Assess client factors and history to develop personalized plans of antipsychotic therapy for clients

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PLAGIARISM MUST BE LESS THAN 10%

sychosis 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

 

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
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

How should the nurse respond to Abby’s mother when she asks if Abby has epilepsy?

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CASE STUDIES

I- Case Study: Care of the Child in Inpatient and Outpatient Settings

Jordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours.

Subjective Data

  • Nausea and vomiting for 24 hours
  • Has not voided today
  • Unable to tolerate oral fluids

Objective Data

  • Vital signs: T 37.8° C, P 120, R24, BP 110/60
  • Weight: 34 kg
  • Hyperactive bowel sounds to auscultation

1. Question 1

When should the discharge teaching begin for Jordan and his family?

2. Question 2

What is the best way to approach Jordan regarding the IV that has been ordered.

3. Question 3

What would be good distractions for a child of Jordan’s age?

II- Case Study: Pediatric Cancer

Mario is a 7-year-old male who presents with a 1-week history of body aches and pallor. He has a 2-day history of fever to 103° F and a 1-day history of bruising and lethargy.

Subjective Data

  • Complains of hurting all over
  • States he feels very tired
  • States he feels dizzy when he stands up

Objective Data

  • Weight 26.1 kg
  • Vital signs: T 38.9° C, P 140, R 40, BP 108/54, O2 sat 100%
  • Purpural rash on extremities
  • WBC 0.7
  • HGB 3.1
  • Hct 8.5
  • Plt .08
  • ANC 0.1

4. Question 1

Which of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction?

5. Question 2

What testing is required for a definitive diagnosis of meningitis?

6. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

III-  Case Study: Pediatric Respiratory System

Will is a 4-month-old infant born at 34 weeks of gestation. Will’s mother states that he has not been able to go to day care because he has been coughing with a fever for the past 3 days. She states today he is unable to feed well from the bottle because of nasal secretions.

Subjective Data

  • Mother complains that infant has had cough for 3 days
  • Mother states that infant is having trouble sleeping
  • Not voided in past 6 hours

Objective Data

  • Birth Weight: 1.9 kg
  • Today’s Weight: 5.5 kg
  • Vital Signs: T 38° C, P 186, R 60, BP 90/52, Pulse Oximetry 93%
  • Thick yellow nasal secretions
  • Nasal flaring with moderate intercostal retractions
  • Breath sounds decreased with crackles bilaterally to auscultation

7. Question 1

What risk factors does Will have for contracting bronchiolitis?

8. Question 2

What is the first priority for Will’s treatment?

9. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

IV-  Case Study: Pediatric Gastrointestinal System

Lucy is a 44-day-old formula-fed infant who presents with a 4-day history of vomiting.

Subjective Data

  1. Mother states infant has been vomiting undigested formula after feedings
  2. Mother states that infant has not had fever or diarrhea
  3. Mother states that infant has had 8 wet diapers in the past 24 hours

Objective Data

  1. Weight 4.8 kg (birth weight 3.5 kg)
  2. Vital signs: T 37.1° C (rectal), P 130, R 30, BP 92/52
  3. Mucous membranes moist, anterior fontanel flat and soft
  4. Awake and alert, lusty cry
  5. Good muscle tone
  6. Olive-sized mass palpated at epigastrium

10. Question 1

What test will be used to diagnose pyloric stenosis?

11. Question 2

What should the nurse do in this clinical situation? Using the case study above, the first prioritization step the nurse would take is ____.

12. Question 3

The second prioritization step the nurse would take is ____.

13. Question 4

The third prioritization step the nurse would take is ____.

14. Question 5

The fourth prioritization step the nurse would take is ____.

15. Question 6

The fifth prioritization step the nurse would take is ____.

16. Question 7

The sixth prioritization step the nurse would take is ____.

17. Question 8

The seventh prioritization step the nurse would take is ____.

18. Question 9

The eighth prioritization step the nurse would take is ____.

V- Case Study: Pediatric Cardiovascular System

Michael is a 7-week-old breastfed infant who presents with a 2-day history of irritability and poor feeding.

Subjective Data

  • Mom states patient has been “fussy” for past 2 days
  • Only feeds for a “few” minutes at a time
  • Breathing heavily and fast for 2 days

Objective Data

  • Weight: 4.8 kg
  • Vital Signs: T 36.8° C, P 250, R 65, BP 84/58
  • Breath sounds clear to auscultation
  • Oxygen Saturation 95%
  • Central capillary refill 4 sec

19. Question 1

What is the treatment for an unstable patient with SVT?

20. Question 2

Decreased cardiac output from prolonged SVT will produce what complication?

21. Question 3

In this clinical situation what should the nurse do? Prioritize actions.

VI-  Case Study: Hematologic System

Liam is an 8-year-old male with a history of hemophilia. Liam presents today with a 1-day history of right elbow pain.

