NURS 6630 Week 7 Assignment Assessing and Treating Patients With Psychosis and Schizophrenia Essay

NURS 6630 Week 7 Assignment Assessing and Treating Patients With Psychosis and Schizophrenia Essay

Solution:

Introduction

Psychosis is a psychiatric term used to describe the mental condition in which the victims lose contact with reality. It is not an infection but rather a behavioral condition. About 8 to 30 % of the general population experiences delusional or hallucination in their lifetime (Kesby, Eyles, McGrath,  & Scott, 2018). The common symptoms ofthe psychotic disease include sleep problems, depression, anxiety, social withdrawal, difficultysleeping, impaired motivation, and decline in function. Psychosis may be ruled out using the various symptoms but hallucinations and delusions remain the most subtle signs of psychosis. Psychosis is attributed to several mental health conditions including bipolar disorder, schizophrenia, substance abuse, schizoaffective disorder among others. Schizophrenia is a critical mental condition that interferes with the individual’s way of thinking, making decisions and managing emotions.

The current case involves a patient with a Pakistan woman aged 34 years following a 21-day follow-up hospitalization. The client has been prescribed Risperdal but stopped citing that her husband might poison her. This is in addition to a series of other delusional thoughts including the vision of her being Allah’s prophet with a mission to rescue the world from sin.  She reports improved mood. She denies auditory/visual hallucinations although she trusts the voice from her television. She is sometimes aggressive during the interview but calms down with time.  A previous medical report shows normal overall health with normal limits.

The patient is alert and in place and time. However, upon undergoing a Positive and Negative Syndrome Scale (PANSS), the client is diagnosed with a paranoid type of schizophrenia. PANSS is a diagnostic tool that consists of various interview items to determine the positive or negative progression of patients with schizophrenia. She reportseuthymic mood with impaired insights and judgment. The patient denies any suicidal and homicidal thoughts.

Decision One

The first decision involved starting Invega Sustenna 234 mg intramuscular (IM) X1 and continue with 156 mg intramuscular from the 4th day. After administering the 156 mg intramuscular, the next thing would be to administer the same dose on a monthly interval. According to Emsley and Kilian (2018), antipsychotic treatment is recommended in preventing multiple relapses associated with schizophrenia. Paliperidone (9-hydroxyrisperidone) is regarded as a functioning metabolite of risperidone. It has an element of receptor building. It works by blocking the serotonin and dopamine receptors of the brain (McNeil, Gibbons, Cogburn, Risperidone,2021). The drug is administered on monthly basis through injections to ensure a normal mood, enhanced thinking, and stabilizing behaviors.

Abilify and Zyprexa would be greater choices however not suitable for the current case. The combination is likely to increase adverse events such as blurred vision, drowsiness, flushing, abdominal cramping, and memory-related issues (Johnsen et al., 2020). The goal is to reduce schizophrenia symptoms with the minimum side effects possible. Therefore, long-acting injectables (LAIs) like Paliperidone are known to reduce the number of relapses and ER visits for schizophrenia patients compared to other forms of oral medications. As a result, a therapy involvingLATs is associated with a high rate of adherence tolerability and efficacy due to its intramuscular injection element.

The primary aim of this therapy was to help the client adhere to the treatment and experience reduced symptoms before making the next visit.  Another expectation was to see a reduced  PANSS score during the next visit. With antipsychotic drugs, the symptoms may improve within the first  7 days however, it may take as long as 6 weeks to determine the efficacy of the current therapy.

Fortunately, the client returns and report a drop in PANSS to score upto 25 % after 4 weeks.She also reports high tolerance to the medications, along with a slight addition of weight.

Decision 2

The second decision involves continuing with the same decision but ordering deltoid injection from this visit onward. I would make such a decision since the patient reported a 25% fall in the PANSS score. I would change the injection site to prevent avoid further complaints of pain and inability to sit down. However, I would be considered discussing with the client my decision to change the regime. This would help her understand the benefits, risks, and effects of the prescribed medication. I would not consider starting t Haldol Decanoate (haloperidol…….Please click the icon below to order original answer at only $12.55

NURS 6630 Week 7 Assignment Assessing and Treating Patients With Psychosis and Schizophrenia Essay