Thursday, December 12, 2019
Pharmacotherapy of Neuropsychiatric Symptom- myassignmenthelp
Question: Write about thePharmacotherapy of Neuropsychiatric Symptom. Answer: Discuss the key interpersonal skill sets you will use to engage with Andrew In the presented clinical scenario, the graduate nurse requires utilizing interpersonal skills for effectively engaging with the patient. Nurse professional needs to communicate with the patient in a manner for establishing the pattern of interpersonal relatedness. The subjective analysis of patients mental disruption is highly necessary by the registered nurse with the systematic utilization of her past interpersonal experiences of similar situations (Ratcliffe, 2015). The nurse professional requires empowering the thought process of the treated patient and includes him in the process of shared medical decision-making. The process of shared decision-making would assist in improving the adherence of the patient to the recommended treatment regimen as well as care taking strategies requiring administration in the 24-hours clinic (Mahone, Maphis, Snow, 2016). The nurse professional also requires administering interpersonal communication with the objective of understanding the psyche a nd ego state of the mentally ill patient for the configuration of effective healthcare strategies. The planning and administration of qualitative rehabilitative interventions by the nurse professional for the mentally unstable patient warrant the thorough analysis of his problem-solving ability, wisdom, learning capacity, integrity, a desire for justice, self-confidence, listening skills and collaborative capacity by the nurse physician. This analysis requires the administration of evidence-based cognitive approaches for improving the pattern of engagement of the nurse professional with the treated patient (Ertem Kececi, 2016). The nurse professional should actively engage the family members of the patient in the process of his psychosocial care and educate him for acquiring the pattern of optimism, positive attitude and self-esteem. The improvement in the pattern of engagement of the nurse professional with the treated patient requires the thorough understanding of his psychotic m anifestations and disturbed thought process. The nurse professional should attempt to challenge the pattern of patients habitual thinking with the systematic utilization of subjective experiences and reasoning approaches. The effective mitigation of patients habitual thought process would assist in the development of self-management, problem solving and coping capacity across the community environment. Resultantly, the patient would systematically overcome the psychosocial manifestations and acquire a stable mental state. The nurse professional in the presented clinical scenario needs to track and record patients socio-emotional status, evaluate his individualized perspectives, executive capacity, memory, concentration and attention span as well as the extent of socialization through the administration of various cognitive exercises. The effective evaluation of the psychosocial challenges experienced by the patient would assist in improving the pattern of his vocational functioning and community adjustment (Chien, Leung, Yeung, Wong, 2013). The doctor stated that Andrew has symptoms of a psychosis. Using correct clinical terms and the clinical cues in the scenario, discuss three important signs and symptoms that support the doctors opinion The behavioural deviation of the patient and disruption in the thought process and perception indicates the development of psychosis (NCCMH, 2014). Evidence-based clinical literature reveals the adverse implications of psychosis on the pattern of perception, thoughts and psychological attributions of the treated patient (NCCMH, 2014). In the presented clinical scenario, the patient exhibits manifestations of thought disorder, hallucinations and delusions (Gaebel, 2015). The pattern of disorganized thought process of the patient is evidenced by his inappropriate interpretation of the external environment. The patient shares his fear of attack from the external non-living objects and apprehends an intrusion into his brain through technological intervention. This psychosocial abnormality indicates patients adverse psychomotor behaviour leading the development of negative mental symptoms. The misidentification of facts by the patient is rationally evident by the presented case scenario. The patient suspects discussions between his fellow students and lecturer that are undertaken with the objective of creating hindrances and troubles in his day-to-day routine. These misidentified thought processes of the patient evidently indicate the development and progression of psychotic disorder (Arciniegas, 2015). The altered sensations experienced by the patient results in the development of hallucinations that substantially increases the level of his psychological stress and associated mental manifestations (Chaudhury, 2010). The clinical findings in (Waters, et al., 2014) describe the pattern of hallucinations in terms of visual illusions experienced by the patient under the influence of external stimulus. The psychotic patient fails to normally perceive the stimulus and misinterprets the same thereby leading to the development of psychosocial complications. The patient in the presented clinical scenario also experiences auditory hallucinations that make him feel the presen ce of other