Complaint of Insomnia Essay Paper.

BACKGROUND This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia. SUBJECTIVE Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. Complaint of Insomnia Essay

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The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient\’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. Complaint of Insomnia Essay Paper.The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed. MENTAL STATUS EXAM The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented. Decision Point One Select what you should do: 1- Zolpidem: 10mg daily at bedtime 2- Trazodone: 50-100mg daily at bedtime 3- Hydroxyzine: 50mg daily at bedtime. Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. Complaint of Insomnia Essay Paper.You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. Introduction to the case (1 page) • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Decision #1 (1 page) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Complaint of Insomnia Essay Paper.Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #2 (1 page) • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). •Complaint of Insomnia Essay Paper. Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Decision #3 (1 page) • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Conclusion (1 page) • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.Complaint of Insomnia Essay Paper.

Introduction

According to previous research, mental disorders are characterized with alternation of human normal daily activities that include thinking, mood, and behavior. Currently, such cases have escalated thereby creating an alarming attention in the health sector as well as stakeholders. This paper presents a case study of a 31-year-old male reporting in a clinical office with a chief complaint of insomnia. More so, the patient states that his condition worsened over the past 6 months. As per the patient reports he has been experiencing sleeping difficulties contrary to his “great sleeper” behavior. This condition is traced back for the last six months after losing a fiancé.Complaint of Insomnia Essay Paper.

In addition, the condition has paralyzed his daily activities where he operates a forklift in a chemical company. The patient has been treating the issue with diphenhydramine to sleep but does not like the feeling experience in the morning hours. According to the patient’s mental assessment it indicates he is oriented and alert to people, time and place. He maintains good eye contact and dress appropriately to according to weather. In fact, the patient denies auditory hallucinations and has a correct judgement. Lastly, the paper will explore patient’s assessment and examination based on medical grounds while answering some of the most probable decisions made and the reason as to why such decision are employed.Complaint of Insomnia Essay Paper.

Decision point 1: Zolpidem: 10mg daily at bedtime

According to the presented patient’s case study my initial decision is starting zolpidem 10 mg daily at bed time. Besides, my take to this decision is supported by the patient report with difficulties to have good sleep which alters his normal working activities. This medication is appropriate since it serves as a sleeping pill applicable in treating insomnia for a patient with sleeping difficulties. Besides, Zolpidem medication will assist the client to fall asleep rapidly as well as decreasing chances of waking up during the night (Abad, & Guilleminault, 2018). This treatment decision usually takes approximately an hour to function in the body systems. More so, the treatment remedy is normally taken for a period of four weeks.Complaint of Insomnia Essay Paper.

According to the presented case he is eligible taking the drug since he is 18 years and above. Still, the dosage comes inform of tablets issued one hour before sleeping. The patient will take the medication with a glass of water. It is advisable not to crush or chew the tablet and can be taken with or without food. The presented client will start experiencing notable positive changes as soon as he starts taking the medication. Notably, the drug response might vary from one patient to another depending on individual’s body responses towards drugs (Chase et al., 2018).

Complaint of Insomnia Essay Paper.My main idea behind this proposal was to reduce the causing agent of insomnia and the patient will start experiencing comfortable sleeping trend. Even though my selection was based on choosing the most appropriate drug from other choices such as Trazodone and Hydroxyzine. Notably, the other choices would be significant towards the patient condition but after critically assessing the issue I decided to employ the above choice as a valid remedy that would provide the patient with optimal results.Complaint of Insomnia Essay Paper.

In addition, taking Zolpidem will have minimal side effects such as experiencing bitter taste in the mouth. Even though the side effect may be managed by use of mouthwash prior going to bed. The mode of action for this drug mechanism act as a non-benzodiazepine hypnotic agent which work as a GABE receptor chloride channel agonist (Horowski, 2020). This receptor increases GABA inhibitory effects that leads to sedation. Also, it has an anticonvulsant, minor myorelaxant, and anxiolytic properties.Complaint of Insomnia Essay Paper.

