This case study examines the treatment of insomnia in a 31-year-old male patient. The patient has experienced worsening insomnia for 6 months following the loss of his fiancée. He reports difficulty falling and staying asleep and uses alcohol to help fall asleep. The patient's medical history includes past opioid abuse. The case study involves three decision points to select a pharmacologic treatment for the patient's insomnia, considering relevant patient factors and ethical considerations.

1. Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a
Younger Adult.
Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger
Adult.Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger
Adult.Permalink: https:// /case-study-pharm…-a-younger-adultBACKGROUNDThis week,
we examine a 31-year-old male who presents to the office with a chief complaint of
insomnia.SUBJECTIVE Patient is a 31-year-old male. He states that his insomnia has gotten
progressively worse over the past 6 months. Per the patient, he has never been a “great
sleeper” but is now having difficulty both falling asleep and staying asleep at night. The
problem began approximately 6 months ago after the sudden loss of his fiancé. The patient
states this is affecting his ability to perform his job, which is a forklift operator at a local
chemical company. The patient states he has used diphenhydramine in the past to sleep but
does not like the way it makes him feel the morning after. He states he has fallen asleep on
the job due to lack of sleep from the night before. The patient’s medical record from his
previous physician states that he has a history of opiate abuse, which began after he broke
his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for
acute pain management. The patient has not received a prescription for an opiate analgesic
in 4 years. The patient states recently he has been using alcohol to help him fall asleep,
approximately four beers prior to bed. Case Study: Pharmacologic Approaches to the
Treatment of Insomnia in a Younger Adult.MENTAL STATUS EXAMThe patient is alert and
oriented to person, place, time, event. He makes good eye contact and is dressed
appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight,
and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future
oriented.Decision Point OneSelect what you should do:Zolpidem: 10 mg daily at
bedtimeTrazodone: 50–100 mg daily at bedtimeHydroxyzine: 50 mg daily at
bedtimeAssignment 2: Assessing and Treating Patients With Sleep/Wake DisordersSleep
disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo
Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health,
safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with
psychopharmacologic treatments, however, many of these drugs can have negative effects
on other aspects of a patient’s health and well-being. Additionally, while
psychopharmacologic treatments may be able to address issues with sleep, they can also
exert potential challenges with waking patterns. Thus, it is important for the psychiatric

2. nurse practitioner to carefully evaluate the best psychopharmacologic treatments for
patients that present with sleep/wake disorders.Reference: Mayo Clinic. (2020). Sleep
disorders. https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-
causes/syc-20354018Note: To access the following medications, use the IBM Micromedex
resource. Type the name of each medication in the keyword search bar. Be sure to read all
sections on the left navigation bar related to each medication’s result page, as this
information will be helpful for your review in preparation for your
Assignments. alprazolamamitriptylineamoxapineamphetaminedesipraminediazepamdoxep
ineszopicloneflunitrazepamflurazepamhydroxyzine imipraminelemborexantlorazepammel
atoninmethylphenedatemodafinil
armodafinilcarnitineclomipramineclonazepamnortriptylinepitolisantramelteonsodi
um
oxybatesolriamfetolSSRI’stemazepamtrazodonetriazolamtrimipraminewellbutrinzaleplonz
olpidemTo prepare for this Assignment:Review this week’s Learning Resources, including
the Medication Resources indicated for this week.Reflect on the psychopharmacologic
treatments you might recommend for the assessment and treatment of patients with
sleep/wake disorders.The Assignment: 5 pagesExamine Case Study: Pharmacologic
Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make
three decisions concerning the medication to prescribe to this patient. Be sure to consider
factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.
Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult.At
each decision point, you should evaluate all options before selecting your decision and
moving throughout the exercise. Before you make your decision, make sure that you have
researched each option and that you evaluate the decision that you will select. Be sure to
research each option using the primary literature.Introduction to the case (1 page)Briefly
explain and summarize the case for this Assignment. Be sure to include the specific patient
factors that may impact your decision making when prescribing medication for this
patient.Decision #1 (1 page)Which decision did you select?Why did you select this decision?
Be specific and your response with clinically relevant and patient-specific resources,
including the primary literature.Why did you not select the other two options provided in
the exercise? Be specific and your response with clinically relevant and patient-specific
resources, including the primary literature.What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources
(including the primary literature).Explain how ethical considerations may impact your
treatment plan and communication with patients. Be specific and provide
examples.Decision #2 (1 page)Why did you select this decision? Be specific and your
response with clinically relevant and patient-specific resources, including the primary
literature.Why did you not select the other two options provided in the exercise? Be specific
and your response with clinically relevant and patient-specific resources, including the
primary literature.What were you hoping to achieve by making this decision? your
response with evidence and references to the Learning Resources (including the primary
literature).Explain how ethical considerations may impact your treatment plan and
communication with patients. Be specific and provide examples.Decision #3 (1 page)Why

