Strategies in Managing Patient's Medication

Please respond to the discussion below. please provide new information. Thank you.

Professor and class,

Tate is a 30-year-old client. When he was 16, he was in foster care and began to show signs of the prodromal symptoms of schizophrenia. At 17, he began to experience hallucinations and delusions. He was hospitalized for treatment where he was diagnosed with schizophrenia and treated with risperidone which was effective in managing his symptoms. At 18, he graduated from high school and aged out of foster care leaving him with no support system. He did not have consistent housing and frequently stayed with friends and acquaintances. Over the next few years, he was hospitalized with several acute psychotic episodes. Following the most recent episode, he was prescribed olanzapine 15 mg. He adheres to his treatment regimen when he can find transportation to the community clinic, but he sometimes runs out of medication. He self-medicates with alcohol to “make the voices be quiet.”
Tate has no college or vocational training. He occasionally works odd jobs but lacked steady employment. He receives a small amount of supplemental security income, food assistance, and his health care is provided via Medicaid. He lacks the social and cognitive skills to obtain consistent employment and housing without assistance.

Application of Course Knowledge

Discuss how the psychiatric mental health nurse practitioner could assist the client in the creation of a more viable medication management plan. When a diagnosis of schizophrenia is made, there should be strategies to prevent relapse of medications in place. This treatment plan should stay active after the first episode and last up to 2 years. It may be beneficial for the treatment plan to be simplified to help the patients’ chances of adherence improve. The PMHNP can suggest the use of a pillbox for patients who have trouble remembering to take their medication. The PMHNP should employ behavioral interventions like behavioral modeling, skill building, reinforcement strategies, and practicing activities to help patients improve adherence to medication management. Treatment plans are to be adapted to the lifestyle, routine, and habits of the patient.

Write a prescription appropriate for the client with evidence support. According to the 2020 American Psychiatric Association Practice Guideline, other benefits of LAIs “include greater convenience as a result of needing to take fewer medications daily, and reduced conflict with family five first-generation antipsychotic LAIs (flupentixol, fluphenazine, haloperidol, pipotiazine, zuclopenthixol) and four second-generation antipsychotic LAIs (risperidone, paliperidone, olanzapine, and aripiprazole) are currently available” (Ifteni & Teodorescu, 2021). Haloperidol may be a great medication for this patient. This medication will not have the side effects of sedation and weight gain, although it may cause disorders of movement. Haldol will help control mood and thought.

Patient name DOB

Address Date

Haloperidol 50mg/ml

Inject 1 ml every 4 weeks by intramuscular route
Dispense: 1 ml
Refills: 0

TH
Identify housing and support resources available in your community that are relevant for this client. It is important to give these patients options, even if they do not wish to take these options. The National Alliance of Mental Illness has a website that can point the PMHNP to local places that may offer housing to patients who have severe mental illnesses. This site offers resources and education for patients and their families. There are support groups that the patient can join to meet other patients who are struggling to adhere to treatment for mental illness. There are also assisted living facilities that are catered to patients with mental illnesses all over the world. This is not always helpful for homeless patients who do not have support and that are not stable enough to see any kind of care. The PMHNP can also give out flyers to all the homeless shelters that include resources for people that come in and display mental illness.

Discuss how services provided via a mental health clubhouse model may benefit the client. Consider the effectiveness of the model according to research findings. The clubhouse is an environment provided for people dealing with severe mental disorders. These individuals may need support with their mental illness or help with their recovery. When people become members of a clubhouse, it allows them to have a circle of friends, more education, better job opportunities, and more family. These people are allowed the opportunity to enter the world with more support than ever.

Ifteni, P., & Teodorescu, A. (2021). Schizophrenia long-acting injectable antipsychotic initiation index: A clinician rated instrument for improving treatment in schizophrenia. https://doi(dot)org/10.21203/rs.3.rs-437463/v1Links to an external site.

Karakasi, V., Pavlidis, P., & Vlachaki, A. (2020). T167. qualitative differences in long acting injectable antipsychotic medications among schizophrenia patients. Schizophrenia Bulletin, 46(Supplement_1). https://doi(dot)org/10.1093/schbul/sbaa029.727

What are clubhouses? Clubhouse International. (2020). Retrieved March 7, 2023, from https://clubhouse-intl(dot)org/what-we-do/what-clubhouses-do/