(Solved) NURS 6630 Week 7 Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia; a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was

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Psychosis according to National Institute of Mental Health [NIMH] (2016), is used to describe conditions that affect the mind, where the individual has some loss of contact with reality. Psychosis i... s a symptom, not an illness, and in the U.S., approximately 100,000 young people experience psychosis each year. A person who is in a psychotic episode may experience depression, anxiety, sleep problems, social withdrawal, lack of motivation, and difficulty functioning overall (NIMH, 2016). Psychosis includes a range of symptoms but typically involves one of these two, hallucinations and delusions and treatment may involve psychotherapy and medication. Psychosis also can be related to several mental health conditions such as schizophrenia, bipolar disorder, schizoaffective disorder, and substance abuse (National Alliance on Mental Illness [NAMI], 2019). Schizophrenia is a serious mental illness that affects This study source was downloaded by 100000860583932 from CourseHero.com on 01-26-2023 10:51:57 GMT -06:00 https://www.coursehero.com/file/38106723/WK6AssgnAssessing-and-Treating-Clients-With-Psychosis-and-Schizophreniadocx/ a person’s ability to think clearly, manage emotions, make decisions and relate to others; hence, it is a complex, long-term medical illness, affecting about 1% of Americans (NAMI, 2019). In the case study for this assignment, a 34-year-old woman from Pakistan presents with a diagnosis of “brief psychotic disorder” following 21 days of hospitalization. After a week of taking the medication Risperdal prescribed to her, she reports to have stopped because of her delusional thinking that her husband is going to poison her. The client has been experiencing delusional and paranoid thoughts such as having visions of Allah, believing she was Prophet Mohammad, and that she would deliver the world from sin (Laureate Education, 2016j). The Positive and Negative Syndrome Scale (PANSS) is administered to the client and her scores reveals a diagnosis of schizophrenia, paranoid type (Laureate Education, 2016j). PANSS is a standardized, clinical interview that rates the presence and severity of positive and negative symptoms, as well as general psychopathology for people with schizophrenia (Depp, Loughran, Vahia, & Molinari, 2010). The purpose of this paper is to show how to assess and treat clients requiring antipsychotic therapy based on the decision concerning the medication to prescribe to a 34-year-old woman from Pakistan with a diagnosis of schizophrenia, influence of pharmacokinetic and pharmacodynamic, and including ethical considerations might impact the treatment plan and communication with clients. Decision One The first decision selected is to start Invega Sustenna 234 mg intramuscular (IM) X1 followed by 156 mg intramuscular on day 4 and monthly thereafter. According to NAMI (2016), paliperidone is a medication that works in the brain in treating schizophrenia and schizoaffective disorder. It is long-acting injectables (LAIs) that allow for the slow release of medicine into the blood, it rebalances dopamine and serotonin to improve thinking, mood, and behavior; therefore This study source was downloaded by 100000860583932 from CourseHero.com on 01-26-2023 10:51:57 GMT -06:00 https://www.coursehero.com/file/38106723/WK6AssgnAssessing-and-Treating-Clients-With-Psychosis-and-Schizophreniadocx/ it is given monthly. Invega Sustenna works by blocking dopamine 2 receptors, reducing positive symptoms of psychosis and stabilizing affective symptoms; also blocks serotonin 2A receptors, causing enhancement of dopamine release in certain brain regions and thus reducing motor side effects and possibly improving cognitive and affective symptoms (Stahl, 2014b). long-acting antipsychotic injections are a valuable form of therapy; therefore, it may be a suitable option in patients who refuse oral treatment (Bishara, 2010). Zyprexa and Abilify are also antipsychotic (AP) medications used to treat psychosis but will be infective at this time as the client’s symptoms are of delusion and confusion; also the side effects are likely to hinder client from adhering to treatment. LATs were also associated with significantly lower ER visit rates and mental disorder-related and schizophrenia-related rehospitalization rates compared with oral Aps; therefore suggesting that the efficacy and patient tolerability improved patient adherence to the injectable form of the second-generation antipsychotics reducing the demand for hospitalizations and ER visits of relapsed patients with schizophrenia (Lafeuille et al., 2013). The goal for the treatment is for the client to adhere to the treatment and reduction in symptoms within four weeks before returning back to the clinic, also hoping to see a decrease in her PANSS score at the next visit. Psychotic symptoms can improve within 1 week, but it’s recommended to wait at least 4–6 weeks to determine efficacy of drug (Stahl, 2014b). I am expecting that when client returns after four weeks for follow up, she will report tolerating the medication with reduction in psychotic symptoms and improvement in mood. Client returns to clinic in four weeks, reports tolerating medication, and a decrease on her PANSS score of 25% is noted at this visit. Client also reports a 2 pound weight gain but complains of injection site pain stating she has trouble siting for a few hours after the injections. Decision Tw [Show More]

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