NRNP 6675: PMHNP Care Throughout the Lifespan II
Week 5: Schizophrenia Spectrum and Different Psychotic Issues; Medicine-Induced Motion Issues
Two teams of signs discovered with schizophrenia spectrum and associated psychotic issues are “constructive” and “destructive” signs. Optimistic signs usually “add” and embody issues akin to delusions, hallucinations, and repetitive actions. Destructive signs usually “detract” and should embody problem exhibiting feelings, withdraw from social relationships, or apathy.
Whereas many issues outcome within the improvement of “constructive” signs, not all of those situations signify schizophrenia. When treating schizophrenia spectrum and different psychotic issues, place emphasis not solely on treating the constructive signs however the destructive and residual signs as nicely.
Medicine-induced motion issues, one instance of which is tremors, can stem from each leisure and therapeutic medicine, with dopamine receptor blocking medicine, akin to antipsychotic and antiemetics, being widespread causes. All these issues can vary from refined to deadly.
This week, you’ll discover all kinds of issues alongside the schizophrenia spectrum in addition to medication-induced motion issues.
Studying Aims
College students will:
Assess sufferers with schizophrenia, different psychotic, and medication-induced motion issues
Develop differential diagnoses for sufferers with schizophrenia, different psychotic, and medication-induced motion issues
Develop acceptable remedy plans for sufferers with schizophrenia, different psychotic, and medication-induced motion issues
Advocate well being promotion and affected person training methods for sufferers with schizophrenia, different psychotic, and medication-induced motion issues
Studying Assets
Required Readings (click on to develop/scale back)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For evaluation as wanted)
Chapter 7, “Schizophrenia Spectrum and Different Psychotic Issues”
Chapter 29.2, “Medicine-Induced Motion Issues”
Chapter 29.three, “α2-Adrenergic Receptor Agonists, α1-Adrenergic Receptor Antagonists: Clonidine, Guanfacine, Prazosin, and Yohimbine”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s baby and adolescent psychiatry (sixth ed.). Wiley Blackwell.
Chapter 43, “Pharmacological, Medically-Led and Associated Issues”
Chapter 57, “Schizophrenia and Psychosis”
Zakhari, R. (2021). The psychiatric-mental well being nurse practitioner certification evaluation handbook. Springer Publishing Firm.
Chapter 9, “Psychotic Issues and Delusions”
Doc: Targeted SOAP Word Template
Doc: Targeted SOAP Word Exemplar
Required Media (click on to develop/scale back)
PsychScene Hub. (2017, April 24). Motion issues with antipsychotic medicine – Conversations with Dr. Stephen Stahl [Video]. YouTube. https://www.youtube.com/watch?v=ipW5AcbFzzE
Vallejo, E. (2020). Sensible schizophrenia simulation [Video]. YouTube. https://www.youtube.com/watch?v=63lHuGMbscU
Walden College. (2021). Case examine: Sherman Tremaine. Walden College Blackboard. https://class.waldenu.edu
Accessible participant
Medicine Overview
Overview the FDA-approved use of the next medicines associated to treating schizophrenia-spectrum and different psychotic issues:
Psychosis Schizoaffective dysfunction
alprazolam (adjunct)
amisulpride
aripiprazole
asenapine
blonanserin
carbamazepine (adjunct)
chlorpromazine
clonazepam (adjunct)
clozapine
cyamemazine
flupenthixol
fluphenazine
haloperidol
iloperidone
lamotrigine (adjunct)
lorazepam (adjunct)
loxapine
lurasidone mesoridazine
molindone
olanzapine
paliperidone
perospirone
perphenazine
pimozide
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone perospirone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Schizophrenia Cataplexy syndrome Catatonia Extrapyramidal unintended effects
amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone
perospirone perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol
Seasonal affective dysfunction
bupropion
Sedation-induction
hydroxyzine
midazolam clomipramine
imipramine
sodium oxybate alprazolam
chlordiazepoxide
clonazepam
clorazepate
diazepam
estazolam
flunitrazepam
flurazepam
loflazepate
lorazepam
midazolam
oxazepam
quazepam
temazepam
triazolam benztropine
diphenhydramine
trihexyphenidyl
Project: Targeted SOAP Word for Schizophrenia Spectrum, Different Psychotic, and Medicine-Induced Motion Issues
Psychotic issues change one’s sense of actuality and trigger irregular pondering and notion. Sufferers presenting with psychotic issues might undergo from delusions or hallucinations or might show destructive signs akin to lack of emotion or withdraw from social conditions or relationships. Signs of medication-induced motion issues could be gentle or deadly and might embody, for instance, tremors, dystonic reactions, or serotonin syndrome.
For this Project, you’ll full a centered SOAP word for a affected person in a case examine who has both a schizophrenia spectrum, different psychotic, or medication-induced motion dysfunction.
To Put together
Overview this week’s Studying Assets. Contemplate the insights they supply about assessing, diagnosing, and treating schizophrenia spectrum, different psychotic, and medication-induced motion issues.
Picture Credit score: Getty Photographs/Wavebreak Media
Overview the Targeted SOAP Word template, which you’ll use to finish this Project. There’s additionally a Targeted SOAP Word Exemplar offered as a information for Project expectations.
Overview the video, Case Examine: Sherman Tremaine. You’ll use this case as the premise of this Project. On this video, a Walden college member is assessing a mock affected person. The affected person might be represented onscreen as an avatar.
Contemplate what historical past could be needed to gather from this affected person.
Contemplate what interview questions you would wish to ask this affected person.
The Project
Develop a centered SOAP word, together with your differential prognosis and critical-thinking course of to formulate a main prognosis. Incorporate the next into your responses within the template:
Subjective: What particulars did the affected person present relating to their chief criticism and symptomology to derive your differential prognosis? What’s the period and severity of their signs? How are their signs impacting their functioning in life?
Goal: What observations did you make through the psychiatric evaluation?
Evaluation: Focus on the affected person’s psychological standing examination outcomes. What had been your differential diagnoses? Present a minimal of three potential diagnoses with supporting proof, and checklist them so as from highest precedence to lowest precedence. Examine the DSM-5 diagnostic standards for every differential prognosis and clarify what DSM-5 standards guidelines out the differential prognosis to search out an correct prognosis. Clarify the critical-thinking course of that led you to the first prognosis you chose. Embrace pertinent positives and pertinent negatives for the particular affected person case.
Plan: What’s your plan for psychotherapy? What’s your plan for remedy and administration, together with various therapies? Embrace pharmacologic and nonpharmacologic remedies, various therapies, and follow-up parameters, in addition to a rationale for this remedy and administration plan. Additionally incorporate one well being promotion exercise and one affected person training technique.
Reflection notes: What would you do in a different way with this affected person in case you may conduct the session once more? Focus on what your subsequent intervention could be in case you had been in a position to comply with up with this affected person. Additionally embody in your reflection a dialogue associated to authorized/moral concerns (exhibit vital pondering past confidentiality and consent for remedy!), well being promotion, and illness prevention, considering affected person components (akin to age, ethnic group, and so forth.), PMH, and different threat components (e.g., socioeconomic, cultural background, and so forth.).
Present not less than three evidence-based, peer-reviewed journal articles or evidenced-based pointers that relate to this case to assist your diagnostics and differential diagnoses. Make certain they’re present (not more than 5 years outdated).
By Day 7 of Week 5
Submit your Targeted SOAP Word.
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