3. did you select this decision? Be specific and your response with clinically relevant and
patient-specific resources, including the primary literature.Why did you not select the other
two options provided in the exercise? Be specific and your response with clinically
relevant and patient-specific resources, including the primary literature.What were you
hoping to achieve by making this decision? your response with evidence and references to
the Learning Resources (including the primary literature).Explain how ethical
considerations may impact your treatment plan and communication with patients. Be
specific and provide examples.Conclusion (1 page)Summarize your recommendations on
the treatment options you selected for this patient. Be sure to justify your recommendations
and your response with clinically relevant and patient-specific resources, including the
primary literature.Note: your rationale with a minimum of five academic resources. While
you may use the course text to your rationale, it will not count toward the resource
requirement. You should be utilizing the primary and secondary literature.Reminder : The
College of Nursing requires that all papers submitted include a title page, introduction,
summary, and references. The Sample Paper provided at the Walden Writing Center
provides an example of those required elements (available at
https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-
20293632). All papers submitted must use this formatting.By Day 7Submit your
Assignment.Rubric Detail – Case Study: Pharmacologic Approaches to the Treatment of
Insomnia in a Younger Adult.Select Grid View or List View to change the rubric’s
layout.Name: NURS_6630_Week8_Assignment2_RubricGrid ViewList ViewExcellentPoint
range: 90–100 GoodPoint range: 80–89 FairPoint range: 70–79 PoorPoint range: 0–
69Introduction to the case (1 page)Briefly explain and summarize the case for this
Assignment. Be sure to include the specific patient factors that may impact your decision
making when prescribing medication for this patient.9 (9%) – 10 (10%)The response
accurately, clearly, and fully summarizes in detail the case for the Assignment.The response
accurately and clearly explains in detail the specific patient factors that impact decision
making when prescribing medication for this patient.8 (8%) – 8 (8%)The response
accurately summarizes the case for the Assignment.The response accurately explains the
specific patient factors that impact decision making with prescribing medication for this
patient.7 (7%) – 7 (7%)The response inaccurately or vaguely summarizes the case for the
Assignment.The response inaccurately or vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient.0 (0%) – 6 (6%)The
response inaccurately and vaguely summarizes the case for the Assignment, or is
missing.The response inaccurately and vaguely explains the specific patient factors that
impact decision making with prescribing medication for this patient.Decision #1 (1–2
pages)• Which decision did you select?• Why did you select this decision? Be specific and
your response with clinically relevant and patient-specific resources, including the primary
literature.• Why did you not select the other two options provided in the exercise? Be
specific and your response with clinically relevant and patient-specific resources,
including the primary literature.• What were you hoping to achieve by making this
decision? your response with evidence and references to the Learning Resources
(including the primary literature).• Explain how ethical considerations may impact your

4. treatment plan and communication with patients. Be specific and provide examples.18
(18%) – 20 (20%)The response accurately and clearly explains in detail the decision
selected.The response accurately and clearly explains in detail why the decision was
selected, with specific clinically relevant resources that fully the decision selected. Case
Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult.The
response accurately and clearly explains in detail why the other two responses were not
selected, with specific clinically relevant resources that fully the response.The response
accurately and clearly explains in detail the outcome the student was hoping to achieve with
the selected decision, with specific clinically relevant resources that fully the response.The
response accurately and clearly explains in detail how ethical considerations impact the
treatment plan and communication with patients.Examples provided fully the decisions
and responses provided.16 (16%) – 17 (17%)The response accurately explains the decision
selected.The response explains why the decision was selected, with specific clinically
relevant resources that the decision selected.The response accurately explains why the
other two responses were not selected, with specific clinically relevant resources that the
response.The response accurately explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that the response.The
response accurately explains how ethical considerations impact the treatment plan and
communication with patients.Examples provided the decisions and responses provided.14
(14%) – 15 (15%)The response inaccurately or vaguely explains the decision selected.The
response inaccurately or vaguely explains why the decision was selected, with specific
clinically relevant resources that inaccurately or vaguely the decision selected.The
response inaccurately or vaguely explains why the other two responses were not selected,
with specific clinically relevant resources that inaccurately or vaguely the response.The
response inaccurately or vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains how ethical
considerations impact the treatment plan and communication with patients.Examples
provided may the decisions and responses provided.0 (0%) – 13 (13%)The response
inaccurately and vaguely explains the decision selected.The response inaccurately and
vaguely explains why the decision was selected, with specific clinically relevant resources
that do not the decision selected, or is missing.The response inaccurately and vaguely
explains why the other two responses were not selected, with specific clinically relevant
resources that do not the decision selected, or is missing.The response inaccurately and
vaguely explains the outcome the student was hoping to achieve with the selected decision,
with specific clinically relevant resources that do not the response, or is missing.The
response inaccurately and vaguely explains how ethical considerations impact the
treatment plan and communication with patients, or is missing.Examples provided do not
the decisions and responses provided, or is missing.Decision #2 (1–2 pages)• Which
decision did you select?• Why did you select this decision? Be specific and your response
with clinically relevant and patient-specific resources, including the primary literature.•
Why did you not select the other two options provided in the exercise? Be specific and
your response with clinically relevant and patient-specific resources, including the primary

