DISCUSSION: WEEK 9 PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN/NRNP 6675
DISCUSSION: WEEK 9 PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN/NRNP 6675
INTRODUCTION
The psychiatric mental health nurse practitioner assumes probably no greater responsibility than the responsibility of prescribing medications. While someone can be harmed by psychotherapy, the level and intensity of the harm generally does not come to the same level of harm that can occur from improper prescribing. The PMHNP must understand his/her responsibility both at a state and federal level when it comes to prescribing medications. It is of critical importance to understand the risks and benefits of the medications prescribed and their varying potential effects on special populations such as children/adolescents, pregnant women, or older adults.
This week, you examine the special considerations when prescribing for pregnant women and older adults.
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LEARNING OBJECTIVES
Students will:
Recommend psychopharmacological and nonpharmacological interventions for older adults and pregnant women in mental health settings
Evaluate the risks and benefits of pharmacological treatment for older adults and pregnant women
Justify clinical decision making related to pharmacological treatment of older adults and pregnant women in mental health settings
PRESCRIBING FOR OLDER ADULTS AND PREGNANT WOMEN
After assessing and diagnosing a patient, PMHNPs must take into consideration special characteristics of the patient before determining an appropriate course of treatment. For pharmacological treatments that are not FDA-approved for a particular use or population, off-label use may be considered when the potential benefits could outweigh the risks.In this Discussion, you will investigate a specific disorder and determine potential appropriate treatments for when it occurs in an older adult or pregnant woman.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
TO PREPARE:
Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5-TR to use.
Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.
BY DAY 3 OF WEEK 9
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.
Read a selection of your colleagues’ responses.
BY DAY 6 OF WEEK 9
Respond to at least two of your colleagues on 2 different days who selected different disorders. Propose an alternative on-label, off-label, or nonpharmacological treatment for the disorders. Justify your suggestions with at least two references to the literature.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!
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LEARNING RESOURCES
Required Readings
American Psychiatric Association. (2016). The American Psychiatric Association practice guideline on the use of antipsychotics to treat agitation or psychosis in patients with dementiaLinks to an external site.. https://doi.org/10.1176/appi.books.9780890426807
Agency for Healthcare Research and Quality. (2019). Maternal and fetal effects of mental health treatments in pregnant and breastfeeding women: A systematic review of pharmacological interventionsLinks to an external site.. https://effectivehealthcare.ahrq.gov/sites/default/files/pdf/protocol-pharm-pregnant-women_0.pdf
Hardy, L. T., & Reichenbacker, O. L. (2019). A practical guide to the use of psychotropic medications during pregnancy and lactationLinks to an external site.. Archives of Psychiatric Nursing, 33(3), 254–266. https://doi.org/10.1016/j.apnu.2019.04.001
National Library of Medicine. (2006–2020). Drugs and lactation databaseLinks to an external site. (LactMed). https://www.ncbi.nlm.nih.gov/books/NBK501922/
The LactMed® database is a peer-reviewed, evidence-based resource on drugs that may be used by breastfeeding mothers. It includes possible effects on nursing infants and offers drug alternatives where possible.
Boland, R. Verdiun, M. L. & Ruiz, P. (2022). Kaplan & Sadock’s synopsis of psychiatry (12th ed.). Wolters Kluwer.
Chapter 1, “Examination and Diagnosis of the Psychiatric Patient”
Section 1.3, “Geriatric Patients” (pp. 87-92)
Chapter 29, “End-of-Life Issues and Palliative Care”
Chapter 31, “Global and Cultural Issues in Psychiatry”
Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
Chapter 3, “Vulnerable Populations”
Chapter 4, “Mental Health and Primary Care: A Critical Intersection”
Chapter 5, “Cultural Sensitivity and Global Health”
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NRNP_6675_Week9_Discussion_Rubric
Criteria | Ratings | Pts | ||||
---|---|---|---|---|---|---|
This criterion is linked to a Learning OutcomeMain Posting:Response to the Discussion question is reflective with critical analysis and synthesis representative of knowledge gained from the course readings for the module and current credible sources. |
|
44 pts | ||||
This criterion is linked to a Learning OutcomeMain Posting:Writing |
|
6 pts | ||||
This criterion is linked to a Learning OutcomeMain Posting:Timely and full participation |
|
10 pts | ||||
This criterion is linked to a Learning OutcomeFirst Response:Post to colleague’s main post that is reflective and justified with credible sources |
|
9 pts | ||||
This criterion is linked to a Learning OutcomeFirst Response:Writing |
|
6 pts | ||||
This criterion is linked to a Learning OutcomeFirst Response:Timely and full participation |
|
5 pts | ||||
This criterion is linked to a Learning OutcomeSecond Response:Post to colleague’s main post that is reflective and justified with credible sources |
|
9 pts | ||||
This criterion is linked to a Learning OutcomeSecond Response:Writing |
|
6 pts | ||||
This criterion is linked to a Learning OutcomeSecond Response:Timely and full participation |
|
5 pts |