Posted: May 11th, 2022

NRNP 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults

Captain of the Ship Undertaking – Delusional Dysfunction

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School of Nursing-PMHNP, Walden College
NRNP 6670: Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults
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Captain of the Ship Undertaking – Delusional Dysfunction
Introduction
Delusional dysfunction is a well being complication that triggers irrational ideas or worries. The affected person within the case examine is a 50-year outdated African-American feminine. She is excessively afraid of getting contaminated with coronavirus after the demise of her husband. Psychopharmacologic remedy is efficient in enhancing the power to deal with stress and enhance the standard of life. Psychotherapy will cut back the irritable and offended moods of the sufferers, deal with hallucinations and delusions. Group Help assets are important for the reason that shopper misplaced his job and misplaced his husband to COVID-19 associated problems. Comply with-up is crucial to enhance restoration and forestall relapse. The aim of the essay is to debate remedy for somatic delusional dysfunction.
HPI and Scientific Presentation
The chosen affected person is a 50-year outdated African-American feminine. The girl has a previous drug and alcohol abuse drawback. She misplaced her husband final month after he succumbed to COVID-19 associated problems. She presents to the clinic with a delusional tendency. A psychiatric analysis is crucial to find out the dysfunction. She lives alone after the demise of the husband. She presents with various signs equivalent to anger, melancholy, and anxiousness. She is excessively afraid of the virus and believes she is contaminated. The affected person thinks she can not dwell lengthy for the reason that virus is lethal. She experiences hallucinations of her demise and burial. Through the interview, she complains her lung have collapsed. The presentation exhibits the affected person is probably going affected by a somatic kind of delusional dysfunction. The signs improve the shortcoming to sleep or carry out every day duties.
Psychopharmacologic Remedies and Therapeutic Endpoints
Antipsychotics are the first remedy medicine for delusional conduct. The medicine block dopamine receptors to enhance the mind’s cognitive capabilities (Munoz-Negro et al., 2020). Chlorpromazine (Thorazine) is likely one of the typical antipsychotic medicine. Newer medicine equivalent to Risperidone (Risperdal) can be utilized to enhance the function of neurotransmitters within the mind (Munoz-Negro et al., 2020). Tranquilizers and antidepressants deal with melancholy and anxiousness prevalent amongst folks with delusional dysfunction (Lahteenvuo et al., 2021). Psychopharmacologic remedy is efficient in enhancing the power to deal with stress and enhance the standard of life. Chlorpromazine is crucial because it improves participation in every day actions, helps sufferers suppose extra clearly, and really feel much less nervous (Lahteenvuo et al., 2021).
Psychotherapy Selections and Therapeutic Endpoints
Psychotherapy is the first remedy for delusional dysfunction. Speak remedy is efficient for sufferers to debate their signs. Cognitive conduct remedy can be utilized to appropriate irrational considering (Bjornestad et al., 2018). CBT encourages the sufferers to embrace purposeful and more healthy conduct and attitudes. Particular person remedy is significant to Help a person appropriate distorted considering patterns. Household remedy might help households perceive and Help a liked one with delusional conduct (Bjornestad et al., 2018). Supporting a member of the family can result in higher outcomes. Psychotherapy will cut back the irritable and offended moods of the sufferers, deal with hallucinations and delusions. The main focus is to revive the standard of lifetime of a affected person. The affected person ought to attend 10 classes every 60 minutes to facilitate a change of conduct and considering patterns by a dialog with a therapist. A member of the family will accompany the affected person in one of many classes to make sure they perceive the situation and Help the affected person successfully.
Medical Administration Wants
The primary line of remedy for somatic delusional problems is anti-psychotics. Chlorpromazine will Help the affected person suppose extra clearly, take part in every day actions, and really feel much less nervous (Negro & Cervilla, 2017). Chlorpromazine 25 mg tablets orally t.d.s. In case the affected person doesn’t reveal enhancements after 4 to eight weeks, it will likely be important to prescribe 75 mg at bedtime (Negro & Cervilla, 2017). If the affected person has adherence issues with the drug, it will likely be important to think about an injection. Chlorpromazine works by blocking postsynaptic dopamine receptors, thus stopping extra dopamine within the mind (Negro & Cervilla, 2017). The discount is efficient in limiting hallucinations and delusions.