5. literature.• What were you hoping to achieve by making this decision? your response with
evidence and references to the Learning Resources (including the primary literature).•
Explain how ethical considerations may impact your treatment plan and communication
with patients. Be specific and provide examples.18 (18%) – 20 (20%)The response
accurately and clearly explains in detail the decision selected.The response accurately and
clearly explains in detail why the decision was selected, with specific clinically relevant
resources that fully the decision selected.The response accurately and clearly explains in
detail why the other two responses were not selected, with specific clinically relevant
resources that fully the response.The response accurately and clearly explains in detail the
outcome the student was hoping to achieve with the selected decision, with specific
clinically relevant resources that fully the response.The response accurately and clearly
explains in detail how ethical considerations impact the treatment plan and communication
with patients. Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a
Younger Adult.Examples provided fully the decisions and responses provided.16 (16%) –
17 (17%)The response accurately explains the decision selected.The response explains why
the decision was selected, with specific clinically relevant resources that the decision
selected.The response accurately explains why the other two responses were not selected,
with specific clinically relevant resources that the response.The response accurately
explains the outcome the student was hoping to achieve with the selected decision, with
specific clinically relevant resources that the response.The response accurately explains
how ethical considerations impact the treatment plan and communication with
patients.Examples provided the decisions and responses provided.14 (14%) – 15
(15%)The response inaccurately or vaguely explains the decision selected.The response
inaccurately or vaguely explains why the decision was selected, with specific clinically
relevant resources that inaccurately or vaguely the decision selected.The response
inaccurately or vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that inaccurately or vaguely the response.The
response inaccurately or vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains how ethical
considerations impact the treatment plan and communication with patients.Examples
provided may the decisions and responses provided.0 (0%) – 13 (13%)The response
inaccurately and vaguely explains in detail the decision selected.The response inaccurately
and vaguely explains why the decision was selected, with specific clinically relevant
resources that do not the decision selected, or is missing.The response inaccurately and
vaguely explains why the other two responses were not selected, with specific clinically
relevant resources that do not the decision selected, or is missing.The response
inaccurately and vaguely explains the outcome the student was hoping to achieve with the
selected decision, with specific clinically relevant resources that do not the response, or is
missing.The response inaccurately and vaguely explains how ethical considerations impact
the treatment plan and communication with patients, or is missing.Examples provided do
not the decisions and responses provided, or is missing.Decision #3 (1–2 pages)• Which
decision did you select?• Why did you select this decision? Be specific and your response

6. with clinically relevant and patient-specific resources, including the primary literature.•
Why did you not select the other two options provided in the exercise? Be specific and
your response with clinically relevant and patient-specific resources, including the primary
literature.• What were you hoping to achieve by making this decision? your response with
evidence and references to the Learning Resources (including the primary literature).•
Explain how ethical considerations may impact your treatment plan and communication
with patients. Be specific and provide examples.18 (18%) – 20 (20%)The response
accurately and clearly explains in detail the decision selected.The response accurately and
clearly explains in detail why the decision was selected, with specific clinically relevant
resources that fully the decision selected.The response accurately and clearly explains in
detail why the other two responses were not selected, with specific clinically relevant
resources that fully the response.The response accurately and clearly explains in detail the
outcome the student was hoping to achieve with the selected decision, with specific
clinically relevant resources that fully the response.The response accurately and clearly
explains in detail how ethical considerations impact the treatment plan and communication
with patients.Examples provided fully the decisions and responses provided.16 (16%) –
17 (17%)The response accurately explains the decision selected.The response explains why
the decision was selected, with specific clinically relevant resources that the decision
selected.The response accurately explains why the other two responses were not selected,
with specific clinically relevant resources that the response.The response accurately
explains the outcome the student was hoping to achieve with the selected decision, with
specific clinically relevant resources that the response.The response accurately explains
how ethical considerations impact the treatment plan and communication with
patients.Examples provided the decisions and responses provided.14 (14%) – 15
(15%)The response inaccurately or vaguely explains the decision selected.The response
inaccurately or vaguely explains why the decision was selected, with specific clinically
relevant resources that inaccurately or vaguely the decision selected.The response
inaccurately or vaguely explains why the other two responses were not selected, with
specific clinically relevant resources that inaccurately or vaguely the response.The
response inaccurately or vaguely explains the outcome the student was hoping to achieve
with the selected decision, with specific clinically relevant resources that inaccurately or
vaguely the response.The response inaccurately or vaguely explains how ethical
considerations impact the treatment plan and communication with patients.Examples
provided may the decisions and responses provided.0 (0%) – 13 (13%)The response
inaccurately and vaguely explains in detail the decision selected.The response inaccurately
and vaguely explains why the decision was selected, with specific clinically relevant
resources that do not the decision selected, or is missing.The response inaccurately and
vaguely explains why the other two responses were not selected, with specific clinically
relevant resources that do not the decision selected, or is missing.The response
inaccurately and vaguely explains the outcome the student was hoping to achieve with the
selected decision, with specific clinically relevant resources that do not the response, or is
missing.The response inaccurately and vaguely explains how ethical considerations impact
the treatment plan and communication with patients, or is missing.Examples provided do

