Assignment: Assessing and Treating Patients
With Impulsivity, Compulsivity, and Addiction
Impulsivity, compulsivity, and addiction are challenging disorders for patients across the life span.
Impulsivity is the inclination to act upon sudden urges or desires without considering potential
consequences; patients often describe impulsivity as living in the present moment without regard to
the future (MentalHelp.net, n.d.). Thus, these disorders often manifest as negative behaviors,
resulting in adverse outcomes for patients. For example, compulsivity represents a behavior that an
individual feels driven to perform to relieve anxiety (MentalHelp.net, n.d.). The presence of these
behaviors often results in addiction, which represents the process of the transition from impulsive to
compulsive behavior.
In your role as the psychiatric nurse practitioner (PNP), you have the opportunity to help patients
address underlying causes of the disorders and overcome these behaviors. For this Assignment, as
you examine the client case study in this week’s Learning Resources, consider how you might assess
and treat clients presenting with impulsivity, compulsivity, and addiction.
MentalHelp.net. (n.d.). Impaired decision-making, impulsivity, and compulsivity: Addictions’ effect on the cerebral cortex.
https://www.mentalhelp.net/addiction/impulsivity-a…
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 requiring therapy for impulsivity, compulsivity, and addiction.
Lupi, M., Martinotti, G., Acciavatti, T., Pettorruso, M., Brunetti, M., Santacroce, R., Cinose, E., Di
Iorio, G., Di Nicola, M., & Di Giannantonio, M. (2014). Pharmacological treatments in gambling
disorder: A qualitative review. Biomed Research International, 2014.
https://doi.org/10.1155/2014/537306
Reference:
The Assignment: 5 pages
Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make
three decisions concerning the medication to prescribe to this client. Be sure to consider factors that
might impact the client’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 patientspecific resources, including the primary literature.
Rubric, case study and problem statement in detail is also attached. Please let me know if you need me to send any resources which are listed in the materials
Expert Solution Preview
Introduction:
Impulsivity, compulsivity, and addiction are challenging disorders that have adverse outcomes on patients. Patients with these disorders manifest negative behaviors that require psychiatric nurse practitioners to address and help patients overcome them. This Assignment examines a Puerto Rican woman with comorbid addiction, and the nurse practitioner’s role in assessing and treating clients with impulsivity, compulsivity, and addiction.
Decision #1:
I have selected decision one to prescribe Topiramate (Topamax). Topiramate is an effective medication for reducing alcohol consumption and reducing impulsivity. Topiramate helps control seizures and stabilizes mood swings in people with bipolar disorder.
I did not select the other two options based on patient factors that may impact pharmacokinetic and pharmacodynamic processes. Naltrexone may cause liver problems, and the patient has a history of hepatitis C, making Naltrexone less effective. Baclofen is not suitable for patients with a history of epilepsy, making it less effective.
By making this decision, I hoped to achieve reducing the patient’s impulsivity, which can contribute to compulsivity and addiction. Topiramate will also help with the patient’s bipolar disorder, reducing mood swings that could lead to impulsive behavior.
Ethical considerations such as informed consent, confidentiality, and patient autonomy could impact my treatment plan and communication with patients. Patients require sufficient information about the medication’s purpose, benefits, side effects, and potential risks before consenting to a treatment plan. Confidentiality protects the patient’s privacy, and patient autonomy grants patients the right to choose treatment options.
Decision #2:
I have selected decision two to prescribe Sertraline (Zoloft). Zoloft is an antidepressant medication that helps improve mood and reduces compulsive behavior in patients with obsessive-compulsive disorder (OCD). Zoloft also reduces anxiety and helps manage PTSD symptoms in patients with comorbid substance use disorders.
I did not select the other two options because Bupropion (Wellbutrin) has a higher risk of seizures, which could worsen the patient’s epilepsy condition. Additionally, Zonisamide (Zonegran) is not as effective in treating OCD and PTSD as Zoloft.
By making this decision, I hoped to achieve reducing the patient’s compulsive behavior and managing the PTSD symptoms associated with substance use disorders.
Ethical considerations may impact my treatment plan and communication with patients. Patients require sufficient information, including the medication’s purpose and potential risks, to make informed consent. Confidentiality protects the patient’s privacy, and patient autonomy grants patients the right to choose treatment options.
Decision #3:
I have selected decision three to prescribe Acamprosate (Campral). Acamprosate is an effective medication for the treatment of alcohol dependence and reduces the craving to drink alcohol. Acamprosate helps relieve the anxiety that patients with comorbid PTSD may develop.
I did not select the other two options because Disulfiram (Antabuse) causes unpleasant side effects, which could prevent the patient from complying with the treatment. Additionally, Gabapentin (Neurontin) may worsen the patient’s bipolar disorder symptoms.
By making this decision, I hoped to achieve controlling the patient’s alcohol dependence, which reduces compulsive behavior that leads to addiction.
Ethical considerations may impact my treatment plan and communication with patients. Patients require sufficient information, including the medication’s purpose and potential risks, to make informed consent. Confidentiality protects the patient’s privacy, and patient autonomy grants patients the right to choose treatment options.
Conclusion:
In conclusion, treatment options for patients with comorbid addiction, compulsivity, and impulsivity, require PNPs to evaluate medication options, determine potential patient-specific factors, and evaluate ethical considerations. The decisions made should aim to reduce the manifestations of negative behavior and achieve the best outcomes for the patient. In the case of the Puerto Rican woman, prescribing Topiramate, Sertraline, and Acamprosate, considering the patient’s medical history, will help address the underlying causes of compulsivity, impulsivity, and addiction.
