1. As a psychiatric nurse practitioner, one screening tool that could be used when evaluating Brenda is a Structured Clinical Interview for DSM-IV. This tool applies to both clinical and research settings. The Semistructured interview question in the DSM-IV consists of separate modules that are used to identify specific disorders(Cerimele, Fortney, Pyne, & Curran, 2018).
2. Additional clinical information that can be used to make a diagnosis of Bipolar 1 is by taking careful notes of the symptoms based on their severity, frequency, and length. This can be achieved by placing the patient on coordinated patient care. Notably, this will assist in the early identification of Bipolar 1 disorder by monitoring Brenda’s manic and depressive episodes. The symptoms will be fully assessed using her personal and family history of mental illness.
3. Interviewing techniques would be best used for Brenda include active listening, adaptive questioning, nonverbal communication, empathy, and validation. These interview techniques help the patient feel relaxed so that the physician can make a proper diagnosis.
4. Apharmacological evidence-based intervention that could be used to treat the manic symptoms is lithium, divalproex depending on episode and severity of the patient(Fitzgerald, Hoy, Elliot, McQueen, Wambeek,&Daskalakis, 2016). The side effects of these drugs also have to be considered. For example, haloperidol is effective in treating mania, but it is not a first line treatment option based on its extrapyramidal side effects.
5. The interpersonal psychotherapy that can be used to treat Brenda is Interpersonal and Social Rhythm Therapy (ISRT). This is an evidence-based psychotherapy treatment combines a behavioral approach aimed at increasing the regularity of daily routines (social rhythms) and interpersonal approach to deal with the stresses of bipolar and social problems(Findling&Chang, 2018). This type of interpersonal psychotherapy is useful in identifying and tracking mood states between mania and depression based on the routine daily evaluation.
6. For the lab work, I would request Brenda to do a blood test, Uric Acid test, and fMRI scan. Patients with bipolar disorder tend to have high levels of proteins associated with Vitamin D in their blood as opposed to ordinary people. Also, patients with high level of uric acid in their blood are likely to be diagnosed with bipolar.  The fMRI scan is also helpful increased in determining neuronal activity. For patients with bipolar disorder, there is increased blood flow in which regions of the brain are more active than when in the resting state(Corrado& Walsh, 2016). The Functional MRI will help in determining the cerebral blood flow rate in bipolar patients.
7. There is a need for Brenda to get hospital stabilization. Brenda needs a combination of medication and psychotherapy to keep bipolar disorder under control. A brief stay at the hospital will help her stabilize the symptoms.
8. If Brenda requires hospitalization, I would first ensure that there are warning signs that she is a danger to herself and others. These include paranoia, delusion, and disconnected thoughts. I would then seek appropriate medication to calm her down. Alternative psychiatric treatments such as Electroconvulsive therapy can be used if the patient agrees to use them. Later on, the Brenda will be integrated into the hospital therapeutic setting which will consist of regular patient group meeting and occasional interviews with the nurses.
9. I would involve the family in the matter. Notably, family members play a significant role in supporting or helping a patient with bipolar to seek medication. People with bipolar are usually in denial about the need to seek treatment. Therefore the family members can help them by giving them moral support.
10. Often, family members experience a variety of emotions when they realize that someone has bipolar. However, when they support the family member to deal with the illness and continue to love them and believe in them. This helps the patient to recover quickly and learn how to manage the condition.

References

Cerimele, J. M., Fortney, J. C., Pyne, J. M., & Curran, G. M. (2018). Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment. Family practice, 36(1), 32-37.

Corrado, A. C., & Walsh, J. P. (2016).Mechanisms underlying the benefits of anticonvulsants over lithium in the treatment of bipolar disorder. Neuroreport, 27(3), 131-135.

Findling, R. L., & Chang, K. D. (2018).Improving the Diagnosis and Treatment of Pediatric Bipolar Disorder. The Journal of clinical psychiatry, 79(2).

Fitzgerald, P. B., Hoy, K. E., Elliot, D., McQueen, S., Wambeek, L. E., &Daskalakis, Z. J. (2016). A negative double-blind controlled trial of sequential bilateral rTMS in the treatment of bipolar depression. Journal of Affective Disorders, 198, 158-162.

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