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Week 6: Antipsychotic Therapy According to the Nat

Week 6: Antipsychotic Therapy According to the National Alliance on Mental Illness, approximately 100,000 people experience psychosis in the United States each year (NAMI, 2016). In practice, clients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals. Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric mental health nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for clients. This week, as you examine antipsychotic therapies, you explore the assessment and treatment of clients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies. To prepare for this Assignment: • Review this week’s Learning Resources. Consider how to assess and treat clients requiring anxiolytic therapy. The Assignment Examine Case Study: Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: • Decision #1 o Which decision did you select? o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? • Decision #2 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? • Decision #3 o Why did you select this decision? Support your response with evidence and references to the Learning Resources. o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Assignment: Assessing and Treating Clients With Psychosis and Schizophrenia Psychosis and schizophrenia greatly impact the brain’s normal processes, which interferes with the ability to think clearly. When symptoms of these disorders are uncontrolled, clients may struggle to function in daily life. However, clients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with psychosis and schizophrenia. Learning Objectives Students will: • Assess client factors and history to develop personalized plans of antipsychotic therapy for clients • Analyze factors that influence pharmacokinetic and pharmacodynamic processes in clients requiring antipsychotic therapy • Evaluate efficacy of treatment plans • Analyze ethical and legal implications related to prescribing antipsychotic therapy to clients across the lifespan Learning Resources Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus. Required Readings Note: All Stahl resources can be accessed through this link provided. Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press. To access the following chapters, click on the Essential Psychopharmacology, 4th ed tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter. • Chapter 4, “Psychosis and Schizophrenia” • Chapter 5, “Antipsychotic Agents” Stahl, S. M. (2014b). The prescriber’s guide (5th ed.). New York, NY: Cambridge University Press. To access information on the following medications, click on The Prescriber’s Guide, 5th ed tab on the Stahl Online website and select the appropriate medication. Review the following medications: • amisulpride • aripiprazole • asenapine • chlorpromazine • clozapine • flupenthixol • fluphenazine • haloperidol • iloperidone • loxapine • lurasidone • olanzapine • paliperidone • perphenazine • quetiapine • risperidone • sulpiride • thioridazine • thiothixene • trifluoperazine • ziprasidone Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649-659. doi:10.2165/00023210-200923080-00002 Document: Midterm Exam Study Guide (PDF) Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf Walden University. (2016). ASC success strategies: Studying for and taking a test. Retrieved from http://academicguides.waldenu.edu/ASCsuccess/ASCtesting Required Media Laureate Education. (2016j). Case study: Pakistani woman with delusional thought processes [Interactive media file]. Baltimore, MD: Author Note: This case study will serve as the foundation for this week’s Assignment. Optional Resources Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., & … Miller, D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124-134. doi:10.3371/CSRP.5.3.2 Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728-738. doi:10.2146/ajhp130471 Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107-121. doi:10.1007/s11126-014-9326-2 Rubric Detail Select Grid View or List View to change the rubric’s layout. Name: NURS_6630_Week6_Assignment_Rubric • Grid View • List View Show Descriptions Quality of Work Submitted: The extent of which work meets the assigned criteria and work reflects graduate level critical and analytic thinking.– Excellent 27 (27%) – 30 (30%) Assignment exceeds expectations. All topics are addressed with a minimum of 75% containing exceptional breadth and depth about each of the assignment topics. Good 24 (24%) – 26 (26%) Assignment meets expectations. All topics are addressed with a minimum of 50% containing good breadth and depth about each of the assignment topics. Fair 21 (21%) – 23 (23%) Assignment meets most of the expectations. One required topic is either not addressed or inadequately addressed. Poor 0 (0%) – 20 (20%) Assignment superficially meets some of the expectations. Two or more required topics are either not addressed or inadequately addressed. Quality of Work Submitted: The purpose of the paper is clear.– Excellent 5 (5%) – 5 (5%) A clear and comprehensive purpose statement is provided which delineates all required criteria. Good 4 (4%) – 4 (4%) Purpose of the assignment is stated, yet is brief and not descriptive. Fair 3.5 (3.5%) – 3.5 (3.5%) Purpose of the assignment is vague or off topic. Poor 0 (0%) – 3 (3%) No purpose statement was provided. Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to: Understand and interpret the assignment’s key concepts.– Excellent 9 (9%) – 10 (10%) Demonstrates the ability to critically appraise and intellectually explore key concepts. Good 8 (8%) – 8 (8%) Demonstrates a clear understanding of key concepts. Fair 7 (7%) – 7 (7%) Shows some degree of understanding of key concepts. Poor 0 (0%) – 6 (6%) Shows a lack of understanding of key concepts, deviates from topics. Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to: Apply and integrate material in course resources (i.e. video, required readings, and textbook) and credible outside resources.– Excellent 18 (18%) – 20 (20%) Demonstrates and applies exceptional support of major points and integrates 2 or more credible outside sources, in addition to 2-3 course resources to suppport point of view. Good 16 (16%) – 17 (17%) Integrates specific information from 1 credible outside resource and 2-3 course resources to support major points and point of view. Fair 14 (14%) – 15 (15%) Minimally includes and integrates specific information from 2-3 resources to support major points and point of view. Poor 0 (0%) – 13 (13%) Includes and integrates specific information from 0 to 1 resoruce to support major points and point of view. Assimilation and Synthesis of Ideas: The extent to which the work reflects the student’s ability to: Synthesize (combines various components or different ideas into a new whole) material in course resources (i.e. video, required readings, textbook) and outside, credible resources by comparing different points of view and highlighting similarities, differences, and connections.– Excellent 18 (18%) – 20 (20%) Synthesizes and justifies (defends, explains, validates, confirms) information gleaned from sources to support major points presented. Applies meaning to the field of advanced nursing practice. Good 16 (16%) – 17 (17%) Summarizes information gleaned from sources to support major points, but does not synthesize. Fair 14 (14%) – 15 (15%) Identifies but does not interpret or apply concepts, and/or strategies correctly; ideas unclear and/or underdeveloped. Poor 0 (0%) – 13 (13%) Rarely or does not interpret, apply, and synthesize concepts, and/or strategies. Written Expression and Formatting Paragraph and Sentence Structure: Paragraphs make clear points that support well developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are clearly structured and carefully focused–neither long and rambling nor short and lacking substance.– Excellent 5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity Good 4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 80% of the time. Fair 3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity 60%- 79% of the time. Poor 0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for structure, flow, continuity and clarity < 60% of the time. Written Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation– Excellent 5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. Good 4 (4%) – 4 (4%) Contains a few (1-2) grammar, spelling, and punctuation errors. Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) grammar, spelling, and punctuation errors. Poor 0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Written Expression and Formatting The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.– Excellent 5 (5%) – 5 (5%) Uses correct APA format with no errors. Good 4 (4%) – 4 (4%) Contains a few (1-2) APA format errors. Fair 3.5 (3.5%) – 3.5 (3.5%) Contains several (3-4) APA format errors. Poor 0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors. Total Points: 100 Name: NURS_6630_Week6_Assignment_Rubric

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