The unwanted side effects of Chlorpromazine embody dizziness, restlessness, agitation, and nervousness. Through the first days of taking the treatment, the affected person might really feel fatigued and enhance as they proceed taking the drug (Redzuan & Silim, 2020). Allergic reactions to Chlorpromazine are uncommon, however the affected person ought to search rapid medical help in the event that they discover something uncommon. Adherence to the drug is significant within the restoration of the affected person. Through the clinics, after each 4 weeks, the affected person ought to point out the extent of adherence (Redzuan & Silim, 2020). The affected person will take Chlorpromazine till full restoration. The justification for altering the drug is that if solely the affected person isn’t responding positively to the drug.
Group Help Sources
Group Help assets are important for the reason that shopper misplaced his job and misplaced his husband to COVID-19 associated problems. A collaborative strategy is sensible to ascertain a wholesome relationship with different stakeholders (Redzuan & Silim, 2020). She is afraid of going out of the home since she believes she’s going to get contaminated. It is going to be important to seek out neighborhood organizations with employment alternatives for the affected person. She has been an alcoholic and at the moment struggling to give up regardless of previous therapeutic measures. An alcohol nameless Help group will probably be a wholesome avenue for the affected person (Redzuan & Silim, 2020). Group Preventive Companies Process Power (CPSTF) gives neighborhood interventions for the sufferers. One other useful resource locally is One door psychological well being, which helps folks with psychological diseases. The neighborhood assets will improve the probabilities of restoration (Redzuan & Silim, 2020).
Comply with-Up Depth and Frequency and Collaboration
The affected person requires a prescription of Risperidone 2mg tablets orally. The affected person ought to take the medicine for the following 4 weeks and come again for additional analysis. Adherence to the drug is crucial to reinforce consistency of restoration (Bjornestad et al., 2018).
The affected person will attend 10 psychotherapeutic classes. Every session will probably be 60 minutes lengthy. A report from the therapist will probably be important to assessment the enhancements in distorted considering patterns. Through the remedy, a member of the family ought to accompany the affected person. Household remedy will probably be important to facilitate Help (Bjornestad et al., 2018). Through the restoration, the household is essential to reintegrate the affected person into the every day actions.
A collaborative strategy is crucial within the remedy of psychological problems. The collaborators will embody psychotherapists, psychiatrists, pharmacists, and household practitioners (Bjornestad et al., 2018). For instance, a psychiatrist is crucial to judge the psychological standing of the affected person. A report from a psychiatrist will probably be important to rule out different psychological circumstances or point out the potential of comorbidities.
Conclusion
Remedy of delusional dysfunction includes psychotherapeutic and psychopharmacological interventions. Remedy includes collaboration with numerous professionals. A collaborative strategy is significant within the remedy of psychological problems. Remedy targets embody lowering irritable and offended moods of the sufferers, addressing hallucinations and delusions.
References
Bjornestad, J., Veseth, M., Davidson, L., Joa, I., Johannessen, J. O., Larsen, T. Ok., … & Hegelstad, W. T. V. (2018). Psychotherapy in psychosis: experiences of absolutely recovered service customers. Frontiers in Psychology, 9, 1675.
Lähteenvuo, M., Taipale, H., Tanskanen, A., Mittendorfer-Rutz, E., & Tiihonen, J. (2021). Effectiveness of pharmacotherapies for delusional dysfunction in a Swedish nationwide cohort of 9076 sufferers. Schizophrenia Analysis, 228, 367-372.
Munoz-Negro, J. E., Gómez-Sierra, F. J., Peralta, V., González-Rodríguez, A., & Cervilla, J. A. (2020). A scientific assessment of research with clinician-rated scales on the pharmacological remedy of delusional dysfunction. Worldwide Scientific Psychopharmacology, 35(three), 129-136.
Negro, J. M., & Cervilla, J. (2017). A scientific assessment of the pharmacological remedy of delusional dysfunction. European Psychiatry, 41(S1), s825-s825.
Redzuan, N. I., & Silim, U. A. (2020). Coordinated Care in Managing a Postnatal Mom with Delusional Dysfunction and Opioid Use Dysfunction: A Case Report. Malaysian Journal of Psychiatry, 30(1).

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