Question

Saul Kahneman is a 42-year-old, single white male with a diagnosis of schizophrenia. His current symptoms include auditory hallucinations, disorganized speech, and diminished emotional expression. His father, David, brings Saul to the inpatient psychiatric unit for treatment. David reports that Saul stopped taking his Seroquel 400 mg BID for psychosis and his melatonin 6 mg for sleep a week ago. He also reports that Saul has been responding to internal stimuli, talking to himself, not sleeping, and believes the government has bugged their home. This is the third psychiatric admission for Saul in two years.

When you, the psychiatric nurse practitioner, talk to Saul, he reports, “The medication isn’t working anymore.”

• Vital signs: BP 148/72, HR 88, R 18, pulse ox 98%
• HT: 6’ 1”
• WT: 230 pounds
• Appearance: Unkempt, poor hygiene, dressed in several layers of clothing (current season is late spring, average temperature outside is 70 degrees)
• Blood work: A1C 6.2, total cholesterol 188 mg/dl, HDL 22 mg/dl, LDL 176 mg/dl
• Triglycerides: 148 mg
• All other lab results are within normal limits.

Questions

You know you will change Saul’s antipsychotic medication.

1. Based on the information in the case study—vital signs, HT/WT, and appearance, as well as the lab results—what recommendations relative to medications would you make? Name the type of typical or atypical antipsychotic you would prescribe and identify the dosing and administration.
2. Decide whether you would add any other medication, and if so, identify the medication, dose, and time of administration. Provide current literature (EBP, research article, and/or textbook reference) to support your decision.
3. Based on the medications you would prescribe, what education would you provide to Saul?
4. Identify any laboratory testing you would order and explain your rationale.
5. Would you refer Saul to any other providers? If so, to whom would you refer him? Provide your rationale for any referrals.

Answer 1

It's a symptom of schizophrenia.

the idea of emotional challenges in schizophrenia has been considerably improved by travel analysis within the course of recent decades. By consolidating methods and speculations from filled with feeling science, scientists have had the choice to search out that people with dementia praecox show not several outward shows of feeling but report encountering solid sentiments at intervals the sight of sincerely suggestive upgrades .

Part 2)

This work has indicated that people with schizophrenia will encounter feeling at the time; notwithstanding, they appear to expertise problems whereas imagery future gratifying encounters, and this perhaps influences their inspiration to possess such encounters whereas progressions in our comprehension of passionate expertise and articulation in individuals with schizophrenia are created, these advancements have prompted another assortment of analysis addresses coordinated at understanding the time course of feeling in schizophrenia, together with the work of memory

"unblemished reality testing" alludes to the capability to distinction interior encounters with outer proof. Tests convictions concerning world against the important world (do your inner encounters coordinate outside proof).

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