Question:

The following clinical scenario allows you to provide an essay-style response for each of the four question.Four short essay question:

Discuss the key interpersonal skills you will need to interact with Andrew.

Andrew’s symptoms were described by the doctor as psychosis.

Discuss the following signs and symptoms using correct clinical terms.

Andrew asks why Andrew has a prescribed medication.

Please discuss briefly your responses.

Andrew was asked by his GP to be kept informed and monitored closely over the next few week.

Let’s talk briefly about your plan.Clinical Scenario:

As a graduate nurse, you will be working in a small multidisciplinary team within a large 24-hour clinic.

Andrew was referred from the university counseling service.

Andrew is a 21-year-old student studying Law at University.

The Counsellor refers to a noticeable change in his behaviour, as well as a drop in his academic performance for this semester.

At the request of your GP, you are allowed to participate in the appointment interview.

Andrew tells a few stories that are unrelated but plausible about ASIO spying at universities.

He also refers, among other things, to technology such a transmitter chip inserted into his brain in order to monitor his thoughts.

He continues to discuss other evidence of conspiracy against him, including different electrical objects being moved around his apartment, as well as lights outside his home being used to interfere with his thoughts.

According to him, other students had been discussing his activities in order to get him into trouble.

Andrew sits in his chair calmly and maintains a flat monotone voice throughout the interview.

Listening to his story and watching him move around, you’ll notice that he looks at you often as if searching for something.

When you ask him about it, he says that he hears them talking about himself.

There is nobody else in the room.

He stated that he can see other people talking about himself.

He is certain they are real people and doesn’t even know who they might be.

Andrew receives a general health check from the GP. He is then informed that he has psychosis symptoms.

The GP supplies a script for risperidone 0 mg nocte.

Andrew’s GP informs him that he is concerned about Andrew’s health and suggests that he be monitored for the following weeks.

Andrew must be able access information and support in order to set up his next appointment.

Answer to Question: NUR219 Mental Health Nursing

Andrew is my partner in interpersonal relationships.

Interpersonal communication describes an interaction between two people where they express their emotions, thoughts and feelings (Patrick, Catherine, 2015).

It requires the participation of all parties and good skills.

For psychotic patients, appropriate gestures and intonation are essential (David 2013).

As such, I will have a lot of difficulty expressing these skills.

The tone of the conversation will be caring and empathic (Patrick & Catherine 2015.

This will make it easy to get the patient’s attention.

By expressing care through my voice, he will be able express himself verbally as well.

When I ask and answer questions, I can use an empathic tone to help him see the situation and his behavior.

To take an example, I sympathize that he has a series of loosely connected and unlikely stories about ASIO spies.

This will allow me articulate and comprehend his psychotic disorder.

My intonation is positive and optimistic (Cleary Hunt Horsfall, Deacon, & Deacon 2012.

Positive intonation in conversation with Andrew will show him that I am a person who wants the best for him, especially when it comes to his mental disorder.

Andrew will feel free to express his feelings without being constrained, conscious and subconsciously.

Because he will feel loved and safe.

So, this will enable me to fully understand his condition.

This will most importantly have some therapeutic impact in it (Tania Claude & Til (2016)).

This implies that it will help him recover by inducing the desire within him to overcome it.

My gestures, such as my posture, eyecontact, and facial expressions, will communicate encouragement, support, respect and support (Patrick & Catherine 2015).

In the same way, gestures should generate interest and engagement in patients (Rebekka Margret Peter Rolf Roland 2011).

This will make him feel more connected and motivated to speak his mind and be open to criticism.

He will feel supported and encouraged to persevere in his fight against the disorder and eventually overcome it.

The support gesture will inspire him to keep fighting the condition.

Facial expressions and eye contact that convey respect will also help him to see that I understand his condition.2.

Andrew was diagnosed with psychosis by the doctor.

Discuss the following signs and symptoms using correct clinical terms. (400 words)`

A common sign of psychosis, is trouble concentrating (Heckers, Heckers, and others, 2013).

As you can see, Andrew is struggling to concentrate on our conversation.

Andrew looks at the world around him, sometimes even past me, when we talk. This is a sign that he is trying to find something.

This means that he doesn’t pay much attention to what is being discussed about his condition.

It is clear that he is a psychotic individual who needs rehabilitation and pharmacological treatment.

Hallucinations can also be experienced by psychotic patients (Bentall Wickham Shevlin, Varese & Varese, 2012).

They describe the state in which an individual hears or sees things that are not there.

The severity of psychosis will affect how different types of hallucinations are experienced by each patient.

