NU 665 WEEK 9 DISCUSSION 1: SLEEP DISORDERS

NU 665 WEEK 9 DISCUSSION 1: SLEEP DISORDERS

Dashboard My courses NU-665C-02-25PCSP Week 9: Sleep Disorders

Week 9 Discussion 1: Sleep Disorders

Value: 100 points

Due: Create your initial post Day 3 and

reply to at least one of your peers by Day

7.

Grading Category: Discussions

Note: In this type of discussion, you will

not see the responses of your classmates

until after you have posted your own

response to the following prompts.

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Initial Post

Please choose one of the patient

scenarios below and answer the

associated prompts.

Scenario 1

Mrs. Jones is an 85-year-old female,

widowed patient who lives alone in her

own one-story home. She has strong

family support in her children, and a strong

tie to her Christian faith. She tries to keep

busy but recognizes how dicult getting

older is, with the loss of many family

members and friends she once had. Other

than this loneliness and grief, she feels

well. She denies depressive symptoms,

states anxiety and panic symptoms are

well managed with her current medication

regimen. Her chief complaint today is

insomnia. She states despite her current

medication regimen, she still cannot

initiate or maintain sleep. Mrs. Jones

states, “I’ve just never been a good

sleeper!” Her current medications include:

Week 9 Discussion 1: Sleep Disorders

Dashboard My courses NU-665C-02-25PCSP Week 9: Sleep Disorders

Week 9 Discussion 1: Sleep Disorders

 

To do: Make forum posts: 1

 

Mirtazapine 7.5 mg PO QHS –

insomnia

Doxepin 10 mg PO QHS – insomnia

Gabapentin 100 mg PO TID – mild

idiopathic neuropathy

Zolpidem 5 mg PO QHS

Xanax 0.5 mg PO BID

Venlafaxine 225 mg PO daily

Answer the following prompts using 2-3

scholarly references:

1. Write an original patient education

script explaining Mrs. Jones’ current

medication regimen. (1–2

paragraphs)

2. Is there any further evaluation or

testing you would order? (1–2

paragraphs)

3. Are there any changes to her

medication regimen you would

make? If so, what would your

changes be? (1–2 paragraphs).

Scenario 2

James is a 15-year-old patient who

identi

es as male. James presents today

with his mother, who provides collateral

information. James has a diagnosis of

autism spectrum disorder. He is currently

prescribed:

Oxcarbazepine 300 mg PO BID – off

label for mood swings and irritability

Paroxetine 20 mg PO daily in the PM

– social anxiety

James states that he feels sluggish during

the day and has trouble waking up for

school. He states that if he had his way, he

would stay in bed and sleep all day. His

mother laughs and states, “You’d never

know it! He sure sounds like he’s sleeping,

with the way he snores!”

Upon interview, James reports the

following symptoms as positive when the

PMHNP screens for depression:

Depressed mood – some days

Insomnia or poor sleep – nearly

every day

Appetite – Intact

Suicidal ideation – None

 

Concentration – Impaired nearly

every day

Hobbies/Interests/Pleasure: Video

games (online gaming with friends)

– intact

Guilt/worthlessness/hopelessness:

None

Energy: Low nearly every day

This information was corroborated by the

patient’s mother.

Answer the following prompts using 2-3

scholarly references:

1. Write an original dialogue between

yourself and James and his mother,

including additional questions you

have for them. (1–2 paragraphs)

2. List the three most likely causes of

James’ current symptoms with brief

rationale. (1–2 paragraphs)

3. Given your differentials, what is your

next step in this case? How would

you explain the reasoning for this

step to James and his mother? (1–2

paragraphs)

Use the appropriate APA formatting as

listed in the syllabus.

Replies

Reply to at least one of your peers who

wrote about the opposite prompt. In your

reply post, respond with scholarly

discourse and an evidence-based

framework. Does your peers’ post follow

the current evidence? What might you do

differently in practice? Your assertions

should be backed by evidence that

references at least two scholarly sources.

Please refer to the Grading Rubric for

details on how this activity will be graded.

The described expectations meet the

passing level of 80%. You are directed to

review the Discussion Grading Rubric for

criteria which exceed expectations.

Introduction

For this discussion, you will review the Week 9 Sleep Disorders case, focusing on Scenario 1: Mrs. Jones, an 85-year-old female patient presenting with chronic insomnia despite multiple prescribed sleep medications. Sleep disorders are especially prevalent among older adults and can significantly impact both physical and mental health. In geriatric populations, sleep disturbances are often multifactorial—arising from physiological changes of aging, comorbid medical conditions, polypharmacy, grief, and psychosocial stressors such as loneliness or reduced social interaction. Understanding these contributing factors is essential for accurate diagnosis and the development of an effective, individualized treatment plan.

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Mrs. Jones’ case highlights the complexity of managing insomnia in elderly patients, particularly when several sedative and antidepressant medications are already in use. The overlapping pharmacologic effects, potential for drug interactions, and age-related alterations in metabolism must be carefully considered when evaluating her symptoms. Beyond the pharmacologic dimension, psychological factors such as bereavement and lifestyle adjustments may also play a role in her difficulty initiating and maintaining sleep.

This discussion will analyze Mrs. Jones’ medication regimen, explore appropriate diagnostic evaluations, and propose evidence-based treatment adjustments. By integrating pharmacologic principles with a holistic, patient-centered approach, the goal is to improve her sleep quality, minimize medication burden, and enhance her overall quality of life.

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