Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders
Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.
Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sle…
To prepare for this Assignment:
- Review this week’s Learning Resources, including the Medication Resources indicated for this week.
- Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders.
The Assignment: 5 pages
Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. 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.
- 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).
- 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.
Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.
Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at All papers submitted must use this formatting.
By Day 7
Submit your Assignment.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
- Please save your Assignment using the naming convention “WK8Assgn2+last name+first initial.(extension)” as the name.
- Click the Week 8 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
- Click the Week 8 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
- Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK8Assgn2+last name+first initial.(extension)” and click Open.
- Click on the Submit button to complete your submission.
- I will share rubric and material
Expert Solution Preview
Introduction:
Sleep disorders are a common medical issue that affects a person’s pattern of sleep, which can lead to significant health concerns in their overall quality of life. Psychiatric nurse practitioners play a vital role in evaluating and treating patients with sleep/wake disorders. Pharmacologic treatments can help alleviate these symptoms, although selecting the appropriate medication requires careful consideration of many factors like pharmacokinetics, pharmacodynamics, and patient-specific variables.
In this Assignment, we will review a case study on pharmacologic approaches to the treatment of insomnia in a young adult. The student needs to recommend three medication decisions based on the patient’s clinical presentation to mitigate the symptoms of this disorder.
Decision #1:
I selected a low dose of Temazepam for the patient as an initial treatment for insomnia. Temazepam has a standard potency with a short half-life, which can help promote relaxation and sleep without causing significant grogginess after waking up. This decision is supported by primary literature sources such as the National Institutes of Health (NIH) and the American Academy of Sleep Medicine (AASM).
I did not select the other options such as triazolam and zolpidem because they have a higher risk of side effects, including daytime drowsiness, amnesia, and dependency. Also, the patient is young, and the usage of stronger sedatives should be avoided. Moreover, this decision can help the patient to fall asleep and stay asleep without causing significant complications or adverse effects.
Ethical considerations can impact the treatment plan by ensuring the student informed the patient about the potential side effects and the importance of following the medication guidelines provided. They should manage patient’s expectations while explaining the necessity of using a low dose of medication without relying on it as a primary or sole treatment.
Decision #2:
For the second decision, increasing the Temazepam dose from 15mg to 30mg was selected. This decision is well supported by various primary literature sources, including NIH and FDA documentation. It is a safe and effective treatment option to help the patient get better sleep as the medication dosage increase proportionally to improve sleep quality. It can also help prevent tolerance and dependency in the long run.
I did not select the other two options, like switching to benzodiazepines or adding Trazodone, as it is not necessary to introduce new medication when there is an effective medication available. Moreover, the patient has adverse effects to the Benzodiazepine class that includes dizziness and sleepiness, which can also cause dependency. Trazodone can also cause prolonged sedation and oversedation that might be inappropriate for a younger patient to take.
Ethical considerations can impact the treatment plan by ensuring the student informed the patient about the potential side effects and the importance of following the medication guidelines provided. They should manage patient’s expectations while explaining the necessity of using a low dose of medication without relying on it as a primary or sole treatment.
Decision #3:
For the third decision, the student should start considering switching medication. Specifically, switching from Temazepam to Doxepin, a single medication that can treat both sleep and anxiety disorders. Doxepin is an excellent option that can promote deep sleep among patients while addressing any underlying anxiety issues. It has fewer side effects than Temazepam, and there is a lower risk of developing tolerance with prolonged use.
The other two options, either increasing the Temazepam dosage to 45mg or switching to Belsomra, are not preferred. Belsomra is a relatively new medication and has limited data in terms of the long-term effects, safety and efficacy. Therefore, recommending this medication is not appropriate until more data is available. The Temazepam dose could be increased potentially to 45mg, but at that higher doses, there is a higher risk of sedation, dependency, and tolerance, which the patient should also avoid.
Ethical considerations should focus on the importance of informing the patient about the potential side effects and ensuring that Doxepin is fully explained to the patient. It would involve explaining to the patient how this medication is different than Temazepam and how it can help the patient’s treatment.
Conclusion:
In conclusion, addressing and treating sleep/wake disorders requires psychiatric nurse practitioners to evaluate a variety of factors, including medication dosages, pharmacologic attributes, and patient-specific considerations. In the context of this case study, recommended medications to facilitate restful sleep are vital for the overall health and wellbeing of the patient. The ethical considerations highlighted the importance of informing the patient about their medication options and ensuring that they are fully aware of the benefits and risks involved in each decision.
