Psychosis and Schizophrenia Therapy

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia. Psychosis and Schizophrenia Therapy

ORDER A FREE-PLAGIARISM PAPER NOW

Learning Objectives

Students will:

Assess client factors and history to develop personalized plans of antipsychotic therapy for clients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy
Evaluate efficacy of treatment plans
Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan
To prepare for this Assignment:

Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy.
The Assignment

Examine Case Study: Pakistani Woman with Delusional Thought Processes. 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 pharmacodynamic processes.

At each decision point stop to complete the following:

Decision #1
o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3
o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Psychosis and Schizophrenia Therapy

o 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 three academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement.

CASE STUDY

Examine Case Study: Pakistani Woman with Delusional Thought Processes.

Psychosis and schizophrenia have been shown to have a devastating impact on the normal functioning of the brain. As a result, people who suffer from it cannot think clearly, which in turn affects their interactions with other people, work and even educational performances. However, it is imperative to control the symptoms of the condition through appropriate diagnostic procedures such as the Positive and Negative Syndrome Scale (PANSS) (Kay, Fiszbein, & Opler, 1987). After the diagnosis, a medication therapy may be formulated and this is impacted by both the tolerance levels and effectiveness of individual drugs (Stahl, 2013). In the present paper, a Pakistani woman with delusional thought process whose PANSS scale scores read 40 for positive symptoms, 20 for negative symptoms, and 60 for general psychopathology scale will form the foundation of the analysis. Moreover, the different available medication options plus the necessary alterations in either the dosage or type as the therapy progresses will be conducted so as to ensure that the therapy succeeds and appears to do so by the patient.

OPTION 1B

Decision Point 1

Selected decision

Start Abilify (aripiprazole) 10 mg orally at BEDTIME

Reason for selection

Abilify at 10mg has undergone systematic evaluation, which has shown that is effective with regard to treating psychosis and schizophrenia. According to the PANSS score, the patient suffers from schizophrenia that makes her paranoid. The list of the medications presented could all be used to manage the symptoms. However, only Abilify is the best fit as it is the first line medication in such situations and it is generally well-tolerated in the system (Stahl, 2014b). Zyprexa cannot be used as it is less effective yet its level of tolerance is similar to Ability. Also, the nurse cannot recommend Invega Sustenna as its mode of administration is inconvenient and level of tolerance is comparatively lower. Therefore, this leaves Abilify as the best start medication for the schizophrenic patient. Psychosis and Schizophrenia Therapy

Expected Results

According to studies, Abilify achieves steady state within two weeks of administration. Hence, the patient is expected to demonstrate improvement in schizophrenia symptoms after the second week (Shirley & Perry, 2014). By the fourth week, the patient should show reduction in her paranoid symptoms, her insights and judgment need to have improved, and the apparent hallucinations reduced.

Difference between Expected Results and Actual Results

Upon reporting to the clinic by the fourth week, the client did not show improved symptoms as expected. Instead, she looked disheveled, and her sleep pattern has been impacted (Stahl, 2013). Her level of concentration has also been impacted as she continuously dozes during an appointment. Evidently, the client is not responding to Abilify, which is not consistent with the expected results.

ORDER A FREE-PLAGIARISM PAPER NOW

Decision Point Two

Selected decision

Discontinue Abilify and start Geodon (ziprasidone) 40 mg orally BID with meals.

Reason for selection

Abilify has clearly not worked according to expectations. Standard procedure in the management of the schizophrenia dictates that a nurse should change medications in the event that the first line medication fails (Fangfang et al., 2014). Therefore, Geodon 40 mg is of a higher dose and also more effective compared to Abilify. Hence, it is wise to change the anxiolytic intervention from Abilify to Geodon.

Expected results

The nurse expects the symptoms of schizophrenia to undergo remission as the patient is expected to respond to Geodon due to its increased dosage. The incidences of paranoia are expected to remarkably decrease. The apparent hallucinations that she displays are also expected to dissipate (Stahl, 2013). Further, her concentration levels are also expected to improve by the eight week. In other words, the PANSS scale scores are expected to reduce when the client next comes back for assessment. Psychosis and Schizophrenia Therapy

Difference between Expected Results and Actual Results

Upon changing the medication, the client was expected to visit the clinic again after four weeks. The nurse anticipated that Geodon would lower the schizophrenic symptoms suffered by the patient. Hence, when the patient reported that the symptoms had reduced, the assertion was proven by a PANSS score reduction of 40%. Further, her weigh had also decreased and her hunger had been curbed (Stahl, 2013). All these were coherent with the expected results. However, the client also confessed that she had issues with compliance. This was totally unexpected and there was need to address it.

Decision Point Three

Selected decision

Give her a few test doses of Risperdal 1 mg orally BID for 3 days to see if she tolerates the medication. If tolerated, start Invega Sustenna at an appropriate starting and maintenance dos.

Reason for selection

The client has indicated compliance issues when it comes to Geodon. Further, she also demonstrated good effect from oral therapy. For these reasons, the client can be switched from Geodon to Invega Sustenna (Fangfang et al., 2014). However, this decision will be subject to the tolerability that she may show to Risperdal 1mg dosage. If the client does not respond to the Risperdal, the Geodon will be maintained probably at an increased dosage.

Expected results

The changing of the anxiolytic therapy from Geodon to Invega Sustenna is expected to achieve two things. One is that the compliance issue that was shown with Geodon will be eliminated as the patient is expected to adhere to the dosage (Stahl, 2013). Moreover, the client will be anticipated to show a reduction of the symptoms when the PANSS scale is utilized.

Difference between Expected Results and Actual Results

The choice to try the decision point three is in harmony with the standard procedures. The main issue that is being addressed here is compliance and as such, if the tolerability of Invega Sustenna can be determined, then it can effectively replace Geodon. Therefore, it is critical to determine this and make the decision based on the results. Psychosis and Schizophrenia Therapy

Impact of Ethical Considerations on Treatment Plan

The treatment intervention will be influenced by the side effects that accompany the drug. Therefore, the treatment intervention will be influenced by taking into account some of them. Before the anxiolytic therapy is formulated, the nurse will be required to discuss with the client and make them know of the varied side effects (Stahl, 2014b).

Conclusion

In conclusion, schizophrenia is an enervating condition whose impact is felt by both the patient and the people around them. An accurate diagnosis is thus paramount for the formulation of the necessary therapy. Also, the anxiolytic medications can be altered or switched depending on the response from the patient. Studies also reveal that a nurse will need to consider certain ethical angles, primarily the side-effects of the disease before designing a therapy.

References

Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471

Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.

Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author.

Shirley, M., & Perry, C. (2014). Aripiprazole (ABILIFY MAINTENA): A Review of Its Use as Maintenance Treatment for Adult Patients with Schizophrenia. Drugs, 74(10), 1097-1110

Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press Psychosis and Schizophrenia Therapy.

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our Guarantees

Money-back Guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism Guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision Policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy Policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

4-hour deadlines

Your urgent tasks will be completed within 4 hours. Your discussion responses and late orders will be will be handled fast and we still maintain our quality.

Read more
error: