My Approach to Managing This Patient’s Weight Concern
In my approach, I would use psychoeducation and collaborative treatment as a Psychiatric Mental Health Nurse Practitioner (PMHNP) to help this 36-year-old lady with bipolar disorder and anxiety with her weight (Menear et al., 2020). First, I would use compassionate communication to identify the psychosocial aspects affecting her weight management, taking into consideration her considerable stressors, including caring for a severely challenged child and her husband’s terminal illness. I would teach psychoeducation on the bidirectional relationship between mental health disorders, drugs, and weight, emphasizing the importance of lifestyle on both physical and mental health. Furthermore, I would create a comprehensive care plan with the patient’s PCP. This includes discussing how medications affect weight, researching other pharmacological alternatives that may help, and working with a certified dietitian to create a nutritional plan that matches her family’s schedule. Given her limited physical activity, I would recognize her caregiving duties and set reasonable and achievable workout goals with her. Empowering the patient to adopt sustainable lifestyle adjustments promotes a comprehensive approach to mental and physical well-being within her specific family and medical conditions.
Approach to the Sexual Side Effects she is Experiencing
In addressing the sexual side effects of the 36-year-old lady with bipolar disorder and anxiety, I would conduct a thorough assessment and work with her to address them. First, I would thoroughly evaluate her pharmaceutical regimen to determine if the sexual side effects are related to fluoxetine and olanzapine, which are known to cause sexual dysfunction. With her prescribing physician’s approval, she may seek alternate medications with fewer sexual adverse effects or dosage adjustments due to her complex medical and psychiatric history. Simultaneously, In practice, I would address her psychological and relational sexual problems through open, non-judgmental communication (Leavitt et al., 2020). Psychoeducation on how mental health and psychotropic medicines affect sexual function may make her feel less ashamed. I would work with her spouse to improve intimacy and communication, possibly using couples therapy to address the emotional toll of the fatal prognosis. This integrated approach optimizes the woman’s mental health by recognizing and addressing the complex relationship between psychiatric medications, psychological well-being, and relational dynamics in sexual health issues.
My state’s Prescribing Laws.
Nurses must follow state-specific prescribing laws for advanced practice nursing. Let us say the patient’s sexual side effects are caused by fluoxetine and olanzapine. In New York, PMHNPs can prescribe psychiatric drugs independently because of too wide prescribing laws. Arbitraryly, the patient reports a change in her sexual functioning, particularly orgasm problems, since starting her current pharmaceutical regimen. A thorough psychiatric examination encompasses the duration and severity of these side effects, their impact on the patient’s quality of life, and any emotional or interpersonal difficulties.
Moreover, the nurse would objectively assess the patient’s mental health by reviewing her medical history, medications, and psychiatric symptoms. The nurse may propose reducing the dosage of fluoxetine or olanzapine or switching to a drug with fewer sexual adverse effects with the prescribing physician. Objective assessment includes monitoring vital signs, checking for adverse reactions or drug interactions, and considering the patient’s general physical health in decision-making. The Psychiatric, however, would follow separate prescription norms, which may limit banned substances and demand collaboration to meet with state laws. In jurisdictions with limited prescribing authority, nurses may need to work with a doctor to approve medication adjustments.
In conclusion, psychiatrists can recommend extra drugs based on state prescribing laws. In the PMHNP field of practice, safe and successful sexual side effect management requires a thorough assessment, coordination with the prescribing physician, and state compliance.
References
Leavitt, C. E., Whiting, J. B., & Hawkins, A. J. (2020). The Sexual Mindfulness Project: An Initial Presentation of the Sexual and Relational Associations of Sexual Mindfulness. Journal of Couple & Relationship Therapy, pp. 1–17. https://doi.org/10.1080/15332691.2020.1757547
Menear, M., Dugas, M., Careau, E., Chouinard, M.-C., Dogba, M. J., Gagnon, M.-P., Gervais, M., Gilbert, M., Houle, J., Kates, N., Knowles, S., Martin, N., Nease, D. E., Zomahoun, H. T. V., & Légaré, F. (2020). Strategies for engaging patients and families in collaborative care programs for depression and anxiety disorders: A systematic review. Journal of Affective Disorders, 263(1), 528–539. https://doi.org/10.1016/j.jad.2019.11.008
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