people in his immediate surroundings even when he stands isolated in the closed room. These auditory hallucinations are indicative of perceptual problems that prevalently occur in the psychotic patients. The pattern of hallucinations experienced by the patient predisposes him towards the development of depression and associated neurodegenerative manifestations (Opjordsmoen, 2014). The pattern of delusional manifestations experienced by the patient is associated with the idiosyncratic beliefs that remain unaltered in the absence of interactive interventions by the nursing professional. The tendency of misjudgement and misinterpretation of the patient is indicative of the development of psychosis manifestations (Opjordsmoen, 2014). The patient also has trouble in socializing under the influence of psychosis that adversely influences his mental health and associated wellness outcomes. The psychotic patient also experiences an elevated risk of acquiring suicidal and homicida l tendency across the community environment. Andrew asks you why he has a prescription for medication. Briefly discuss how you would respond Risperidone is prescribed to the patient with the objective of effectively controlling the progression of his psychotic manifestations (THA, 2017). Nurse professionals need to explain the psychotic patient regarding the effectiveness of Risperidone in controlling mental health adversities related to the manic as well as psychotic episodes. The nurse requires describing the potential influence of pharmacotherapy on the systematic mitigation of dissociative psychotic manifestations. The concomitant administration of prescription management approaches with psychotherapy is highly warranted in the context of controlling the pattern of auditory hallucinations experienced by the psychotic patients (Gentile, Dillon, Gillig, 2013). The antipsychotic prescription assists in controlling the co-morbid mood symptoms as well as the pattern of anxiety that could result in the development of psychotic disassociation. The mood stabilization and depression control of the psychotic patient are essent ially required and made possible with the administration of prescription medication approaches. Risperidone evidentially decreases the predisposition of the treated patient in terms of experiencing a relapse of the psychotic manifestations. The compliance with the prescribed treatment regimen will not only control the adverse mental manifestations of the psychotic patient, but also enhance his confidence and desire in overcoming the psychosocial complications through effective medical management. Evidence-based clinical literature emphasizes the requirement of administering cognitive behavioural as well as pharmacotherapy interventions for stabilizing the negative mental symptoms associated with psychotic disorder (Nordentoft Austin, 2014). The absence of prescription medication might aggravate the psychosocial symptoms that would intensely destabilize the mental health of the treated patient. The pattern of neuropsychiatric symptoms (including mood disturbances and apathy) require s the administration of antipsychotic drugs with the objective of decreasing patients risk of developing agitation as well as suicidal/homicidal ideation (Casey, 2015). The administration of prescription management approaches to the psychotic patient would also decrease his psychological resistance against the positive reinforcement strategies requiring administration for controlling the adverse psychosocial outcomes. The overall decrease in the pattern of hallucinations, delusions, anxiety and depression after the administration of medication intervention would potentially elevate the positive influence of psychiatric and rehabilitative approaches on the mental health of the psychotic patient. This will also stabilize the disfigured thought process of the patient and reduce his predisposition towards acquiring destructive tendencies and associated health adversities across the community environment. The administration of medication prescription will improve the pattern of professio nal collaboration between the psychotic patient and the nurse professional. This regular association would also assist in mitigating the intensity of psychotic exacerbation and associated depressive episodes. The GP has requested Andrew is informed and carefully monitored over the next few weeks. Briefly discuss your plan The registered nurse professional requires safeguarding patients integrity and ascertain the administration of appropriate safety measures warranted for reducing the risk of occurrence of self-inflicted harm to the treated patient. The nurse also requires tracking and monitoring the individualized requirements of the psychotic patient and assist him in accomplishing the basic healthcare needs. The psychotic symptomatology elevates patients risk of experiencing trauma and associated complications. The nurse professional requires undertaking preventive interventions in the context of reducing patients predisposition towards acquiring trauma across the community environment. The responsibilities, obligations and rights of the psychotic patient require effective preservation while administering psychotherapeutic treatment interventions. The nurse professional requires actively undertaking the process of personal care of the treated patient and assist him in accomplishing the activities o f daily living. The administration of an effective culturally