7. not the decisions and responses provided, or is missing.Conclusion (1 page)• Summarize
your recommendations on the treatment options you selected for this patient. Be sure to
justify your recommendations and your response with clinically relevant and patient-
specific resources, including the primary literature.14 (14%) – 15 (15%)The response
accurately and clearly summarizes in detail the recommendations on the treatment options
selected for this patient.The response accurately and clearly explains a justification for the
recommendations provided, including clinically relevant resources that fully the
recommendations provided.12 (12%) – 13 (13%)The response accurately summarizes the
recommendations on the treatment options selected for this patient.The response
accurately explains a justification for the recommendation provided, including clinically
relevant resources that the recommendations provided.11 (11%) – 11 (11%)The
response inaccurately or vaguely summarizes the recommendations on the treatment
options selected for this patient.The response inaccurately or vaguely explains a
justification for the recommendations provided, including clinically relevant resources that
inaccurately or vaguely the recommendations provided.0 (0%) – 10 (10%)The response
inaccurately and vaguely summarizes the recommendations on the treatment options
selected for this patient, or is missing.The response inaccurately and vaguely explains a
justification for the recommendations provided, including clinically relevant resources that
do not the recommendations provided, or is missing.Written Expression and Formatting –
Paragraph Development and Organization:Paragraphs make clear points that well-
developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully
focused—neither long and rambling nor short and lacking substance. A clear and
comprehensive purpose statement and introduction are provided that delineate all required
criteria.5 (5%) – 5 (5%)Paragraphs and sentences follow writing standards for flow,
continuity, and clarity.A clear and comprehensive purpose statement, introduction, and
conclusion are provided that delineate all required criteria.4 (4%) – 4 (4%)Paragraphs and
sentences follow writing standards for flow, continuity, and clarity 80% of the
time.Purpose, introduction, and conclusion of the assignment are stated, yet they are brief
and not descriptive.3.5 (3.5%) – 3.5 (3.5%)Paragraphs and sentences follow writing
standards for flow, continuity, and clarity 60%–79% of the time.Purpose, introduction, and
conclusion of the assignment is vague or off topic.0 (0%) – 3 (3%)Paragraphs and sentences
follow writing standards for flow, continuity, and clarity < 60% of the time.No purpose
statement, introduction, or conclusion were provided.Written Expression and Formatting –
English writing standards:Correct grammar, mechanics, and proper punctuation5 (5%) – 5
(5%)Uses correct grammar, spelling, and punctuation with no errors.4 (4%) – 4
(4%)Contains a few (1 or 2) grammar, spelling, and punctuation errors.3.5 (3.5%) – 3.5
(3.5%)Contains several (3 or 4) grammar, spelling, and punctuation errors.0 (0%) – 3
(3%)Contains many (? 5) grammar, spelling, and punctuation errors that interfere with the
reader’s understanding.Written Expression and Formatting – The paper follows correct
APA format for title page, headings, font, spacing, margins, indentations, page numbers,
parenthetical/in-text citations, and reference list.5 (5%) – 5 (5%)Uses correct APA format
with no errors.4 (4%) – 4 (4%)Contains a few (1 or 2) APA format errors.3.5 (3.5%) – 3.5
(3.5%)Contains several (3 or 4) APA format errors.0 (0%) – 3 (3%)Contains many (? 5) APA

8. format errors.Total Points: 100Name: NURS_6630_Week8_Assignment2_Rubric. Case Study:
Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult.