Practice Week 8 Assignment. Health, Medicine, Nursing Essay.

Practice Week 8 Assignment
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Practice Week 8 Assignment
Neurocognitive disorders are characterized by a decline in mental function because of another medical condition other than psychiatric problem. Older adults are at increased risk of neurocognitive disorders. One of these is neurocognitive disorder with Lewy bodies as discussed here.
Decision #1: Differential Diagnosis
The selected decision is major neurocognitive disorder with Lewy bodies. Mr. Wingate meets in criteria for probable major neurocognitive disorder with Lewy bodies based on the DSM 5 diagnosis (American, 2013). He meets two core features and one suggestive feature. Mr. Wingate shows a fluctuation in cognition, leading to instability in attention and alertness. He also has features of parkinsonism with a commencement of a cognitive decline (American, 2013). For example, his constant forgetfulness, that interferes with everyday activities, as well as abnormal movements. He also meets the suggestive feature of rapid eye movement (REM) sleep behavior disorder (American, 2013). The situation is evident in his “vivid nightmares” causing him to kick or swing during sleep. I was expecting a diagnosis for major neurocognitive disorder due to Alzheimer’s disease. However, this condition requires meeting criteria for evidence of genetic mutation based on family history. Mr. Wingate does not have a history of Alzheimer’s disease in his family.
Decision #2: Treatment Plan for Psychotherapy
Decision #2 is beginning Rivastigmine 1.5 mg orally twice a day. The physician should start with a low dose and gradually increase while observing the side effects (Case #3, n.d.). Rivastigmine does not cure major neurocognitive disorder with Lewy bodies but can enhance memory, awareness, and the ability to perform daily functions. However, Mr. Wingate and his son should be informed while the drug slows disease progression, it does not have a major effect on the existing cognitive deficits (Case #3, n.d.). I expected that Olanzapine would be the appropriate ...