Assessing And Treating Patients With Bipolar Disorder Free Writing Sample

Bipolar disorder is a mental condition which impacts 1 to 4% of the public. The signs and symptoms will differ depending on the kind of disease present. Someone who is manic-depressive may be euphoric and ecstatic, whereas someone who is depressed might be sad or depressed. Each episode is marked by a significant shift in the patient’s conduct and behavior. Bipolar disorder is characterized by extreme variations in a person’s mood and energy levels throughout time. Changes in a person’s conduct are frequently noticed first by those closest to them. According to recent research, 69% of persons with bipolar illness are misdiagnosed as having unipolar depression instead of bipolar disorder (Bonnín et al., 2019). Misdiagnosis raises the risk of inadequate antidepressant medication, which might result in manic episodes in certain situations.

Doctors take time to diagnose most of their patients correctly. Consequently, diagnosing the disease is challenging since most individuals seek care when experiencing a depressive episode but remain silent when they have a manic episode. Patients are usually uninterested in their manic episodes. In some aspects, the symptoms of bipolar disorder are comparable to those of other mental diseases, such as borderline personality disorder (Jawad et al., 2018). Due to a significant delay in diagnosis, patients with bipolar illness have a prolonged time of stability in their life. Consequently, practicing nurses must be well-versed in the pathophysiology of the condition they’re treating.

In this case, the complainant is an Asian-American lady. It has been determined that bipolar disorder exists. The report outlines what is safe and suitable for the patient during the presentation.

Decision One

Which Decision Did You Select?

Risperdal 2 mg twice a day was recommended for the first two weeks.

Why Did You Select This Decision?

Risperdal was selected since it has been shown to help a wide range of bipolar disorder patients. It has been demonstrated to benefit persons with mixed episodes of type 1 bipolar illness. Because of its tolerability, the FDA has authorized Risperdal to treat schizophrenia. It is used to treat schizophrenia because of its efficiency in restoring brain stability. According to studies, the receptor-binding profile of risperidone efficiently balances dopamine and serotonin levels, resulting in improvements in mood and behavior in specific individuals. Second-generation (atypical) antipsychotics, maybe utilized as effective alternatives to standard stabilizers in the treatment of manic episodes (Chopko & Lindsley, 2018). Short-term adjunctive therapy with benzodiazepine drugs like Risperdal is effective.

Why Did You Not Select the Other Two Options Provided in The Exercise?

Due to the risk of side effects, starting with a lithium dose of 300 mg is not recommended. Starting with Seroquel XR 100 mg is not recommended because the patient has a positive CYP2D6 test. The patient’s safety should be the primary consideration when making decisions. Because the patient’s condition isn’t critical, you don’t need to start giving him lithium.

What Were You Hoping to Achieve by Making This Decision?

Patients taking Risperdal will notice that their mania symptoms are less severe. He should be able to sleep well and concentrate on his work, for example. This medication is expected to help restore brain balance and improve mood. Risperdal is a medication that helps people with bipolar disorder who have manic episodes (Jawad et al., 2018). According to a score of 22 on the Young Mania Scale, the patient has moderate mania symptoms and should be treated right away.

Explain How Ethical Considerations May Impact Your Treatment Plan and Communication with Patients.

Before administering any psychiatric medication, it is critical to obtain the patient’s consent. When patients were informed about the pharmacodynamics of their disease, they were more likely to give informed consent. Patients from minority ethnic groups require culturally sensitive care, starting with patient education and continuing throughout treatment.

Decision Two

Which Decision Did You Select?

Instead of stopping Risperdal, the best next step is to cut the dose to 1mg at bedtime every day.

Why Did You Select This Decision?

The patient expressed his exhaustion. Drowsiness is a common side effect of Risperdal. On the other hand, the patient’s CYP2D6 level was abnormally high, even more concerning. In comparison to Caucasians, Asians had lower CYP2D6 activity. Polymorphisms in the CYP2D6 enzyme have affected the pharmacokinetics and tolerability of traditional antipsychotics (Hirschfeld, n.d.). Drowsiness is a source of contention for patients throughout the day.

Why Did You Not Select the Other Two Options Provided in The Exercise?

Patients are encouraged to keep taking Risperdal because it effectively treats bipolar disorder symptoms. Lithium and Seroquel XR 100 mg have side effects that can harm a patient’s overall health (Rolin, Whelan & Montano, 2020). Remember that adding another drug to a drug combination increases the severity of side effects, toxicity, and drug-drug interactions that must be considered.

What Were You Hoping to Achieve by Making This Decision?

Lowering the Risperdal dose to 1 mg may help reduce side effects, and changing the patient’s bedtime may help them function better during the day. Patients will reap the drug’s benefits with the fewest possible side effects.

Explain How Ethical Considerations May Impact Your Treatment Plan and Communication with Patients.

Drug interactions with Asian medicines should be considered when making decisions. The Practitioner Nurse (NP) must take all reasonable precautions to protect the patient. Learning more about Risperdal’s psychodynamics in Asian patients can help Nurse Practitioners (NPs) improve patient safety (Hirschfeld, n.d.). Some antipsychotics have a different effect on Asians than they do on Caucasians. NPs must prescribe drugs that have been proven to work in various patients.

Decision Three

Which Decision Did You Select?

It was decided to keep using Risperdal 1 mg orally in high doses.

Why Did You Select This Decision?

The drug assists in achieving the desired result. Dosage adjustments are not clinically useful because they can affect the patient’s mood and destabilize their mental state.

Why Did You Not Select the Other Two Options Provided in The Exercise?

After this point, there is no reason in the treatment plan to change the drug or its dosage. In this case, the patient tolerated Risperdal well (Jawad et al., 2018). The other two options have too many unknowns, making patient treatment difficult. To keep the patient’s mental health stable, you must continue to use Risperdal.

What Were You Hoping to Achieve by Making This Decision?

According to the manufacturer, Risperdal treatment will help maintain a reduction in bipolar symptoms over time. Patients report no adverse side effects and long-term mood stability. The patient’s relationship with their family and friends is expected to improve. Patients will be able to devote more time to their professional pursuits. Furthermore, until their next doctor’s appointment, patients are expected to take the same medication.

Explain How Ethical Considerations May Impact Your Treatment Plan and Communication with Patients.

It is a moral obligation to consider the drug’s pharmacodynamics before and during the treatment of the bipolar disorder. The medication you choose should give you the best possible results. Patients should be aware of the drug’s side effects and the long-term consequences of taking it. In cases of severe psychiatric illness, the law allows the practicing nurse to disregard the patient’s care preferences (Chopko & Lindsley, 2018). The responsibility of the practicing nurse (NUR) is to think about the moral implications of any decision so that the patient does not suffer as a result of the care provided. Antipsychotic patients must be ethically monitored. The drug and any potential side effects should be explained to the patient’s family members. This makes it easier to keep track of the patient.


Several medicines may be utilized in treating bipolar disorder, all of which have been certified by the FDA. Nurse Practitioners (NURs) are specially trained to select the most appropriate medication for each patient (Bonnín et al., 2019). Genetics impacts the absorption, distribution, and metabolism of drugs. The adverse reaction that an Asian patient with a positive CYP2D6 gene has is different from the adverse reaction that a patient with a negative CYP2D6 gene has. Genetic testing should determine the appropriate dose for patients of Asian ancestry. Risperdal is a highly effective first-line treatment for bipolar disorder. It is more effective in the treatment of manic episodes. The patient received a 22 on the young mania scale applied to him.

The patient requires medication to relieve their mania symptoms. Some Asian patients have a low tolerance for traditional mood stabilizers like lithium and Seroquel XR, and they may experience unwanted side effects, prompting them to stop taking the medication. As a result, there may be inconsistencies. There have been fewer reports of side effects with this drug than with traditional antipsychotics. When treating Asian patients, the FDA’s regulations and recommendations should be followed. Nurses must always put the safety of their patients and their families first. Because of the balance of efficacy, safety, and cost-effectiveness, Risperdal is recommended to treat manic episodes.


Bonnín, C. D. M., Reinares, M., Martínez-Arán, A., Jiménez, E., Sánchez-Moreno, J., Solé, B., … & Vieta, E. (2019). Improving functioning, quality of life, and well-being in patients with bipolar disorder. International Journal of Neuropsychopharmacology22(8), 467-477.

Chopko, T. C., & Lindsley, C. W. (2018). Classics in chemical neuroscience: risperidone. ACS Chemical Neuroscience9(7), 1520-1529.

Jawad, I., Watson, S., Haddad, P. M., Talbot, P. S., & McAllister-Williams, R. H. (2018). Medication nonadherence in bipolar disorder: a narrative review. Therapeutic Advances in Psychopharmacology8(12), 349-363.

Hirschfeld, R. M. A. (n.d.). Guideline watch: Practice guideline for the treatment of patients with bipolar disorder (2nd ed.). olar-watch.pdf

Rolin, D., Whelan, J., & Montano, C. B. (2020). Is it depression or is it bipolar depression?. Journal of the American Association of Nurse Practitioners32(10), 703-713.

Community Resources: World Health Organization Sample Assignment

World Health Organization is a specialized agency of the United Nations (UN) that deals with international public health whose headquarter is based in Geneva, Switzerland. World Health Organization (WHO) has six regional offices and over 145 field offices worldwide. WHO was formed in 1948 to work across the globe to promote health, keep the world safe from disease, and serve the vulnerable members of society (World Health Organization, 2019). The agency advocates for universal health care coverage, promoting the health and wellbeing of people, monitoring public health risks, and coordinating responses to all health emergencies. World Health Organization offers technical assistance to countries and nations in setting international health standards and collecting data on the world health issue. The vision of the World Health Organization is to create a world in which every person can live a healthy and productive life. This vision is supported through funding by State Members and voluntary states to help reach out to vulnerable groups and keep the world safe. This report seeks to evaluate the role of the World Health Organization (WHO) in public health and safety improvement. The report also evaluates how World Health Organization promotes equal opportunity and improves the quality of life in the community.

According to World Health Organization, public health is defined as “the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society” (World Health Organization, 2016). World Health Organization is focused on strengthening public health capacities at the community level across the world so that people can maintain their health status as well as improve their wellbeing. The objective of this world agency is to make people attain or achieve the highest possible level of their health status across the world. World Health Organization has played a critical role in many public health achievements; for instance, it has helped eradicate smallpox, polio, Ebola, controlling the spread of HIV/AIDS, coronavirus, tuberculosis, and non-communicable diseases.

World Health Organization defined its role in public health as providing leadership on matters essential to health and involving in partnerships, especially where joint action is required. The second objective of the World Health Organization in public health is shaping the research agenda and generation stimulation and translation of helpful knowledge. Other objectives of WHO in public health include articulating the ethical and evidence-based alternative policies, establishing norms and standard measures, enhancing and monitoring their policy implementations, monitoring health status and evaluating health trends, and offering technical support and structuring sustainable institutional capacity (World Health Organization, 2020).

World Health Organization promotes health in the community through many enabling processes by increasing control over and improving people’s health. Health promotions by this organization focus on achieving the physical, mental, and social wellbeing of people across the world to realize and identify their aspirations, satisfy their needs and cope with the environment. Health is a resource to every individual across the globe. Therefore, World Health Organization focuses on making social, political, cultural, economic, environmental, biological, and behavioral factors stable through advocacy for health to all people across the world. Through health promotions, World Health Organization has improved many people’s lives. It continues to inform them what they could do to stay healthy and address challenges in the community that may jeopardize people’s health.

World Health Organization (WHO) develops and implements the cross-cutting normative, fiscal, and legal actions as well as capacity development tools across the globe. WHO plays critical roles in the community by advancing world health in health literacy, good governance for health, and community engagement? The organization also fosters or cultivates public health action in the setting of human lives. World Health Organization gets its funding from its member states which is paid as countries’ membership dues and voluntary contributions from different partners and the Member States. The funding from the named sources is used in advancing gender quality and human rights in the health system, catalyzing health progress to fight against non-communicable diseases, and improving countries’ health systems by incorporating people. This world health agency remains independent and focused on dealing with pressing health challenges worldwide.

Since health is determined by many factors, including personal behaviors, economic status, genetic inheritance, and physical environment, World Health Organization seeks to promote equity in health care across the globe. These variables create disparity in health care systems at all levels. Therefore, World Health Organization’s objectives focus on making health care services accessible to all people in the community. The health promotion strategies adopted by World Health Organization seek to fit individual countries’ local needs and possibilities because of diversity in social, cultural, and economic systems adopted across the world. World Health Organization has many stipulated public health objectives such as articulating the ethical and evidence-based alternative policies, establishing norms and standard measures, enhancing and monitoring their policy implementations, monitoring health status and evaluating health trends, and offering technical support and structuring sustainable institutional capacity.

