you can save time when creating the final reference list. You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching about. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next you should create a detailed outline of the paper so that it can help you to create headings and subheadings to be used in the paper. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NURS 6630 Week 5 Assignment

The introduction of the paper is the most crucial part as it helps to provide the context of your work, and will determine if the reader will be interested to read through to the end. You should start with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NURS 6630 Week 5 Assignment

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence conducted from the research, ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance and how it connects to the thesis statement. You should maintain a logical flow between each paragraph by using transition words and a flow of ideas.

How to Write the In-text Citations for NURS 6630 Week 5 Assignment

In-text citations help the reader to give credit to the authors of the references they have used in their works. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Smith (2021), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Johnson and Brown (2020) highlight that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.

How to Write the Conclusion for NURS 6630 Week 5 Assignment

When writing the conclusion of the paper, start by restarting your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper, by restating them. Discuss the implications of your findings and your arguments. End with a call to action that leaves a lasting impact on the reader or recommendations.

How to Format the Reference List for NURS 6630 Week 5 Assignment

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded, in sentence sentence care. The references should be organized in an ascending order alphabetically and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Johnson, L. M., & Brown, R. T. (2020). The role of telehealth in improving patient outcomes. Journal of Nursing Care Quality, 35(2), 123-130. https://doi.org/10.1097/NCQ.0000000000000456

Smith, J. A. (2021). The impact of technology on nursing practice. Health Press.

An Example NURS 6630 Week 5 Assignment Follows:

Assessing and Treating Patients with Bipolar Disorder

The prevalence of Bipolar I disorder differs in different regions and populations. The 12-month prevalence of DSM-5 Bipolar I disorder in a nationally representative U.S. adult sample was reported to be 1.5%. This implies that among the adults in the US, 1.5% met the diagnostic criteria for this disorder. The peak age at the onset of Bipolar I disorder was between 20 and 30 years, but onset can occur throughout the life cycle. The mean age at onset of DSM-5 Bipolar I disorder in the United States is 22 years, with a slightly younger age for women (21.5 years) than for men (23.0 years) (American Psychiatric Association, 2022). The purpose of this paper is to identify a unique population affected by Bipolar I Disorder, explore the neurobiology of the disorder, diagnosis of the disorder, and the management of the condition.

The neurobiology of Bipolar I disorder involves complex interactions among genetic, neurochemical, and structural brain abnormalities. Several key neurobiological factors have been implicated in the development and manifestation of Bipolar I disorder. Recent studies have shown that there is a strong hereditary component in the development of bipolar I disorder. Even though the exact mechanisms have not been fully discovered, scientists believe that small genes interact with each other, the environment, and other random factors, contributing to the overall susceptibility of one developing this disorder (Bauer, 2022). While exposure to depression and mania is inherited separately, schizophrenia and bipolar I disorder share the same genetic origin (Bauer, 2022). 

The pathophysiology of bipolar I disorder has also been associated with the dysregulation of neurotransmitters such as serotonin, norepinephrine, and dopamine. Imbalances brought on by the dysregulation of these neurotransmitters have been implicated in the development of impulsivity, dysregulation of mood, and cognitive deficits, which are common in individuals who have bipolar disorder. For instance, it has been observed that during manic episodes, there is an increase in the activity of dopamine, while during depressive episodes, there is a decreased dopamine activity (American Psychiatric Association, 2022). Some structural and functional abnormalities, such as alteration in the amygdala, the prefrontal cortex, and the hippocampus, have been observed in patients who have bipolar disorder. Studies suggest that these changes may be the cause of mood instability, cognitive impairments, and emotional dysregulation in individuals suffering from bipolar I disorder (American Psychiatric Association, 2022).

 The disruption of circadian rhythm has also been observed as a common feature in individuals suffering from bipolar I disorder. Some of the disturbances in the sleep-wake cycle, such as the dysregulation of the rapid eye movement (REM) sleep, have been established to be important factors in the pathophysiology of bipolar I disorder. Changes in the melatonin signaling pathways and abnormalities in the biological clock have been shown to contribute to the timing of mood episodes in the cycling nature observed in the disorder.

Differences Between Bipolar I and Bipolar II Disorders

Both bipolar I and bipolar I disorders exhibit mood dysregulation; however, the severity and the nature of the episodes experienced differ. The DSM 5 TR provides a clear diagnostic criterion to distinguish between the two. In Bipolar I disorder, there must be at least one manic episode; this is the principle diagnostic criteria. The manic episode is characterized by abnormally and persistently elevated, expansive, or irritable mood that should last for at least one week with significant changes in energy and activity  (American Psychiatric Association, 2022). The patients undergoing manic episodes often experience an elevated sense of self-esteem, decreased need for sleep, racing thoughts, distractibility, increased talkativeness, and goal-directed activity (McIntyre et al., 2020). These individuals present with a euphoric, irritable, or excessively cheerful mood. In other instances, the patient may present with enthusiasm for interpersonal, occupational, or sexual interactions. For one to be diagnosed with bipolar I disorder, there must be the presence of at least one manic episode.

