Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia NURS 6630N
Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia NURS 6630N
Assessing and Treating Patients With Psychosis and Schizophrenia
Schizophrenia is a chronic mental disorder characterized by hallucination, delusion, disorganized thought process, disorganized speech, and lack of motive. It is associated with perceived reality difficulties among those around the affected individual. The cause of schizophrenia is associated with biological and genetic factors, despite its actual cause being unknown. This disorder accounts for about 1% of mental disorders among people in the United States (Ganguly, Soliman, & Moustafa, 2018). Through evidence-based practice, several diagnostic criteria have been proposed for the early detection of schizophrenia. Studies also show that patients who seek timely medical intervention tend to display positive outcomes from the available treatment options (Lähteenvuo & Tiihonen, 2021). In this paper, the care plan of a Pakistani adult female has been illustrated with drug choices based on pharmacodynamic and pharmacokinetic factors. The ethical and legal considerations encountered by the PMHNP while caring for this patient have also been discussed.
The provided case study demonstrates a 34 years old Pakistani female patient who presented to the psychiatric unit following a 21-day hospitalization as a result of a “brief psychotic disorder.” The patient demonstrates visual hallucinations as she claims to see Allah, and even calls herself the prophet
Mohammed. Her husband reports finding it quite hard to leave the patient with their four children, and at some point was forced to call the police, who led to involuntary admission of the patient to the psychiatric clinic. During the mental examination, the patient denied her husband’s claims, stating that he wants to leave her for an American woman. She also claims that at times, the television speaks to her. She was however in a stable mood throughout the interview with a history of paranoia and delusion. She has a BMI of 23.3. The patient was prescribed Risperdal when she was admitted, which she stopped taking 1 week after being discharged.
Decision #1
Selected Decision
Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter
Reason Behind the Selected Decision
Invega Sustenna is approved by the FDA for the management of schizophrenia among adults either as monotherapy or in combination with another psychotropic agent (Cerveri, Gesi, & Mencacci, 2019). It is an atypical antipsychotic agent which acts by antagonizing 5HT2A and D2 receptors centrally in the management of schizoaffective symptoms. Invega Sustenna is long-acting and administered intramuscularly, with a starting dose of 234 mg on the first day followed by a dose of 156 mg once daily after 4 to 7 days (Lähteenvuo, & Tiihonen, 2021). When the patient displays great tolerance, continuous doses of the medication are administered once a month displaying great compliance. The drug is extremely water soluble with a desirable safety profile as a result of minimal side effects (Hui et al., 2019). Consequently, the patient BMI is relatively high, which makes this medication the most appropriate as a result of fewer side effects associated with weight gain as compared to the other alternatives.
Zyprexa could not be considered for this patient given its undesirable side effects of weight gain for a patient with a higher BMI (Cerveri, Gesi, & Mencacci, 2019). The drug also has a short duration of action, which requires daily administration that might be inappropriate for the patient given her history of non-compliance (Hui et al., 2019).
Abilify is also not appropriate for the patient since the drug is associated with a low tolerance among most patients as reported by several studies (Ganguly, Soliman, & Moustafa, 2018). The drug is also associated with several adverse effects which would otherwise compromise the patient’s quality of life such as daydreaming, blurred vision, anxiety, and insomnia among others (Hui et al., 2019).
Expected Outcome
Within the next four weeks, the patient is expected to report back to the clinic with at least 50% remission of schizoaffective symptoms (Cerveri, Gesi, & Mencacci, 2019). She should be able to record a PANSS score of 2 or less within this time. No side effects are expected to be exhibited by the patient (Hui et al., 2019).
Ethical Implications
The patient is an adult has the right to confidentiality (Keating et al., 2017). However, given the history of involuntary admission and disoriented thought process, the patient’s husband must be informed about the patient’s condition in addition to the therapeutic approaches taken in the management of her symptoms (Hui et al., 2019).
Name: NURS_6630_Week7_Assignment_Rubric
| Excellent
Point range: 90–100 |
Good
Point range: 80–89 |
Fair
Point range: 70–79 |
Poor
Point range: 0–69 |
|
|---|---|---|---|---|
| Introduction to the case (1 page)
Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. |
Points Range: 9 (9%) – 10 (10%)
The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. |
Points Range: 8 (8%) – 8 (8%)
The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. |
Points Range: 7 (7%) – 7 (7%)
The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. |
Points Range: 0 (0%) – 6 (6%)
The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient. |
| Decision #1 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
| Decision #2 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
| Decision #3 (1–2 pages)
• Which decision did you select? |
Points Range: 18 (18%) – 20 (20%)
The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided. |
Points Range: 16 (16%) – 17 (17%)
The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. |
Points Range: 14 (14%) – 15 (15%)
The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided. |
Points Range: 0 (0%) – 13 (13%)
The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. |
| Conclusion (1 page)
• Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. |
Points Range: 14 (14%) – 15 (15%)
The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. |
Points Range: 12 (12%) – 13 (13%)
The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided. |
Points Range: 11 (11%) – 11 (11%)
The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. |
Points Range: 0 (0%) – 10 (10%)
The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing. |
| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
Points Range: 5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. |
Points Range: 4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive. |
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic. |
Points Range: 0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. |
| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
|
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
|
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
|
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
|
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. |
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
|
Points Range: 4 (4%) – 4 (4%)
Contains a few (1 or 2) APA format errors.
|
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains several (3 or 4) APA format errors.
|
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
|
| Total Points: 100 |
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