The auditory hallucination, which is common in patients with psychotic disorders, is the most common form of hallucination. (Schimmelmann Walger, and Schultze (2013)

It is typically characterized by the perception of voices in the ears that are not real.

He tells me, for example, that he can sometimes hear people talking to him.

This is a clear sign that he is dreaming of imaginary people conversing about him.

This is despite only being two of us in that room.

Visual hallucination, another type of hallucination, is also common in psychotic patients (Schimmelmann Walger and Schultze, 2013,).

It is a way of seeing things that are not there.

The scenario shows that he is certain that there are actually other people in the room talking about him. However, he does not know the identity of these people.

Persecutory Delusions, which describe the feeling that an individual is constantly under surveillance, are a manifestation psychotic condition.

This is often a false belief that one’s being monitored constantly by a third person.

Andrew, for instance, describes evidence of a conspiracy to him as ‘the lights around his unit being manipulated in order to alter he thoughts’.

He also discusses how electrical items were being moved around the apartment to keep him under watch.

According to him, all of these are meant to monitor his apartment and alter his thinking.3.

Andrew asks you to explain why he has a prescribed medication.

Briefly, explain your answer. (400 words)`

Charles, 2012 states that the level of psychosis in a patient should determine the appropriate pharmacological intervention.

To be able to advise the patient on the most appropriate pharmacological treatment and rehabilitation steps, it is crucial that the General Practitioners conduct a complete analysis of the patient’s psychosis.

This is because each individual’s situation can be different.

Patients with psychotic symptoms must be treated by antipsychotic medications. This is one of the most important principles (Harsh & Kiki (2012).

As such I would explain to him the need to take the 1mg of risperidone nocte. This is a necessary requirement for patients with psychotic symptoms such as his.

I would like to remind him that the prescribed medication is very effective in stabilizing his psychotic symptoms.

This means that the medication is designed to assist in controlling his hallucinations as well as difficulty in concentration, delusions and suspiciousness.

I would tell him, for example, that the antipsychotic medication would stabilize him’s persecutory delusions. This would give him some peace and tranquility in his apartment.

I would also describe to him the need for risperidone 1mg/nocte in order to reduce his psychotic symptoms like delusions, hallucinations, and hallucinations. (Budson & Barofsky (2012).

This is crucial because it is amazing news for other patients suffering similar symptoms to learn that the specific prescription for the medication is going to significantly lower their distressing symptoms.

This includes the possibility to completely eliminate symptoms provided that the medication is used according to the doctor’s instructions.

I would like to point out to Andrew that the medication prescription also helps in preventing these symptoms from recurring. (Budson & Barofsky. 2012).

Andrew would like me to explain how the antipsychotic medication recommended by the GP will successfully prevent the current symptoms from returning once he has healed. This will be a sure way to get him to take the risperidone 0mg nocte prescription along with the complete dosage.

He is not like any other patient with similar symptoms and cannot relapse to those initial psychotic symptoms.

This will increase the likelihood that he will accept to take the medication.4.

Andrew should be kept informed by his doctor and monitored closely over the next few months. Briefly, discuss your plan. (400 words)`

Medication is a major aspect in the monitoring of psychotic patients (Robert Joseph & Marilyn 2017).

This is why I will make sure that this factor plays a major role in my plans.

Andrew’s recovery is dependent on the medication.

Psychoeducation is a key part of treatment. This includes establishing a partnership with the psychotic person and providing psychoeducation (with their family and patient) about how to manage the disorder.

Based on this, I will consider both the patient and his immediate relatives.

This will enable him to get rehabilitation and psychoeducation quickly.

A patient registry is necessary to track the patient’s progress (Robert Joseph and Marilyn, 2017).

This will ensure that the registry contains all relevant information regarding the patient’s treatment, response, and recovery.

Anna, Jurgen Wayne, Kari, 2016, recommend that treatment goals be reinforced and included in the patient’s overall communication and monitoring plan.

This is crucial because it allows patients to have their own goals and the monitoring plan.

Thus, the desired treatment goals are crucial in determining the plan’s success.

Andrew’s communication, treatment and monitoring plans will include several important elements.

The most important elements are his health records and psychotic recovery phases. They also include goals, baseline and week one-five.

All of his medical information, including his past and present health, will be recorded in the health records.

The three stages of psychotic healing will be divided into the following categories: stabilization phase, acute phase, and stabilize phase.

Each phase will have specific goals which must be monitored to ensure that they are achieved.

The baseline will indicate the patient’s current psychotic status.

The baseline will serve as a guideline for the next weeks.

Refer toAnna, R., Jurgen, U., Wayne, K., & Kari, S. (2016).

Integrative Care: Establishing effective Primary and Mental Health Care Teams.