On the other hand, bipolar II disorder is characterized by at least one hypomanic episode with at least one major depressive episode. In this disorder, the patient should have a hypomanic episode that entails a period of abnormally persistently elevated, expansive, or irritable mood that lasts for four days with changes in energy or activity  (American Psychiatric Association, 2022). In the hypomanic episode, the symptoms are similar to those in a manic episode but at a lesser version. The symptoms usually indicate a significant shift from the individual’s normal behavior. The symptoms that are observed during the change from hypomanic episodes to depression can also lead to a significant impairment in the occupational, social, or other essential areas of functioning of these individuals. 

Special Population

Bipolar I disorder is more common in elderly populations due to a variety of causes. Manic episodes may begin due to cumulative life stressors and age-related brain structure and function changes. Further factors that may increase the risk include the frequency of illnesses, drug interactions, and changes in sleep patterns in the elderly. Neurochemical abnormalities and other biological factors might also be involved. The intricate interaction between these factors highlights how older people are more susceptible to developing Bipolar I disorder.

The legal issues in the management of bipolar I disorder in the older adult population usually revolve around the competence of making decisions. There are concerns about whether an individual can fully understand the effects of choices of treatment, especially in the case where the disorder is likely to cause impairment (Citation 6). Healthcare workers must, therefore, strike a balance between ensuring the safety of the patients and respecting autonomy. They may be forced to collaborate with other family members and legal professionals to ascertain whether legal arrangements to honor the patient’s interests are necessary.

Ethical considerations involve the extended issues of non-maleficence, autonomy, and beneficence. The healthcare workers must ensure that the interests of the patients are put first and that the interventions do not harm the patient. The potential side effects of the medications on the patients must be considered, especially in patients with multiple comorbidities, and they remain informed (Dellasega & Kanaskie, 2021). The issue of cultural diversity is essential, especially when dealing with individuals from different cultural backgrounds. Healthcare workers must recognize the patients’ cultural beliefs, norms, and values that can influence how they perceive and cope with this disorder (Dellasega & Kanaskie, 2021). Some cultures with varying levels of stigma on mental health issues may lead to patients not seeking healthcare help. It is essential to engage with these patients in open dialogues and consideration of culturally sensitive information to ensure that all interventions align with the patient’s cultural context. 

Social determinants of health equally affect the health-seeking behavior of older individuals. Housing, financial constraints, and social support networks can influence the disorder’s course and outcomes. Lack of social support can expose one to isolation, increasing the development and exacerbation of the symptoms of the disorder. Healthcare workers must, therefore, address these determinants to ensure that the patients receive holistic and effective care that considers their resources and the unique challenges they face.

Management of Bipolar I Disorder

The American Psychiatric Association (2010) recommends that in the acute phase of managing bipolar disorders, in the manic or mixed phases, monotherapy should be initiated with lithium, divalproex, or any atypical antipsychotic. In the depressive episodes, the patients should be prescribed monotherapy with lithium, quetiapine, or lamotrigine. For the maintenance and continuation phase of Bipolar I disorder, therapy should be continued with monotherapy with lithium, quetiapine, or lamotrigine. Suppose the patient does not respond to monotherapy. In that case, it is recommended that they are put on a combination of lithium or divalproex with an atypical antipsychotic or a combination of lithium or lamotrigine with an atypical antipsychotic. 

Table Summarizing the Medications for the Management of Bipolar I Disorder

DrugFDA ApprovalSide EffectsWarnings
LithiumApprovedIncreased thirst and urination, Hand tremors, Weight gain, Frequent nausea and vomiting, Diarrhea, Muscle weaknessRegular monitoring of blood levels required, Potential kidney and thyroid issues, Interactions with other medications
DivalproexApprovedNausea, Vomiting, Upset stomach, Dizziness, Hair loss, TremorsLiver function monitoring is required, Increased risk of pancreatitis, Teratogenicity (risk to the fetus during pregnancy)
LamotrigineApprovedHeadache, Dizziness, Double vision, Nausea, InsomniaSerious skin reactions (e.g., Stevens-Johnson syndrome), Titration required to minimize the risk of skin reactions
QuetiapineApprovedDrowsiness, Dizziness, Weight gain, Increased cholesterol levels, Elevated blood sugarIncreased risk of diabetes, Neuroleptic malignant syndrome (rare but serious), Regular monitoring of metabolic parameters

What is Important to Monitor when Managing Bipolar I Disorder

When lithium is prescribed, there should be regular monitoring of the blood concentrations of the drug to ensure that a therapeutic concentration is achieved and that there is no risk of toxicity (American Psychiatric Association, 2010). Due to the potential effects of the drug on renal function, the kidney function tests, including Glomerular Filtration Rates (GFR), should be monitored. Patients taking lithium should be monitored for thyroid function, as lithium has been shown to affect the thyroid. Monitoring electrolyte levels, especially sodium, is also essential to avoid complications.

Divalproex is hepatotoxic and requires regular monitoring of liver function tests. Monitoring amylase levels can help identify pancreatitis and complete blood count (CBC) to avoid hematological complications (American Psychiatric Association, 2010). Lamotrigine can lead to dermatological issues such as Stevens-Johnson syndrome. Therefore, patients should be continuously monitored for any dermatological complications and discontinuation of the drug if any complications arise. Quetiapine can lead to metabolic syndromes and excessive gain of weight. Patients should be monitored for cardiovascular issues, dyslipidemia, and diabetes.

Examples of Prescriptions

I.         Patient: Sarah M

Date: January 5, 2024

Medication: Lithium Carbonate

Strength: 300 mg

Amount to be Taken: 1 tablet

Route: PO

Frequency: BD

Indication: Bipolar I disorder

Quantity: 60 tablets

Refills: 3

Provider’s Signature: [Signature]

II.         Patient: John P.

Date: January 5, 2024

Medication: Divalproex Sodium

Strength: 500 mg

Amount to be Taken: 1 tablet

Route: PO

Frequency: OD

Indication: Bipolar I disorder

Quantity: 30 tablets

Refills: 2

Provider’s Signature: [Signature]

III.         Patient: Emma R

Date: January 5, 2024

Medication: Quetiapine

Strength: 100 mg

Amount to be Taken: 1 tablet

Route: Oral

Frequency: Nightly at bedtime

Indication: Bipolar I disorder

Quantity: 30 tablets

Refills: 1

Provider’s Signature: [Signature]

Conclusion

The influence of age-related changes, accumulated stressors in life, and the complex medical comorbidities in older persons should not be overlooked, as they greatly influence the development of Bipolar I disorder. Healthcare workers should ensure that the interventions are tailored to each individual and that their cultural beliefs, values, and norms are considered. The patients should also be screened for social determinants of health that may affect their health-seeking behavior, and interventions to ensure they are addressed are forged. The diagnosis of Bipolar I disorder in elderly patients calls for a patient-centered and integrated strategy that prioritizes the needs and interests of the patients.

Congratulations for the milestone made so far. You are now conversant with assessing and treating patients presenting with bipolar disorder. The next assignment, due in week 6 of NURS 6630, will introduce you to the assessment and treatment of patients with anxiety disorder. Be sure to master the concepts.

NURS 6630 Week 5 Assignment References

American Psychiatric Association. (2010). Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar.p

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787

Bauer, M. S. (2022). Bipolar disorder. Annals of Internal Medicine, 175(7), ITC97–ITC112. https://doi.org/10.7326/aitc202207190

Dellasega, C., & Kanaskie, M. L. (2021). Nursing ethics in an era of pandemic. Applied Nursing Research, 62, 151508. https://doi.org/10.1016/j.apnr.2021.151508

McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., Malhi, G. S., Nierenberg, A. A., Rosenblat, J. D., Majeed, A., Vieta, E., Vinberg, M., Young, A. H., & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841–1856. https://doi.org/10.1016/s0140-6736(20)31544-0

Frequently Asked Questions (FAQs)

When approaching a 500-word essay, it’s essential to understand the nuances of this compact form of writing. These frequently asked questions will guide you through the process of crafting a concise and impactful essay.

How many pages is a 500-word essay typically?

A 500-word essay usually spans about one page if single-spaced or two pages when double-spaced, with standard margins and a 12-point font size.

Can you provide examples of a well-structured 500-word essay?

Certainly, to see the structure and flow of a well-written essay, you might want to take a look at a student’s writing guide that provides insights and examples.

Are there specific formatting guidelines for a 500-word essay?

Formatting guidelines typically involve using a legible font like Times New Roman or Arial, size 12, with double-spacing and one-inch margins on all sides. Check any specific requirements your instructor might have provided.

What are some effective strategies for writing a personal essay of 500 words?

For a personal essay, focus on a singular event or characteristic, ensuring your ideas are clear and you reflect on the significance of the subject matter. Use concise language and powerful imagery to maximize impact.

What topics are suitable for a concise 500-word essay?

Choose topics you can thoroughly address within the word limit, such as a personal anecdote, a critical analysis of a poem, or a focused argument on a singular point or issue.

How much time should you allocate to write a 500-word essay effectively?

Depending on your familiarity with the topic and writing proficiency, allocate anywhere from one to several hours for planning, drafting, and revising to ensure a well-presented essay.