Week 6: Antipsychotic Therapy

According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients.

This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.

Photo Credit: Ingram Publishing/Getty Images

Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia

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.

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

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

 

Note: All Stahl resources can be accessed through the Walden Library using this link. This link will take you to a log-in page for the Walden Library. Once you log into the library, the Stahl website will appear.

 

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

 

To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.

·         Chapter 4, “Psychosis and Schizophrenia”

·         Chapter 5, “Antipsychotic Agents”

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

 

To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication.

 

Review the following medications:

• amisulpride
• aripiprazole
• asenapine
• chlorpromazine
• clozapine
• flupenthixol
• fluphenazine
• haloperidol
• iloperidone
• loxapine
• lurasidone

• olanzapine
• paliperidone
• perphenazine
• quetiapine
• risperidone
• sulpiride
• thioridazine
• thiothixene
• trifluoperazine
• ziprasidone

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002

Note: Retrieved from Walden Library databases.

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

Note: Retrieved from Walden Library databases.

 

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

 

Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting

 

Required Media

 

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

 

Note: This case study will serve as the foundation for this week’s Assignment.

 

Optional Resources

Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2

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

Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2

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.

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 yo

• Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the paper.
• Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.
• Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.
• Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.

The reason that I have decided to continue my education was that it was always part of the plan. I just recently graduated from an ADN program at the end of 2018 and passed the dreaded NCLEX. The next step was to decided on which RN to BSN school and format to go with and obviously I went with GCU. The reason that BSN was always part of the plan is because I do not want to be limited in job prospects in the future.  Graduating with  a baccalaureate degree from university has been something that I have always wanted to do for the sense of accomplishment.

The concerns that I have for completing the program are the unknown. This is my first online class so I don’t know exactly what to expect, you don’t know what you don’t know. Another concern that I have is the load and or time management aspect of it all. Dealing with completing assignments and starting as a new grad nurse.

In the course materials section their is a blog post by Philip Murphy in which he list out 7 habits for being a student nurse. I believe that to be successful in any program or on an even broader setting for completeing any goals these are tools for success. I also think that one has to make these tools their own take ownership. A little experimentation to apply the concepts in the post to your specific life will yield greater results than just following some generic tips. I will personally probably end up using several different strategies in a some sort of combination but will adjust and modify them until they fit my personal life.

ssignment: The Nurse Leader as Knowledge Worker

The term “knowledge worker” was first coined by management consultant and author Peter Drucker in his book, The Landmarks of Tomorrow (1959). Drucker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services. Does this sound familiar?

Nurses are very much knowledge workers. What has changed since Drucker’s time are the ways that knowledge can be acquired. The volume of data that can now be generated and the tools used to access this data have evolved significantly in recent years and helped healthcare professionals (among many others) to assume the role of knowledge worker in new and powerful ways.

In this Assignment, you will consider the evolving role of the nurse leader and how this evolution has led nurse leaders to assume the role of knowledge worker. You will prepare a presentation with an infographic to educate others on the role of nurse as knowledge worker.

Reference: Drucker, P. (1959). The landmarks of tomorrow. New York, NY: HarperCollins Publishers.

To Prepare:

Review the concepts of informatics as presented in the Resources.

Reflect on the role of a nurse leader as a knowledge worker.

Consider how knowledge may be informed by data that is collected/accessed.

The Assignment:

Explain the concept of a knowledge worker.

Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.

Develop a simple infographic to help explain these concepts.

NOTE: For guidance on infographics, including how to create one in PowerPoint, see “How to Make an Infographic in PowerPoint” as presented in the Resources.

Present the hypothetical scenario you originally shared in the Discussion Forum( the answer of the discussion question is attached bellow in a document). Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ replies.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

• Chapter 1, “Nursing Science and the Foundation of Knowledge” (pp. 7–19)

• Chapter 2, “Introduction to Information, Information Science, and Information Systems” (pp. 21–33)

• Chapter 3, “Computer Science and the Foundation of Knowledge Model” (pp. 35–62)

24Slides. (2018). How to make an infographic in PowerPoint. Retrieved September 27, 2018, from https://24slides.com/presentbetter/how-make-infographic-powerpoint/

Nagle, L., Sermeus, W., & Junger, A. (2017). Evolving role of the nursing informatics specialist. In J. Murphy, W. Goossen, & P. Weber (Eds.), Forecasting Competencies for Nurses in the Future of Connected Health (212–221). Clifton, VA: IMIA and IOS Press. Retrieved from https://serval.unil.ch/resource/serval:BIB_4A0FEA56B8CB.P001/REF

Sweeney, J. (2017). Healthcare informatics. Online Journal of Nursing Informatics, 21(1).

Note: You will access this article from the Walden Library databases.

Required Media

Laureate Education (Producer). (2018). Health Informatics and Population Health: Trends in Population Health [Video file]. Baltimore, MD: Author.

 

Accessible player

Public Health Informatics Institute. (2017). Public Health Informatics: “translating” knowledge for health [Video file]. Retrieved from https://www.youtube.com/watch?v=fLUygA8Hpfo.

 

NOTE: CHECK EVERY DOCUMENT ATTCHED BELLOW TO COMPLETE THE ASSIGNMENT.  Check the assignment for plagiarism

The benchmark assesses the following competency:

Benchmark: 5.1. Understand the human experience across the     health-illness continuum.

Research the health-illness continuum and its relevance to patient   care. In a 750-1,000 word paper, discuss the relevance of the   continuum to patient care and present a perspective of your current   state of health in relation to the wellness spectrum. Include the following:

1. Examine the health-illness continuum and discuss why this     perspective is important to consider in relation to health and the     human experience when caring for patients.
2. Reflect on your     overall state of health. Discuss what behaviors support or detract     from your health and well-being. Explain where you currently fall on     the health-illness continuum.
3. Discuss the options and     resources available to you to help you move toward wellness on the     health-illness spectrum. Describe how these would assist in moving     you toward wellness (managing a chronic disease, recovering from an     illness, self-actualization, etc.).

Prepare this assignment according to the guidelines found in the APA   Style Guide. An abstract or thesis is required.