see attached
2 part assignment-the case study and questions should be written as a paper with references.
Then the self reflection part can just be something for me to read in a video.
The purpose of this video is self-reflection regarding the therapeutic process and one’s own role in that process as a PMHNP provider. Through reflective practice, you will evaluate your own emotional intelligence as defined as the capacity to recognize one’s own feelings as well as others’ and one’s ability to monitor and manage those feelings. The point of the exercise is to learn about yourself, your triggers, the types of cases you end up getting overly involved with, and those you would rather refer to someone else. The idea is to be able to step back personally and analyze your behaviors/thoughts/decisions and how those impact both you and your clients.
Your video should be 3–5 minutes in length.
Case scenario:
Nick is a 22-year-old man with a history of schizophrenia who is admitted to the inpatient psychiatric unit for psychosis. He has been nonadherent with his outpatient medication regimen and has developed auditory hallucinations of voices talking about “demons stalking him” and delusions that helicopters are following him. He smashed all the televisions in the house because he believed that the local news anchorwoman was broadcasting his location to the authorities. His mother, with whom he lives, called the police.
Nick has no past medical history other than schizophrenia. Basic metabolic panel, complete blood cell count, thyroid function tests, and urine analysis are normal. Urine toxicology is negative. When he arrives on the unit, he is started on risperidone 4 mg daily. Within the next 24 hours, nursing calls to request an urgent evaluation of the patient. He is circling the nursing station, appears anxious, and is having trouble speaking. Through clenched teeth he calls out, “My jaw is stuck!” His lower mandible is clenched, locked into position, and resists passive movement. His neck is slightly extended, and his eyes appear to be forcefully rolled in the direction of the upper right quadrant. He lacks rigidity in his upper or lower extremities.
Vital signs are taken for this patient. Nick’s temperature is 98 °F, blood pressure is 125/82 mm Hg, pulse rate 88/min, respiratory rate is 18/min, and oxygen saturation is 98% on room air. Although it is difficult for him to speak, he is awake, alert, and oriented to person, place, time, and current situation. He is not diaphoretic. Diphenhydramine 50 mg is given intramuscularly. Within 20 minutes, Nick regains voluntary movement of his extraocular muscles and mandible. “Doctor, you are my hero!” he exclaims down the hallway.
Two days later, Nick is seen pacing the hallways. When brought into the interview room, he sits down momentarily and then quickly stands back up. He marches in place for the duration of the interview. He comments, “I’m so uncomfortable. I can’t stay still.”
· What is the primary diagnosis for Nick?
· What are the different medication-induced movement disorders that occur in a client on antipsychotics?
· What is acute dystonia? What is the treatment modality for acute dystonia?
· What is akathisia? Explain the possible symptom presentation for a client exhibiting akathisia.
· What is the treatment recommendation for akathisia?
· What is tardive dyskinesia? How will you treat tardive dyskinesia?
· What are the possible risks and benefits of long-acting injectable antipsychotic medications?
· As a PMHNP, how will you promote the client’s medication compliance?