How ethical considerations may impact your treatment plan and communication with patients

The most crucial ethical consideration according to the presented case include the informed consent, beneficence, non- maleficence, and autonomy. Before issuing a patient with any drug it is vital to expound the reason as to why prescribing certain drug is important towards the disorder (Lee et al., 2018).Complaint of Insomnia Essay Paper. Notably, this enables the client to get fully informed what they are consenting to as well as possible risks and expectations involved. Secondly, any prescribed treatment remedy should be aimed at maintaining patient’s interest and expose fewer side effects. However, this action guarantees the patient of having a treatment that cause no harm. Lastly, the patient should not be forced to engage in a certain treatment plan while being coerced to uphold a treatment modality against their will (Knack, Chandler & Fedoroff, 2020).Complaint of Insomnia Essay Paper.

Decision point 2: continue taking Zolpidem 10mg daily at bedtime

My second take for insomnia disorder is to continue taking Zolpidem 10 mg daily at bedtime. After patient analysis and assessment progress the patient initial difficulties have significantly decreased thus indicating a positive result. My aim of choosing and proposing this decision is to aid the patient experience improvement in sleep as well as increasing residual and adverse events effects. In this case, Zolpidem perceived and anticipated effectiveness to such a patient with decrease in sleep will act by maintaining and increasing sleeping duration. This implication will tend to improve the sleeping quality without posing various side effects that will probably affect his normal working schedules performances. However, this suggest that Zolpidem is an outstanding medication in treating insomnia in the second phase.Complaint of Insomnia Essay Paper.

How ethical considerations may impact your treatment plan and communication with patients

Patient confidentiality is an applicable ethical consideration in the second decision while treating patient with insomnia. Confidentiality consideration upholds maintenance of patient health record safely from being accessible by unauthorized individuals (Campbell et al., 2020). Complaint of Insomnia Essay Paper.More so, this guideline only permits disclosure of such medical information with the patient consent. Still, beneficence ethical consideration applies in this case where the medics prescribes the patient to stick with same dosage while undergoing treatment. By doing so, medical personnel follow medical regulation that monitors dispensing of the right medication primarily aiming to benefit and manage patent condition successfully.

Complaint of Insomnia Essay Paper.In fact, as per the patient progress it is worth to maintain the same dosage since it reveals a positive outcome. My choice for this dosage will be primarily maximizing the patient outcome while completely decreasing probable remaining signs and symptoms of insomnia disorder that could be remaining in the patient treatment plan. By disregarding other probable choices, this choice is critical since the patient condition will improve significantly. Complaint of Insomnia Essay Paper.

Decision point 3: increase Zolpidem to 10 mg at bet time.

My third clinical decision is anchored to increase Zolpidem from 7mg to 10 mg at bet time. My aim of choosing this decision is to uphold patient’s outcomes and to optimize results. After client return to the clinic there are notable changes of having positive outcome. Importantly, is to fully reduce the insomnia effects that distract the patient. However, the third trial is designed to evaluate the effective and safety of taking a 10 mg dose. Notably, this dosage will decrease sleeping difficulties that the patient might be experiencing.Complaint of Insomnia Essay Paper.

Ethical considerations impacting treatment plan and communication

According to the third proposed treatment plan informed consent consideration is applicable in the treatment plan. This rule give patient an insight of getting information about changes done by medical practitioner. For instance, in this trial the patient has the right to understand why a certain decision is made and if their health is safe. By so doing, the patient is given an allowance to agree the choice based on benefits achieved from changing the dosage. Secondly, patient voluntary participation is an ethical guideline that engage patient to take medication on their will. However, this consideration allows patients to freely comply with doctor’s prescription without having fear of being coerced. Complaint of Insomnia Essay Paper.

Recommendation

The management and treatment of insomnia condition requires a thorough and careful assessment that allows medics to plan for a critical medication strategy. According to the presented client’s case application of Zolpidem is a worth remedy. More so, this is the best medication for the patient condition that is likely to give an outstanding outcome with an increase in dosage. Patient should ensure they take this drug without omission to rapidly get significant outcomes. Complaint of Insomnia Essay Paper.