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Assessing Patients with Psychosis and Schizophrenia (Coursework Sample)


According to the DSM-5, a diagnosis of schizophrenia is made if a person has two or more core symptoms, one of which must be hallucinations, delusions, or disorganized speech for at least one month. The other core symptoms are gross disorganization and diminished emotional expression. Assessing Patients with Psychosis and Schizophrenia


Assessing Patients with Psychosis and Schizophrenia
Institutional affiliation
Schizophrenia is a disease characterized by brain dysfunction. It causes delusions, sometimes hallucinations, and difficult relationships with others. This situation is controlled by antipsychotics and psychotherapy to help patients recover and adjust to the new standards of a better society (Boggs et al., 2018). One case study spoke of a Palestinian woman who suffered from short-term symptoms of mental illness. This became clear by believing that she was the Prophet Muhammad. The client also believes that when her husband took her to a mental hospital for a physical exam, her husband disproportionately messed up everything. The client also thought the TV was talking to her, but denied the problem with the hallucinations. She became hostile to answering some questions. Factors that can influence the treatment decision plan include the patient's ethnicity, patient compliance, and the client's response to medications provided. Therefore, this review focuses on recommending treatment plans for patients in case studies and examining the impact of nursing ethics on treatment and communication with patients.
Decision One Analysis
I think the first option is to start the 234 mg intramuscular injection of Invega Sustenna X1, then the 156 mg intramuscular injection on day 4 and every month thereafter. This choice was made because it is a drug that blocks the serotonin 2A receptors, resulting in increased release of the hormone dopamine in the patient's body. This ultimately helps reduce the side effects of exercise by improving clients' cognitive and emotional symptoms (Fellner, 2017). This is because dopamine is released in specific areas of the brain, helping to reduce the side effects of exercise. The drug will immediately affect the client's psychiatric symptoms in about a week, but it is important to note that some patients' behavioral and cognitive results may take a little longer between 4 and 20 weeks.
The reason for not choosing the first and third options is that Zaipura and Abilify can only be taken orally, given the patient's condition, this method is not effective due to compliance reasons. Additionally, Zipule drugs are associated with side effects, such as dry mouth, drowsiness, dizziness, increased client appetite, and weight gain that clients may not want to experience when they start taking the medicine (Fellner, 2017). On the other hand, Abilify drugs are also associated with vomiting, headache, constipation, blurred vision, excessive saliva / drooling and insomnia, and the case study may have too much. 'Side effects that the client has to face.
With this option, the patient must present to the hospital after 4 weeks, indicating that the PANSS score has significantly decreased and the treatment effect has been achieved. I also hope that the patient will reduce her delusions and focus on getting to know her husband. The results showed that the client appeared to be able to tolerate the drug, and the PANSS score fell by 25%. However, the customer added 2 pounds. This means that the drug made her gain weight, which is one of the side effects of the drug. Most antipsychotics, including Invega Sustenna, increase patient weight (Ojimba, Oyelakin & Khandaker, 2019). In this case, the drug Invega Sustenna will increase the appetite of the customers who use it, increase the intake and storage of calories and fat in the body and cause the patient to gain weight in a short time. The client also complained that the pain at the injection site restricted her sitting position. This is expected for clients who experience pain from injections rather than oral medications. However, there are many solutions to this problem, such as using injections into the deltoid muscle, which will gradually wear off over time.
In this case, the ethical considerations of informed consent must be applied before the client begins the medication. This opens the door for communication between the client and the healthcare professional (in this case, the nurse) regarding the most appropriate treatment plan. Nurses should educate patients and their families about their illnesses and available medications. The nurse should also inform the patient of the expected side effects of the drug administered in case she has side effects due to intolerance. This helps to understand the patient's allergic reactions to foods and drugs, and to ensure that the treatment plan does not include such drugs that could cause problems for the patient in the future.
Decision Two Analysis
The second decision was to stick with the same medication, but on this visit I started injecting the deltoid muscle and asked the management nurse to move on. The decision to change the site is due to the fact that it reduces the pain experienced by the patient. There is no need to replace drugs with beneficial and therapeutic effects, thereby reducing delusions and other symptoms of schizophrenia. Ferner, C. (2017). This choice increases the surface area, which results in the release of the drug to the patient, and also results in a faster stable state of the drug to improve the outcome of the client's faster treatment. In addition, the benefit of injecting the drug into the deltoid muscle is 28% greater than the concentration using the hip muscle. Therefore, this option is affectionate.
That is why I did not choose the third option and decided to continue with Invega sustenna, start the injection into the deltoid muscle and add Abilify Maintena 300 mg intramuscularly every month. Make changes that may ensure that meditation is not a side effect that the client may not tolerate in the future. If the patient develops akathisia, she may not be able to tolerate the prescription, which will make her future life difficult. Meditation cannot be a condition that makes the client restless and difficult to sit properly. Hence, you don't need to choose this option as you realize that side effects will occur in the future and negatively affect your customers.
The expectation of this choice is that the client will reduce symptoms by an additional 25% thanks to the PNNS score after this choice. I also hope that customers can tolerate this drug and choose the injection site to reduce pain and pain. The results showed that the client's PNNS score was reduced by 50%. This is an important aspect of the significant reduction in delusions and other symptoms associated with patients with schizophrenia. The client also stated that the pain was significantly reduced from the expected decision tree choice 2. However, the patient's weight gained another 2.5 kg. It doesn't look good for the client because the husband thinks he might leave her because of it. Unless the weight issue is resolved, the drug will increase the client's appetite and should gain weight in the process, so the client should continue to gain weight. In view of the fact that the drug has obtained and achieves an essential therapeutic effect for improving the prognosis of the patient, this problem must be solved outside of the prescription.
Here, the ethical considerations to be resolved must be non-malicious. This is a consideration that states that actions taken by nurse practitioners must be based on the fact that they will not harm the client. In this case, the client feels pain when injecting the medicine. Therefore, if you are causing problems for your clients, you need to design a solution to relieve the pain or change the medication. In this case, the injection into the deltoid muscle is used to help the client tolerate the drug as it improves their condition. According to medical reports. This is to make sure that in the next report, because the decision fails, the client should feel better, and the nurse will prescribe pain relievers for the patient. At the injection site, this means that the principle of benefit must be adopted.
Decision Three Analysis
The third option is to continue to use Invega sustenna and inform the client that the weight gain caused by the use of sustenna is not as great as that which other medicines with similar effects may cause. This choice shows that the drug has done good for the client and eliminated the main symptoms of schizophrenia, which is the main idea of ​​treatment. Additionally, nutritionists can troubleshoot weight issues in deciding what foods to eat to avoid overweight (Mustafa et al., 2019). Referral of clients to dietitians is essential to prevent patients from eating foods high in fat. Food’s high in fat increase calories in the body and increase unnecessary weight. Exercise is an evidence-based platform that ensures clients look healthy and lose weight in about a month. However, given the visitor's psychological stability, it is essential to encourage her husband to accompany her and participate in her physical exercises to reduce the rate of weight gain.
The reason for not switching the drug to Abilify is that the FDA has stated that if the drug achieves therapeutic effect and has controllable side effects, the drug should be tested for at least 6 months (Boggs et al., 2018). Abilify drugs also have unaccep

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