Decision Tree For Neurological Disorders Assignment

This week you will be reviewing the neurologic and musculoskeletal systems. After reviewing the course materials your assignment includes:

Write a 1- to 2-page summary paper that addresses the following:

-Briefly summarize the Alzheimer’s case, including each of the three decisions you took for the patient presented Decision Tree For Neurological Disorders Assignment.

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-Based on the decisions you recommended for the patient case study, explain whether you believe the decisions provided were supported by the evidence-based literature. Be specific and provide examples. Be sure to support your response with evidence and references from outside resources.

-What were you hoping to achieve with the decisions you recommended for the patient case study you were assigned? Support your response with evidence and references from outside resources.

-Explain any difference between what you expected to achieve with each of the decisions and the results of the decision in the exercise. Describe whether they were different. Be specific and provide examples.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references Decision Tree For Neurological Disorders Assignment.

Summary of the Case Scenario

Alzheimer’s disease exhibits a form of continuing neurologic illness disorder that is characterized by the brain beginning and proceeding to lessen in size (atrophy), and reduced cognitive and behavioral functioning. The size reduction initially begins with the development of plaques coupled with tangles in areas of the brain that are associated with memory (Breijyeh & Karaman, 2020). These locales are inclusive of the entorhinal cortex alongside the hippocampus. The damage then gradually progresses toward the cerebral cortex, which is mainly involved in language, reasoning together with social functioning (Dubois et al., 2021)Decision Tree For Neurological Disorders Assignment. Eventually, the damage is extended to the other locales of the brain, leading to possible Alzheimer’s disease and dementia.

This paper will be founded on assessing the case study of the patient who was presented to the care facility with aspects of being disinterested in everyday social activities, together with disinhibited behavioral traits. The patient also exhibited signs of confabulation, in regards to being unable to effectively remember specific normal experiences within his life.

Decision 1

Commencement of Exelon (rivastigmine) 1.5 mg Orally BID, and Gradual Increase to 3 mg Orally BID in 2 weeks

The use of Mini-Mental State Examination (MMSE) is significant for clinically assessing the presence of Alzheimer’s disease or other associated illnesses such as dementia in patients. The basis involves checking the presence of cognitive or behavioral dysfunctionality or dementia (Ip et al., 2021)Decision Tree For Neurological Disorders Assignment. The reading of 18 out of 30 is reflective of medium dementia.

The initiation of Rivastigmine (an evidence-based acetylcholinesterase inhibitor) is significant for aiding in enhancing the extents of the patient’s brain chemical levels (acetylcholine). The basis increases the brain cells’ aptitude of communicating with one another through a reduction in the breaking down of acetylcholine. Acetylcholine is usually conveyed towards the synaptic clefts and has an increased aptitude for steering cholinergic neurotransmission. Starting Rivasigmine administration from 1.5 mg orally BID and steadily increasing to 3 mg orally BID within a fortnight to the aging patient is founded on the drug’s reduced capability of readily interacting with other drug agents (Nguyen et al., 2020)Decision Tree For Neurological Disorders Assignment. As a result, the use of Rivastigmine helps reduce the negative effects of Alzheimer’s disease or dementia and helps increase the underlying cognitive and behavioral functioning of the patient.

Decision 2

Enhancing Drug Admission to Exelon 4.5 mg orally BID

On returning to the clinic after four weeks, it is clinically ascertained that the patient has failed to fully recover to the initial cognitive and behavioral functioning aptitudes. There are however specific positives such as a return to attending church services with the family, and being amused by former usual everyday events. The increase of the medication to Exelon 4.5 mg is attributed to the increased competency for enhancing the levels of acetylcholine. Acetylcholine is increasingly conveyed towards the synaptic clefts, which increases the steering of cholinergic neurotransmission (Chauhan & Sharma, 2019)Decision Tree For Neurological Disorders Assignment. (As a result, the patient’s overall cognitive coupled with behavioral functioning competencies are further improved.

Decision 3

Maintain Dosage of Exelon 4.5 mg orally BID for the Next Four Weeks and Initiating Cognitive-Behavioral Therapy

On a return to the clinic after four weeks, it is clinically evaluated that the client exhibits general improvements in the underlying cognitive coupled with behavioral functioning. Specific improvements include readiness to attend church services with family members and increased amusement in everyday activities. In this regard, there is a need for maintaining the dosage of Exelon 4.5 mg orally BID for the subsequent four-week period (Chauhan & Sharma, 2019). This concept helps to maintain the optimum levels of acetylcholine and cholinergic neurotransmission.

The initiation of cognitive-behavioral therapy (CBT) is significant for helping the client to effectively return to the former best healthcare outcomes before the cognitive and behavioral impairment. The basis is through helping the patient systemically amalgamate the underlying feelings, thought patterns together with physical sensations (Verreault et al., 2021)Decision Tree For Neurological Disorders Assignment. As a result, the patient is assisted to find ways of improving their behavioral and thought patterns in the everyday life.

References

Breijyeh, Z., & Karaman, R. (2020). Comprehensive Review on Alzheimer’s Disease: Causes and Treatment. Molecules, 25(24), 5789. https://doi.org/https://doi.org/10.3390/molecules25245789

Chauhan, M. K., & Sharma, P. K. (2019). Optimization and characterization of rivastigmine nanolipid carrier loaded transdermal patches for the treatment of dementia. Chemistry and Physics of Lipids, 224, 104794. https://doi.org/https://doi.org/10.1016/j.chemphyslip.2019.104794

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Dubois, B., Villain, N., & Frisoni, G. B. (2021). Clinical diagnosis of Alzheimer’s disease: recommendations of the International Working Group. THE LANCET Neurology, 20(6), 484–496. https://doi.org/https://doi.org/10.1016/S1474-4422(21)00066-1

Ip, E. H., Pierce, J., & Chen, S.-H. (2021). Conversion between the Modified Mini-Mental State Examination (3MSE) and the Mini-Mental State Examination (MMSE). Alzheimer’s Association, 13(1), e12161. https://doi.org/https://doi.org/10.1002/dad2.12161

Nguyen, K., Hoffman, H., & Chakkamparambil, B. (2020). Evaluation of rivastigmine in Alzheimer’s disease. Future Medicine, 11(1). https://doi.org/https://doi.org/10.2217/nmt-2020-0052

Verreault, P., Turcotte, V., & Ouellet, M.-C. (2021). Efficacy of cognitive-behavioural therapy interventions on reducing burden for caregivers of older adults with a neurocognitive disorder: a systematic review and meta-analysis. Cognitive Behaviour Therapy, 50(1), 19–46. https://doi.org/https://doi.org/10.1080/16506073.2020.1819867 Decision Tree For Neurological Disorders Assignment