MEDICATION MANAGEMENT OF A SCIZOPHRENIC (PARANOID TYPE) PATIENT

Assessing and Treating Clients With Psychosis and Schizophrenia. DIAGNOSIS IS SCHIZOPHRENIA, PARANOID TYPE.

FOLLOW THESE INSTRUCTIONS DILIGENTLY AND COMPLETE EACH STEP. PLEASE. I HAVE ALREADY MADE THE DECISIONS. YOU HAVE TO JUSTIFY WHY AND WHY THE OTHERS WEREN’T APPROPRIATE. GIVE RATIONALES.

At each decision point stop to complete the following: For management of Schizophrenia, paranoid type.

OPTIONS
Zyprexa 10mg orally at night time

Start Invega Sustenna 234mg intramuscular X1 followed by 156mg intramuscular on day 4 then monthly after that.

Start Abilify 10mg orally at bedtime

• Decision #1 (Zyprexa 10mg daily at bedtime)

• YOUR JOB

• Which decision did you select? (Zyprexa 10mg daily at bedtime)

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?

o OUTCOME
Patient returns to clinic in four weeks

Client’s PANNS decreased partially by 25% (good)

Client reports weight gain of 5 pounds. When questioned on this point, she says that she never seems full from her meals. So, she’s snacking constantly throughout the day.

• My decision #2 based on outcome of decision #1 (Change medication to Geodon 40mg orally two times a day with meals)

• OPTIONS

o Decrease Zyprexa to 7.5mg at bedtime

Change medication to Geodon 40mg orally twice a day with meals

Add on Wellbutrin XL 150mg in the morning

YOUR JOB

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.
o
o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
o
o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
o
o OUTCOME

Client returns to clinic in four weeks

Client has a significant reduction in her PANNS (Reduction of 40%)

Client notices that her weight is down slightly from previous visit (lost 2 pounds) and that her hunger has been curbed since starting this med

Client complains that it is difficult remembering the afternoon dose and admits to missing a few doses in the past month

• Decision #3 based on outcome of decision #2 (Change the medication to Geodon 80mg at night and monitor for breakthrough symptoms throughout the day)

OPTIONS

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

Change the Geodon to 80mg at night and monitor for breakthrough symptoms throughout the day.

Discontinue Geodon and start Latuda 40mg orally daily

YOUR JOB

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 #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.

YOUR JOB ALSO INCLUDE

Using at least 4 references provide rationales for each step of the decision tree. Following the steps provided in the rubric given.

Provide the purpose for this paper.

Provide an overview of Schizophrenia (paranoid type) with references

Pharmacokinetics and pharmacodynamics of the chosen drugs (Both chosen drugs)

Pharmacodynamics of the chosen drugs (Both chosen drugs)

Ethical considerations when treating patients with schizophrenia

Also include how ethical considerations might impact your treatment plan and communication with clients. Include references.

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