The Assignment Examine Case Study: An Asian American Woman With Bipolar Disorder. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamics processes. At each decision point stop to complete the following: Decision #1 Which decision did you select? Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Note: Support your rationale with a minimum of five or academic resources. BACKGROUND INFORMATION The client is a 26-year-old woman of Korean descent who presents to her first appointment following a 21-day hospitalization for onset of acute mania. She was diagnosed with bipolar I disorder. Upon arrival in your office, she is quite “busy,” playing with things on your desk and shifting from side to side in her chair. She informs you that “they said I was bipolar, I don’t believe that, do you? I just like to talk, and dance, and sing. Did I tell you that I liked to cook?” She weighs 110 lbs. and is 5’ 5” SUBJECTIVE Patient reports “fantastic” mood. Reports that she sleeps about 5 hours/night to which she adds “I hate sleep, it’s no fun.” You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. You find that the patient had genetic testing in the hospital (specifically GeneSight testing) as none of the medications that they were treating her with seemed to work. Genetic testing reveals that she is positive for CYP2D6*10 allele. Patient confesses that she stopped taking her lithium (which was prescribed in the hospital) since she was discharged two weeks ago. MENTAL STATUS EXAM The patient is alert, oriented to person, place, time, and event. She is dressed quite oddly- wearing what appears to be an evening gown to her appointment. Speech is rapid, pressured, tangential. Self-reported mood is euthymic. Affect broad. Patient denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment is grossly intact, but insight is clearly impaired. She is currently denying suicidal or homicidal ideation. The Young Mania Rating Scale (YMRS) score is 22 Bipolar Therapy Client of Korean Descent/Ancestry Decision Point One Begin Lithium 300 mg orally BID RESULTS OF DECISION POINT ONE Client returns to clinic in four weeks Client informs the PMHNP that she has been taking her drug “off and on” only when she “feels like she needs it” Today’s presentation is similar to the first day you met her Decision Point Two Increase Lithium to 450 mg orally BID RESULTS OF DECISION POINT TWO Client returns to clinic in four weeks Client returns reports that she is still taking the medication when she feels that she needs it She remains quite manic and reports that her family is getting really upset because she likes to play her new guitar at night Decision Point Three Assess for rationale for non-compliance and educate client Guidance to Student The PMHNP should further assess for dangerousness to self or others. The client should be assessed for self-care, to including hygiene, eating, sleeping, etc. Hospitalization may be indicated if the client remains non-compliant and is a danger to self. If the client is not a danger to self, and hospitalization is not indicated, the PMHNP needs to assess for rationale for non-compliance. Many clients enjoy mania as it is a nice feeling to be consistently happy. When clients are successfully treated for mania, they often describe themselves as feeling ‘down’ or ‘flat.’ The PMHNP needs to assess for depression at this point as opposed to normalization of mood. Abilify is also FDA approved as monotherapy for mania and mixed presentations, but at a dose of 15 mg. day., so although you may be tempted to begin Abilify- be certain to use correct dose. Also, because it can be “activating” you need to dose this drug in the morning. However, the client is non-compliant and therefore, eliciting reasons for non-compliance is essential to the care of this client.

