Assessing and Treating Clients with Psychosis and Schizophrenia

Assessing and Treating Clients with Psychosis and Schizophrenia

Pakistani Woman with Delusional Thought Processes

Psychosis and Schizophrenia are conditions that affect the normal functioning of the human brain. Persons with these symptoms are not able to think properly, which leads to an inability to function normally. Treating the conditions requires that psychiatrists conduct a proper assessment of the patients. In this case, the Pakistani woman appears calm during the assessment. Notably, she still speaks of the things she reportedly hears from the television concerning her husband. During the assessment, she denies ever hallucinating in the past. However, records indicate she is an overall healthy patient. All her lab test results are within normal limits. Her Psychosis and Schizophrenia conditions require a prescription that affects pharmacokinetic and pharmacodynamics processes.

Decision 1

Which decision did you select?

Decision 1 entailed administering oral Zyprexa 10 mg at all bedtimes from the beginning of the treatment. Moreover, Invega Sustenna 234 mg intramuscular X1 was administered after day 4. Thereafter, 156 mg intramuscular was administered every month. Lastly, this decision included oral Abilify 10 during bedtimes.

Why did you select this decision?

The decision to use the medications emanated from the fact that treating the client would require administering medicine that reduces depression. The combination was essential because the medications are effective in decreasing hallucinations, thereby enabling the patient to think clearly and have balance in everyday life. Oral administration during bedtime was necessary because of the side effects such as dizziness and drowsiness.

What were you hoping to achieve by making this decision?

The client was to return after four weeks for an assessment on the progress. By making this decision, I was hopeful that the medication would help the client gain more control of her brain functioning.

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

There was no difference between the expectation and the achievement of the decision. During the first visit, a decrease of 25% in PANSS was recorded. Notably, the patient had developed a tolerance for the medication. Besides, the client had gained weight during the period. Adding weight was an expected side effect of the medication. It was comforting that the issue of increased weight did not bother the client. Therefore, the results were in line with the expectation.

Decision 2

Which decision did you select?

The client was to discontinue the use of Invega Sustenna and start haloperidol decanoate 50 mg IM for 2 weeks and oral Haldol 5 mg BID for the next three months. The use of Invega Sustenna was continued after the 3 months accompanied by an Abilify Maintena 300 mg intramuscular injection every month. Oral Abilify 10 mg was also administered every morning for two weeks. Nursing care services played a major role in this decision.

Why did you select this decision?

Nursing care was essential in this state because of the injections. At Decision 1, the client’s husband easily administered oral medicines. However, Decision 2 entailed an injection that warranted that a qualified caregiver takes over.

What were you hoping to achieve by making this decision?

The decision was important in helping treat Psychosis and Schizophrenia symptoms through injection of Abilify Maintena 300 mg into the bloodstream. These drugs help in stabilizing the mental capability of patients with visual or auditory hallucinations.

Explain any differences between what you expected to achieve and the results of the decision. Why were they different?

During the visit after four weeks, the client registered a PANNS decrease of 50% since the introduction of Invega Sustenna in the medication. Her weight seemed to have increased by another 2.7 pounds. The additional weight was a deviation from the expected changes. It meant that Invega Sustenna’s side effects were obvious on the client, affecting her weight. The drug is effective; however, the effect on her weight is a concern to the caregivers.

Decision 3

Which decision did you select?

Continue with Invega Sustenna for some time before replacing it with Abilify Maintena 400 mg each month. After three months, Invega Sustenna was continued with an addition of Qsymia to help in weight loss.

Why did you select this decision?

Decision 3 continued with the medication; however, it also entailed the counseling of the patient on matters of weight. During the previous visit, she registered worries that her husband would leave her if her weight continued to increase. As much as other drugs were available to replace Invega Sustenna, the alternatives have worse side effects.

What were you hoping to achieve by making this decision?

With this decision, I hoped to counsel the patient that the prescription was the best alternative for her case. Worries on her weight could lead to more mental problems before the full recovery. Therefore, other than achieving full recovery, the decision also sought to achieve weight loss.

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

The recovery process was on course, and the client responded well. The switching of the drugs from Invega Sustenna to Abilify Maintena helped to reduce the amount of weight gain during the treatment process. However, other counseling and use of Qsymia, the decision could have entailed consultation with a dietician and exercise physiologist. In general, the prescription worked well.

How ethical considerations might impact your treatment plan and communication with clients.

Psychosis and Schizophrenia are mental conditions that impair a patient’s ability to make decisions. In this case, the inability of the patient to make a sober decision concerning her situation presents ethical complications on treatment. All major decisions on the type of treatment had to be made by the medical staff. An ideal situation requires that patients participate in choosing the appropriate treatment procedure. The patient took control of her mental status later after the treatment started. He started asking questions on the alternative medication to some of the prescription.