appropriate therapeutic communication is highly necessary in the context of improving the trust and confidence of the psychotic patient on the recommended treatment regimen (Bhui, et al., 2015). The configuration of patients trust with the nurse professional assists in improving the pattern of his compliance to the administered prescription medication. The nurse professional needs to continuously monitor and adjust the dosage of the therapeutic regimen with the objective of reducing the risk of development of deleterious psychological effects on the treated patient. The regular monitoring of patients endocrine functionality, sleep physiology and sensory perception is highly necessary for tracking the progression of co-morbid states. The nurse professional needs to ascertain the administration of quieting and relaxing interventions prior to bedtime with the objective of facilitating the pattern of sleep and rest of the tre ated patient. The systematic reorientation of the psychotic patient in accordance with the time and place is required in the context of improving his reality-contact with the identification of time, people and surroundings. The nurse professional requires tracking the development of integrative dysfunction, sensory deficits, emotional impairment and hostility feelings in the treated patient for reducing the risk of developing psychosocial deterioration (Schultz Videbeck, 2009, pp. 177-180). The nurse professional requires administering periodic education sessions to the treated patient with the objective of improving the knowledge of the treated patient in relation to the adverse implications of psychotic episodes. Enhancement of patients self-awareness pattern would radically improve his self-esteem, self-sufficiency and associated psychosocial outcomes across the community environment. The regular administration of follow-up nursing care sessions with the psychotic patient is hig hly required for developing the pattern of coping skills warranted for overcoming the adverse psychotic symptomatology. The nurse professional requires redefining the behavioural constraints of the psychotic patient in the context of utilizing the external control approaches warranted for the systematic enhancement of wellness outcomes across the community environment. References Arciniegas, D. B. (2015). Psychosis. Continuum - Lifelong Learning in Neurology, 715-736. doi:10.1212/01.CON.0000466662.89908.e7 Bhui, K. S., Aslam, R. W., Palinski, A., McCabe, R., Johnson, M. R., Weich, S., . . . Szczepura, A. (2015). Interventions to improve therapeutic communications between Black and minority ethnic patients and professionals in psychiatric services: systematic review. The British Journal of Psychiatry, 207(2), 95-103. doi:10.1192/bjp.bp.114.158899 Casey, D. A. (2015). Pharmacotherapy of Neuropsychiatric Symptoms of Dementia. Pharmacy and Therapeutics, 40(4), 284-287. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378522/ Chaudhury, S. (2010). Hallucinations: Clinical aspects and management. Industrial Psychiatry Journal, 19(1), 5-12. doi:10.4103/0972-6748.77625 Chien, W. T., Leung, S. F., Yeung, F. K., Wong, W. K. (2013). Current approaches to treatments for schizophrenia spectrum disorders, part II: psychosocial interventions and patient-focused perspectives in psychiatric care. Neuropsychiatric Disease and Treatment, 1463-1481. doi:10.2147/NDT.S49263 Ertem, M. Y., Kececi, A. (2016). Ego States of nurses working in psychiatric clinics according to transactional analysis theory. Pakistan Journal of Medical Sciences, 32(2), 485-490. doi:10.12669/pjms.322.9426 Gaebel, W. (2015). Focus on psychosis. Dialogues in Clinical Neuroscience, 17(1), 9-18. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4421906/ Gentile, J. P., Dillon, K. S., Gillig, P. M. (2013). Psychotherapy and Pharmacotherapy for Patients with Dissociative Identity Disorder. Innovations in Clinical Neuroscience, 10(2), 22-29. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615506/ Mahone, I. H., Maphis, C. F., Snow, D. E. (2016). Effective Strategies for Nurses Empowering Clients With Schizophrenia: Medication Use as a Tool in Recovery. Issues in Mental Health Nursing, 372-379. doi:10.3109/01612840.2016.1157228 NCCMH. (2014). Psychosis and Schizophrenia in Adults: Treatment and Management. United Kingdom: National Institute for Health and Care Excellence. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK333029/ Nordentoft, M., Austin, S. (2014). CBT for psychotic disorders: beyond meta-analyses and guidelines it is time to implement! World Psychiatry, 13(3), 260-261. doi:10.1002/wps.20164 Opjordsmoen, S. (2014). Delusional Disorder as a Partial Psychosis. Schizophrenia Bulletin, 40(2), 244-247. doi:10.1093/schbul/sbt203 Ratcliffe, M. (2015). The interpersonal world of psychosis. World Psychiatry, 176-178. doi:10.1002/wps.20208 Schultz, J. M., Videbeck, S. L. (2009). Lippincott's Manual of Psychiatric Nursing Care Plans. Philadelphia: Wolters Kluwer Health|LWW. THA. (2017). Risperidone (By injection). Retrieved from https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0012013/?report=details Waters, F., Collerton, D., Ffytche, D. H., Jardri, R., Pins, D., Dudley, R., . . . Lari , F. (2014). Visual Hallucinations in the Psychosis Spectrum and Comparative Information From Neurodegenerative Disorders and Eye Disease. Schizophrenia Bulletin, 40(4), S233S245. doi:10.1093/schbul/sbu036
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