Subjective Data

  • Right elbow pain for 1 day
  • Patient states he hit his right elbow on desk yesterday
  • Patient complains that he cannot move his elbow

Objective Data

  • Weight 31.6 kg
  • Vital sighs: T 37.4° C, P 82, R 20, BP 108/68
  • Rates pain 6 on scale of 10

22. Question 1

How should the nurse respond when Liam’s father explains that they watched and waited to see if Liam needed treatment after his injury?

23. Question 2

Why are neuro checks an important part of Liam’s physical exam?

24. Question 3

What should the nurse do in this clinical situation? Prioritize actions.

VII- Case Study: Common Disorders of the Red Blood Cells

Susan is a 26-year-old G1P0 at 6 weeks of gestation with type 2 diabetes. Her BMI is 32. Her hemoglobin A1C is 9. She uses glyburide 10 mg PO daily. The physician has switched her to insulin at this time.

1. Question 1

What is the nursing priority at this time?

2. Question 2

What should Susan be taught about insulin needs during pregnancy?

3. Question 3

What additional risk factor does Susan have?

4. Question 4

How should Susan be counseled regarding weight gain in pregnancy?

5. Question 5

What advice can be given to Susan regarding exercise?

VIII-  Case Study: Pediatric Genitourinary System

Lilly is a 3-year-old female who presents with complaints of abdominal pain and fever since yesterday.

Subjective Data

  • Complains of lower abdominal pain
  • Fever for 24 hours
  • Lilly has ‘wet her pants’ despite being recently potty trained

Objective Data

  • Vital signs: T38.5° C, P 114, R 32, BP 104/62
  • Urine positive for WBCs, nitrites, blood

6. Question 1

What risk factors does Lilly have for UTI?

7. Question 2

What might prevent Lilly from a recurring UTI?

8. Question 3

What should the nurse do in this situation? Prioritize actions.

IX-  Case Study: Pediatric Neurologic System

Abby is a 1-year-old female who presents after a reported seizure at day care.

Subjective Data

  • Fever for 1 hour
  • Eating and drinking normally per mother

Objective Data

  • Vital signs: T 40° C, HR 160, R 44, BP 104/68
  • Awake and alert
  • Skin hot to touch, otherwise normal physical examination

9. Question 1

How should the nurse respond to Abby’s mother when she asks if Abby has epilepsy?

10. Question 2

How should the nurse respond to Abby’s mothers question about brain damage?

11. Question 3

In this clinical situation what should the nurse do?

Describe the influence of Roy’s Theory in guiding the nurse’s actions in promoting Sgt. Johns adjusted self-concept.

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Part One: 

Neuman Systems Models is a flexible and adaptive model which can be applied to various aspects of nursing disciplines. Today, the model is used globally as a nursing conceptual model to guide curriculum development, research studies, and clinical practice in the full array of health-care disciplines.

Define a nursing practice area where you could apply Neuman Systems Model. What patient population would you target? How would you use this model to guide best practices? How would nursing outcomes be determined? Use at least one current research article related to your practice example.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook.

Part Two: 

Create a Power Point Presentation to discuss the following

Sgt. Eddie Johns leaned back against the chair in the outpatient orthopedic clinic. His head was killing him! He wasn’t sure which was worse, the “morning after” headache or not being able to sleep at night. At least when he had a few beers under his belt so he could catch a few hours of sleep. It had been like this since he was air evacuated back stateside from Afghanistan after the roadside bomb went off. He was thankful that he had only broken his leg in a couple of places and gotten a bad bump on the head. They called that traumatic brain injury but he didn’t know what that was and really didn’t believe them anyway. He was still thinking just fine. His friend Joe wasn’t so lucky! How was Joe going to learn to walk on those artificial legs? He was still in the hospital in Washington, DC. That was pretty far from his home. Eddie wished he could visit Joe. They had been in the same platoon for 9 months. But, Eddie was glad that he had been able to come back to his own home town for outpatient treatment. It took an hour to get here but at least he could see his girl almost every day. Sure he had moved back in with his mom but it was easier to have someone to help him get around and cook for him. It was a bummer that he couldn’t work right now. He guessed it didn’t matter much since he really didn’t have a job to go back to. He had been replaced at the plant. They said they would find something for him to do once he could get around more easily. Eddie sure hoped the doc would take the pins out of his leg today and give him a clearance to work.

  • How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns?
  • Describe the influence of Roy’s Theory in guiding the nurse’s actions in promoting Sgt. Johns adjusted self-concept.
  • From the perspective of the Roy Adaptation Model, why is it important for the nurse to listen to Sgt. Johns’ “story” in his own words and not just base her interactions on information from the chart, fellow colleagues, or his family?
  • Based on Neuman System’s Model, identify at least 4 stressors from the case study. Create a plan of care based on Neuman Systems Model for Sgt. Johns.

Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies.

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Describe the effect of extremely low birth weight babies on the family and community. Consider short-term and long-term impacts, socioeconomic implications, the need for ongoing care, and comorbidities associated with prematurity.

Explain how disparities relative to ethnic and cultural groups may contribute to low birth weight babies.

Identify one support service within your community to assist with preterm infants and their families and explain how the service adequately addresses the needs of the community, or a population in your community. Provide the link to the resource in your post.

Consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart).

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.