Utilize information from industry and scholarly sources to inform problem solving and decision making Scenario You are the sales department manager for a U.S.-based company that builds engines for the automotive manufacturing industry. Your company is considering diversifying into other business opportunities where your motors can be sold in order to bolster the company’s portfolio and increase revenue. Based on your knowledge of the national sales landscape, your manager would like you to conduct preliminary research and prepare a presentation with your recommendation for opportunity in a new industry that will allow for this diversification through a new sales division and increased sales. You have been asked to make your presentation at the next stakeholder meeting, where you will address internal stakeholders from across the company as well as external stakeholders such as customers, investors, and suppliers. As a preliminary step in developing this presentation, your manager would like to see an executive summary of your research findings and evaluate your decision modeling. Directions Complete the Project One Worksheet in your Soomo webtext and submit it for instructor feedback. Part 1: Define You will first conduct research on the U.S.-based automotive manufacturing industry using the Shapiro Library database links provided in the supporting materials section below. Then, prepare an analysis report that addresses the following: Define the problem. Explain the type of qualitative and quantitative data you will be targeting in your research. Provide a broad description of the U.S. automotive manufacturing industry and its value. Include: Total value of the industry Sales by region Sales by fuel type: electric, hybrid, and gas Describe the current trends in the automotive market. The trend toward different types of motors for the vehicles being made and sold, such as electric and hybrid Trends in customer demands such as vehicle color, extra features, and styles Trends in the body types of vehicles sold (SUVs, trucks, sedans) Part 2: Research In Module One, you chose an industry that you think would provide opportunity for your company. Now, using industry-specific and scholarly resources to inform your decision, prepare an industry analysis report that includes the following: Provide a broad description of the new industry. Describe the overall attractiveness of the industry. Is this a growing industry? Is this an industry that has a lot of growth potential? What outside factors are affecting its growth? Identify the factors that have allowed competitors to be successful in this industry thus far. Summarize the overall value of the industry. How is the industry currently trending? Summarize the sales. Speculate if sales vary based on the region of the country. (For example, there would be very few snow plow sales in the southern United States, if any at all.) Define expected growth areas. Describe the current market trends for the new industry. What products or services are trending? What are some current customer demands? Perform a Porter’s Five Forces analysis to determine the potential success of moving into this new industry. Explain your rationale. Part 3: Compare Compare the two industries and summarize your findings. Perform a Porter’s Five Forces analysis to compare the two industries. Summarize how your findings address the problem. What to Submit To complete this project, submit an executive summary report of 3 to 4 pages using the provided templates, or the document you downloaded from Soomo. Sources should be cited according to APA style. Supporting Materials The following resources support your work on the project: Project One Template Word Document Porter’s Five Forces Analysis Template PPT Shapiro Library Database: IBISWorld Shapiro Library Database: MarketLine Competency In this project, you will demonstrate your mastery of the following competency: Utilize information from industry and scholarly sources to inform problem solving and decision making Scenario You are the sales department manager for a U.S.-based company that builds engines for the automotive manufacturing industry. Your company is considering diversifying into other business opportunities where your motors can be sold in order to bolster the company’s portfolio and increase revenue. Based on your knowledge of the national sales landscape, your manager would like you to conduct preliminary research and prepare a presentation with your recommendation for opportunity in a new industry that will allow for this diversification through a new sales division and increased sales. You have been asked to make your presentation at the next stakeholder meeting, where you will address internal stakeholders from across the company as well as external stakeholders such as customers, investors, and suppliers. As a preliminary step in developing this presentation, your manager would like to see an executive summary of your research findings and evaluate your decision modeling. Directions Complete the Project One Worksheet in your Soomo webtext and submit it for instructor feedback. Part 1: Define You will first conduct research on the U.S.-based automotive manufacturing industry using the Shapiro Library database links provided in the supporting materials section below. Then, prepare an analysis report that addresses the following: Define the problem. Explain the type of qualitative and quantitative data you will be targeting in your research. Provide a broad description of the U.S. automotive manufacturing industry and its value. Include: Total value of the industry Sales by region Sales by fuel type: electric, hybrid, and gas Describe the current trends in the automotive market. The trend toward different types of motors for the vehicles being made and sold, such as electric and hybrid Trends in customer demands such as vehicle color, extra features, and styles Trends in the body types of vehicles sold (SUVs, trucks, sedans) Part 2: Research In Module One, you chose an industry that you think would provide opportunity for your company. Now, using industry-specific and scholarly resources to inform your decision, prepare an industry analysis report that includes the following: Provide a broad description of the new industry. Describe the overall attractiveness of the industry. Is this a growing industry? Is this an industry that has a lot of growth potential? What outside factors are affecting its growth? Identify the factors that have allowed competitors to be successful in this industry thus far. Summarize the overall value of the industry. How is the industry currently trending? Summarize the sales. Speculate if sales vary based on the region of the country. (For example, there would be very few snow plow sales in the southern United States, if any at all.) Define expected growth areas. Describe the current market trends for the new industry. What products or services are trending? What are some current customer demands? Perform a Porter’s Five Forces analysis to determine the potential success of moving into this new industry. Explain your rationale. Part 3: Compare Compare the two industries and summarize your findings. Perform a Porter’s Five Forces analysis to compare the two industries. Summarize how your findings address the problem. What to Submit To complete this project, submit an executive summary report of 3 to 4 pages using the provided templates, or the document you downloaded from Soomo. Sources should be cited according to APA style. Supporting Materials The following resources support your work on the project: Project One Template Word Document Porter’s Five Forces Analysis Template PPT