Equity is among the aim of health promotion by the World Health Organization. World Health Organization (WHO) is focused on achieving equity in health across the world by ensuring that people across all walks of life have access to good health care services. WHO’s promotion actions aim to reduce the differences in current health status by ensuring equal opportunities and resources to enable all people worldwide to achieve their fullest health potentials. World Health Organization focuses on achieving equity in the community by establishing a secure foundation in the supportive environment, giving community members full access to health information, life skills, and opportunities to make healthy choices. World Health Organization is focused on establishing equity in the health system by eradicating all possible dimensions of inequality manifested in healthy systems. Since health is a fundamental right, World Health Organization seeks to achieve health equity by ensuring all people in the community have full health potential.

World Health Organization can achieve universal healthcare through social justice when the outcomes are well monitored to practical justice intervention. The world health agency should increase its funding sources by increasing its members and looking for more partnerships to gain a solid financial status (Brownson et al., 2017). Since there are many social injustices in health systems that are caused by social determinants, political class, cultural values, and beliefs, among other barriers, this world health agency should expand community-based services and online services which are easily accessible, sustainable as well as solve major pressing issues more effectively to create a healthy society.

Community health nurses play critical roles in providing health care services in many settings. These nurses can be actively involved in World Health Organization programs such as community health clinics, providing shelters to the homeless, and mental and spiritual nourishments to affected patients at local levels (Bull et al., 2020). Nurses remain at the forefront of world health care, and they can suit everywhere that needs human assistance. Nurses educate, innovate, and advocate for the wellbeing of people in the community; therefore, maximum utilization of nurses in the World Health Organization with expanding health services to communities across the world.

Since the World Health Organization has millions of people at the community level, there is a need to expand its health services worldwide to realize its goals and objectives. There is a need for the world agency to develop comprehensive promotion health strategies such as creating supportive environments, strengthening community action, conducting community-wide campaigns, strengthening and participating in community partnerships, improving access to outdoor recreational services, reorienting health services, and building and maintaining public policies. All these strategies should aim to reduce tobacco use, cardiovascular disease, diabetes, hypertension, obesity, nutritional condition, among other health disorders (Stanhope & Lancaster, 2019). Strengthening public health interventions will help achieve significant impact, especially when dealing with social and environmental variables, so people can easily take health actions seriously.

In conclusion, World Health Organization continues to play a critical role in ensuring people worldwide have access to good health care services without discrimination or prejudices constructed on sex, gender, social class, age, race, disability, ethnicity, and other dimensions of inequality. World Health Organization offers technical assistance to countries and nations in setting international health standards and collecting data on the world health issue. World Health Organization should expand its services to reach individual people at the community level and promote health education on matters concerning health. The agency advocates for universal health care coverage, promoting the health and wellbeing of people, monitoring public health risks, and coordinating responses to all health emergencies.


Brownson, R. C., Baker, E. A., Deshpande, A. D., & Gillespie, K. N. (2017). Evidence-based public health. Oxford university press.

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., … & Willumsen, J. F. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behavior. British journal of sports medicine54(24), 1451-1462.

Stanhope, M., & Lancaster, J. (2019). Public health nursing e-book: Population-centered health care in the community. Elsevier Health Sciences.

World Health Organization. (2016). Community health workers: a strategy to ensure access to primary health care services. World Health Organization. Regional Office for the Eastern Mediterranean.

World Health Organization. (2019). Translating community research into global policy reform for national action: a checklist for community engagement to implement the WHO consolidated guideline on the sexual and reproductive health and rights of women living with HIV.

World Health Organization. (2019). Consolidated guideline on sexual and reproductive health and rights of women living with HIV: web annex: community-led strategies for implementation (No. WHO/RHR/17.33). World Health Organization.

World Health Organization. (2019). Field test version: mhGAP community toolkit: Mental Health Gap Action Programme (mhGAP). World Health Organization.

World Health Organization. (2020). Health policy and system support to optimize community health worker programs for HIV, TB and malaria services: an evidence guide.

