Assessing and Treating Clients with Dementia Paper

Assessing and Treating Clients with Dementia Paper Assessing and Treating Clients with Dementia Paper BACKGROUND Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation. NURS 6630 Chamberlian Assessing and Treating Clients with Dementia Paper SUBJECTIVE During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. Assessing and Treating Clients with Dementia Paper MENTAL STATUS EXAM Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation. Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive) ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS RESOURCES § Folstein, M. F., Folstein, S. E., & McHugh, P. R. (2002). Mini-Mental State Examination (MMSE). Lutz, FL: Psychological Assessment Resources. Decision Point One Select what the PMHNP should do: Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks : Begin Aricept (donepezil) 5 mg orally at BEDTIME Begin Razadyne (galantamine) 4 mg orally BID Alzheimer’s Disease 76-year-old Iranian Male Decision Point One : Begin Aricept (donepezil) 5 mg orally at BEDTIME RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks The client is accompanied by his son who reports that his father is “no better” from this medication He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall Decision Point Two Increase Aricept to 10 mg orally at BEDTIME RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious Decision Point Three Continue Aricept 10 mg orally at BEDTIME Guidance to Student At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son. There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate. There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects. Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern. Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

So much stress and so little time? Take care of yourself: let us help you with your task on
Assessing and Treating Clients with Dementia Paper
Get a 20% Discount on this Paper
Get Help Now
Calculate the price
Make an order in advance and get the best price
Pages (550 words)
$0.00
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
Sign up, place your order, and leave the rest to our professional paper writers in less than 2 minutes.
step 1
Upload assignment instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
s
Get personalized services with Do My Homeworkk
One writer for all your papers
You can select one writer for all your papers. This option enhances the consistency in the quality of your assignments. Select your preferred writer from the list of writers who have handledf your previous assignments
Same paper from different writers
Are you ordering the same assignment for a friend? You can get the same paper from different writers. The goal is to produce 100% unique and original papers
Copy of sources used
Our homework writers will provide you with copies of sources used on your request. Just add the option when plaing your order
What our partners say about us
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Business Studies
I can't even explain how much your help meant to me. Thnk you always
Customer 452443, November 15th, 2021
Economics
Thank you - much appreciated!
Customer 452493, April 2nd, 2022
Finance
Excellent. Thnk you
Customer 452443, October 22nd, 2021
Nursing
Good work, professional and beat the deadline. Thank you so very much
Customer 452445, August 24th, 2021
Education
Awesome work, responded well and clarified everything.. Would definitely recommend, great service
Customer 452445, September 8th, 2021
Nursing
Looks good. Thank you!!!
Customer 452503, April 25th, 2022
Finance
Wow! I should never have doubted you guys. Thank you for the excellent grade
Customer 452443, August 27th, 2021
Nursing
Great services.
Customer 452443, November 22nd, 2021
Philosophy
The paper was done to my satisfaction. Thnk you.
Customer 452443, November 18th, 2021
Economics
Although the paper did not make it at the requested time, the writer did reach out to me and asked for a short extension which I was okay with.
Customer 452493, March 16th, 2022
Economics
THANK YOU! :)
Customer 452493, April 12th, 2022
Education
Looks good. Thank you!
Customer 452523, September 27th, 2022
OUR GIFT TO YOU
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat

Order your essay today and save 15% with the discount code ESSAYHELP