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support@onlinenursepapers.com Delusional Disorders Pakistani Female With Delusional Thought Processes
Background:
The patient is a 34-year-old Pakistani woman who immigrated to the United States in her late teens or early twenties. She is currently in an arranged marriage, a union determined for her when she was just 9 years old. Her recent 21-day hospitalization resulted in a diagnosis of “brief psychotic disorder” due to symptoms lasting less than one month.
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Before hospitalization, she reported having visions of Allah and, over a week, developed a belief that she was the prophet Mohammad destined to save the world from sin. Concerned about her behavior, her husband, with whom she has four children, called the police due to her escalating behavior, leading to her admission to an inpatient psychiatric unit.
Assessment and Diagnosis of Patients with Anxiety Disorders, PTSD, and OCD; Sample Assignment
During the assessment, the patient appears calm and dismisses the incident as exaggerated. She denies ever believing she was the prophet Mohammad, attributing her husband’s actions to his desire for an “American wife.” She claims to receive messages from Allah through the television and exhibits occasional hostility during the clinical interview. Her current weight is 140 lbs., and her height is 5′ 5″.
Subjective:
The client reports a “good” mood and denies auditory or visual hallucinations but believes the television communicates with her, relaying messages from Allah. She occasionally displays hostility but then calms down.
Her hospital records indicate good overall health based on a medical workup with normal lab results. She mentions discontinuing Risperdal, which she had been tolerating well, fearing her husband’s intention to poison her so he can marry an American woman.
Mental Status Exam:
The client is alert and oriented in terms of person, place, time, and event. She is appropriately dressed for the weather and season. Her speech is slow and occasionally interrupted by pauses. Mood is euthymic, but affect is constricted. Although she denies hallucinations, she appears to be listening to something. She exhibits delusional and paranoid thought processes as described earlier. Insight and judgment are impaired, but she denies any suicidal or homicidal ideation.
You administer the PANSS, resulting in the following scores:
– Positive Symptoms Scale: -40
– Negative Symptom Scale: -20
– General Psychopathology Scale: -60
Diagnosis: Schizophrenia, paranoid type
Decision Point One:
Select the appropriate action:
– Initiate Zyprexa (olanzapine) 10 mg orally at bedtime.
– Begin Invega Sustenna 234 mg IM once, followed by 156 mg IM on day 4 and monthly thereafter.
– Commence Abilify (aripiprazole) 10 mg orally at bedtime.
BACKGROUND
The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her when she was 9 years old). She presents following a 21-day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.
Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control,” which resulted in his calling the police and her subsequent admission to an inpatient psych unit Assessing and Treating Patients With Psychosis and Schizophrenia Assignment
During today’s assessment, she appears quite calm and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She says she knows this because the television is telling her so.
She currently weighs 140 lbs., and she is 5’ 5.
SUBJECTIVE
Client reports that her mood is “good.” She denies auditory/visual hallucinations but believes that the television talks to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards you but then calms down.
A review of her hospital records shows that she received a medical workup from a physician, who reported her to be in overall good health. Lab studies were all within normal limits.
Client admits that she was tolerating her Risperdal well but stopped taking about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman Assessing and Treating Patients With Psychosis and Schizophrenia Assignment.
MENTAL STATUS EXAM
The client is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and, at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect is constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.
You administer the PANSS which reveals the following scores:
-40 for the positive symptoms scale
-20 for the negative symptom scale
-60 for general psychopathology scale
Diagnosis: Schizophrenia, paranoid type
RESOURCES
PANSS Scale. Available at: http://egret.psychol.cam.ac.uk/medicine/scales/PANSS
§ Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi:10.1093/schbul/13.2.261
§ Clozapine REMS Program. (n.d.). Clozapine REMS: A guide for healthcare providers. Retrieved September 7, 2016, from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf
http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf
§ Paz, Z., Nalls, M., and Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal, 13(10), 625–629. Retrieved from http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf
Decision Point One
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Provide your requirements and let our native nursing writers deliver your assignments ASAP.
Select what you should do:
Start Zyprexa (olanzapine) 10 mg orally at BEDTIME
Start Invega Sustenna 234 mg IM X1 followed by 156 mg IM on day 4 and monthly thereafter
Start Abilify (aripiprazole) 10 mg orally at BEDTIMEAssessing and Treating Patients With Psychosis and Schizophrenia Assignment