Assumptions About Adult Learning Writing Sample

Merriam and Bierema state and explain six assumptions concerning adult learning. Among the assumptions is shifting adults’ self-concept from dependent to self-directing as they grow and mature. This supposition explains that as individuals grow, they tend to be more independent and learning becomes self-directing. Instructors should ensure that instructions are student-centred. Another assumption is that an adult’s willingness to learn depends on the developmental tasks of their social roles. The various social responsibilities of an adult motivate them to learn particular things. This is closely tied to the second assumption on experiences. A certain experience can trigger an individual to attend a particular training for professional development.

Another assumption presented by the authors is that an individual’s readiness to learn is driven by internal rather than external motivation. The supposition holds that many adult learners are internally motivated to attend particular activities for professional development. These motives include increased productivity and job satisfaction. However, some professional development learning is externally motivated. For instance, if a certain job position requires a particular academic level or is mandated by the government, the employer may be forced to initiate professional development activities. Despite this, the instructor should align the training program with the learners’ needs and interests to make learning internally motivated.

Professional development focuses on teaching workers the skills required for success in their careers. Recently, we had a workplace diversity training seminar for three days at my workplace. The program was optional, although the manager insisted that it would benefit us in our individual and professional lives. The program initiators were severely blended in terms of race, religion, gender and age. We had young and old program leaders, Blacks, Hispanics, Whites, Christians, Hindus and Muslims. The outlook encouraged most of us to attend the training and complete the three-day session. During the sessions, we learnt the importance of diversity in the workplace and ways to ensure maximum diversity in recruitment, training and development among employees to reap the benefits accrued. During the professional development activities, we participated in role-plays, simulations and story-telling sessions to expound on our understanding of diversity in the workplace.

The training seminar addressed the first assumption on adult learning, which states that an adult’s self-concept shifts from dependent to independent self-directing as they mature. The seminar hall was well-ventilated, spacious and with comfortable chairs. The sitting arrangement was circular as we learnt to face each other while the instructors were at the front of the room. The training was student-centred as the instructors repeatedly asked us to write down what we would like to learn on the three-day session before the training day. In the middle of the lessons, we held random discussions to talk about our experiences with a diversified or non-diversified environment in the past. I realized that many of my colleagues were victims of stereotyping either due to race or religion. The sharing created an environment for collaboration and mutual trust, ensuring quality professional development.

Professional development addressed the third assumption that “the readiness of an adult to learn is closely related to the developmental tasks of his or her social role.” (Merriam & Bierema, 2013). It is quite difficult to understand that racial and ethnic minorities undergo stereotyping and discrimination in the workplace as a child. However, as you grow up, you learn the existence of such heinous things, and sometimes, we fall victims during our job hunting periods. The workplace diversity program came at the right time within our organization. The company was previously involved in a scandal of looking down upon women and Muslims. The HR denied Muslim women from reporting to work with henna paintings on their hands and feet. Muslims usually get these paintings during various celebrations. Thus, it made it hard for them to attend the celebrations as they knew the consequences awaiting them at the workplace. The workplace diversity program attendance and readiness to learn was to gain more insights on the significance of respecting people’s cultures and demonstrating cultural competency in the workplace.

The professional development successfully addressed the fifth assumption. During the seminar, I discovered that the primary benefits of achieving workplace diversity are internal, especially among the employees. Diversity allows employees to learn new insights and cultures, enhancing their competency and respect for other people’s backgrounds. This results in increased job satisfaction that facilitates career development. Employees feel appreciated and valued, positively affecting their performance and overall productivity in the organization. Therefore, the employees had internal motives for participating in adult learning. However, as Merriam and Bierema (2013) put it, “there are times when our employer requires us to participate in particular workplace training programs…when mandated by the government.” The government requires organizations to observe the Equal Employment Opportunity Commission (EEOC) requirements on diversity. Therefore, the training could be based on the attainment of this requirement. Nonetheless, the instructors ensured to relate the content to our needs and interests. They did this by ensuring it was student-centred. This resulted in our readiness to learn being more internally inspired, leading to quality professional development.


Merriam, S. B., & Bierema, L. L. (2013). Adult learning: Linking theory and practice. John Wiley & Sons.