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.
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.
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.
Note: All Stahl resources can be accessed through this link provided.
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.
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:
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
Document: Midterm Exam Study Guide (PDF)
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276.
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
Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: AuthorNote: This case study will serve as the foundation for this week’s Assignment.
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:
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:
Also include how ethical considerations might impact your treatment plan and communication with clients.
Note: Support your rationale with a minimum of three
academic resources. While you may use the course text to support your
rationale, it will not count toward the resource requirement.
To submit your completed Assignment for review and grading, do the following:
This exam will cover the following topics,
which relate to psychopharmacologic approaches to treatment for clients
across the lifespan:
Complete the Midterm Exam. Prior to starting the
exam, you should review all of your materials. There is a 2-hour time
limit to complete this 76-question exam. You may only attempt this exam
This exam is a test of your knowledge in preparation for your certification exam. No outside resources including books, notes, websites, or any other type of resource are to be used to complete this exam. You are expected to comply with Walden University’s Code of Conduct.
Now that you have:
Next week, you will build on your
assessment and treatment skills as you examine clients presenting for
therapy for pain and sleep/wake disorders.
To go to the next week:Week 7