John Wiley & Sons.Robert, F., Joseph, C., & Marilyn, F. (2017).

Integrating Primary Care & Behavioral Health.

Oxford University Press.Anna, R., Jurgen, U., Wayne, K., & Kari, S. (2016).

Integrative Care: Establishing effective Primary and Mental Health Care Teams.

John Wiley & Sons.Bentall, P., Wickham, S., Shevlin, M., & Varese, F. (2012).

Does psychosis manifest in specific circumstances?

An analysis of the 2007 Adult Psychiatric Morbidity Survey. Schizophrenia Bulletin, 734-740.Budson, R., & Barofsky, I. (2012).

Principles of Treatment for the Chronic Psychiatric patient in the Community.

Springer Science & Business Media.Charles, S. (2012).

Forensic psychoiatry, an issue of Psychiatric clinics- Ebook. Elsevier Health Sciences.Cleary, M., Hunt, E., Horsfall, J., & Deacon, M. (2012).

«Nurse-patient interaction within acute adult inpatient mental healthcare units: a review of qualitative studies». Issues in mental health nursing, 66-79.David, K. (2013).

Schizophrenia. A guidebook and overview. Springer.Harsh, T., & Kiki, C. (2012).

Psychopharmacology. An issue of Child and Adolescent Psychiatrics in North America. E-Book. Elsevier Health Science.Heckers, S., Barch, M., Bustillo, J., Gaebel, W., Gur, R., Malaspina, D., & Van, J. (2013).

Structure of DSM-5 classifications for psychotic disorders. Schizophrenia Research, 11-14.Patrick, C., & Catherine, G. (2015).

Oxford Handbook of Mental Nursing.

Oxford University Press.Philip, H., & Elaine, W. (2013).

“Positive or Negative Symptoms In Psychosis: Research, Description, and Future Directions”. Routledge.Rebekka, L., Margret, H., Peter, W., Rolf, S., & Roland, V. (2011).

When Psychopharmacology is not enough: Cognitive Behavioural Therapie Techniques for People with Persistent Psychology.

Hogrefe Publishing.Robert, F., Joseph, C., & Marilyn, F. (2017).

Integrating Primary Care & Behavioral Health.

Oxford University Press.Schimmelmann, G., Walger, P., & Schultze, F. (2013).

The importance and significance of at risk-symptoms in the diagnosis of psychosis in children.

Canadian journal of Psychiatry. 32-40.Tania, L., Claude, L., & Til, W. (2016).

Group CBT For Psychosis: a Guidebook for Clinicians.

Oxford University Press.Cleary, M., Hunt, E., Horsfall, J., & Deacon, M. (2012).

The interaction between nurse and patient in acute adult-inpatient mental health units: A review of qualitative studies. Issues in mental health nursing, 66-79.David, K. (2013).

Schizophrenia. A guidebook and overview. Springer.Patrick, C., & Catherine, G. (2015).

Oxford Handbook of Mental Nursing.

Oxford University Press.Rebekka, L., Margret, H., Peter, W., Rolf, S., & Roland, V. (2011).

When Psychopharmacology is not enough: Cognitive Behavioural Therapie Techniques for People with Persistent Psychology.

Hogrefe Publishing.Tania, L., Claude, L., & Til, W. (2016).

Group CBT For Psychosis: a Guidebook for Clinicians.

Oxford University Press.Bentall, P., Wickham, S., Shevlin, M., & Varese, F. (2012).

Does psychosis manifest in specific circumstances?

An analysis of the 2007 Adult Psychiatric Morbidity Survey. Schizophrenia Bulletin, 734-740.Heckers, S., Barch, M., Bustillo, J., Gaebel, W., Gur, R., Malaspina, D., & Van, J. (2013).

Structure of DSM-5 classifications for psychotic disorders. Schizophrenia Research, 11-14.Philip, H., & Elaine, W. (2013).

“Positive or Negative Symptoms In Psychosis: Research, Description, and Future Directions” Routledge.Schimmelmann, G., Walger, P., & Schultze, F. (2013).

The significance and importance of at-risk-symptoms in the diagnosis of psychosis in children.

Canadian Journal of Psychiatry. 32-40.Budson, R., & Barofsky, I. (2012).

“The Chronic Psychiatric Patient In The Community: Principles of Therapy”

Springer Science & Business Media.Charles, S. (2012).

Forensic psychoiatry, an issue of Psychiatric clinics- Ebook. Elsevier Health Sciences.Harsh, T., & Kiki, C. (2012).

Psychopharmacology. An issue of Child and Adolescent Psychiatrics in North America. E-Book. Elsevier Health Science.