Question

Case Study Discussion # 2 NPN 125 Spring 2018 Assignment is due 4/11/19 Please submit your answers via email to me on the due date. Ms. Turner, an African American woman, has a triple diagnosis: HIV+, paranoid schizophrenia, and alcoholism. She was referred to you, the primary care physician, by her social worker. She is not taking any medications for either HIV or her mental diagnosis. She refused to take them. Her social worker, nurse, and you have all noticed her psychosis as she speaks and rambles. She lives in a group home, and has become friends with Mr. J, who lives there also. She reports drinking "a couple of half-pints" of ha liquor every day. She has started threatening Mr. J that if he doesn't have sex with her, she will accuse him of raping her. Her lab results show her CD4+ T cell count is 130 cells/mm3 and her viral load is 500,000 copies/mL. rd Discussion Questions 1- 2- 3- 4- 5- How will you treat her psychiatric complications? What kind of support or resources can you get for her? What is the next step if she continues to refuse treatment? Do you have an ethical obligation with Mr. J? Discuss other Cultural Competence issues that may impact retention into care and treatment.

Answer 1

1)to treat psychiatric condition first we need to handle sign and symptoms at lower dose.we can try different medication with various combination in unique doses.this will help to get better results..This patient have paranoid schizophrenia so antipsychotic medicines should be prescribed first in the form of oral or injection.if she does not take medicine it can lead to delusions and hallucinations.psychotherapy is vital in case of various schizophrenia .Moreover,behavioral therapy assist to improve and regain social abilities and control anxiety and depression.then tell her family to support as it is very important to get cured.

2)coordinated team care includes a team of health care can provide support to this patient to overcome this situation .they do case management,education,family support and medication and job support to improve the cognitive abilities as well as metal health of patient.

Inorder to reduce alcohol consumption behavioral treatment should be given through counseling .primary care should be provided by physician who can help to make a treatment plan as well as evaluation of whole health.behaviour treatment helps to build skills which is essential to stop alcohol intake and also aid to make social support.there are types of behavioral therapy we can provide to her.it contains

1)cognitive behavioral therapy

2)motivational improving therapy

3)marital and family counseling

3)Contineuous counseling should be given to make her understand about the importance of taking messages.Moreover,try to listen her problems and solve it .Tell her family to be with her and support her in her condition.when they feel that family needs her she may have desire to live .this will help to start medication later

4)yes,she is an HIV patient.so i should keep her condition confidential.provide maximum privacy to her.Moreover,I am responsible to act as an advocate for her .because I should give instructions to her to enhance her health condition.furthermore,i should stand with her and speak for her to her family and other health teamss

5)African American have more emotional attachment to their cultural beliefs.they more try home remedies and they don't trust others.so it is necessary to give adequate education due to their health illliteracy ,mistrust and misunderstanding about cultural beliefs.these are problems mainly face while treating these patients.