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Edward Martin , 44-year-old male recently discharged from an outpatient partial hospitalization for paranoid schizophrenia. He was experiencing delusions and causing a public disturbance. Edward was diagnosed with paranoid schizophrenia at age 28 and had one suicide attempt via overdose at age 32. Edward has had episodic hospitalizations for hallucinations and delusions resulting from non-adherence to his medication regimen. Edward’s comorbidities include generalized anxiety disorder and hypertension.
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Edward Martin , 44-year-old male recently discharged from an outpatient partial hospitalization for paranoid schizophrenia. He was experiencing delusions and causing a public disturbance. Edward was diagnosed with paranoid schizophrenia at age 28 and had one suicide attempt via overdose at age 32. Edward has had episodic hospitalizations for hallucinations and delusions resulting from non-adherence to his medication regimen. Edward’s comorbidities include generalized anxiety disorder and hypertension. Medications: NKDA. Risperdal (risperidone) 3 mg one tablet twice daily by mouth Xanax (alprazolam) 0.5 mg one tablet daily by mouth. Melatonin one tablet daily one hour before bed Lisinopril 10 mg one tablet daily by mouth Surgical history: Appendectomy age 10 Social history: Edward lives alone and receives medication-monitoring services. He has worked at the meat packing plant for seven years. He received short-term disability during his outpatient partial hospitalization and is returning to work this week. You responded correctly to 10 out of 10 evaluations: Category Your response Explanation Community Assessment Increased acuity Community assessment needs are increased for Edward. The community ass for mental illness, public transportation, options for socialization and recreati recognition of triggers for anxiety in the community. Culture/Beliefs/Spirituali Normal There is no current evidence of culture/beliefs/spirituality concerns with Edwa ty acuity Disease/Illness
Increased Edward is living with paranoid schizophrenia, generalized anxiety disorder an Prevention acuity severity of disease and other morbidities. Education/Counseling Increased Edward will require education and counseling on managing his diagnoses and acuity counseling include health education and counseling with a purpose of reduci Health Promotion Increased Edward has an increased need for health promotion. Health promotion activit acuity symptom identification and management. As Edward returns to work, manag encourage and nurture health are important components of health promotion Resource Identification Increased Edward will require support from community resources such as medication m acuity evaluation of workplace safety. Risk Reduction Increased Edward has increased need for risk reduction. His immediate concerns are m Category Your response Explanation acuity illness. Observation at work and early identification of positive and negative components of risk reduction. Self-Management Increased Edward has increased need for self-management of his mental health. Self-m acuity adequate rest, eliminating or minimizing triggers, and symptom recognition f Social Determinants of Increased Social determinants of health include living alone, living with mental illness, r Health acuity Surveillance Increased acuity
adherence effort needs be made to understand the reason for the poor/no Social skills Social skills are important in the process of recovery and the tra training needed to live, learn and work with minimum support. Addressi illness is an essential component in the treatment process. Crisis resolution Crisis resolution aims to offer alternatives to hospital admission Stat us Label Explanation assessment and home treatment. At this time, Edward does not Vocational Vocational rehabilitation services exist to help mentally ill peopl rehabilitation new employment; they are assessing available accommodation Education on Identification of positive and negative symptoms of paranoid sc symptom management will be essential components of case managemen identification Nutritional counseling add to normal behavior (hallucinations, delusions, and disorgan symptoms are those that subtract from normal behavior (lack o There is no indication that Edward needs nutritional counseling Scenario 3 ou correctly selected 5 out of 6 actions: Stat us Label Explanatio Medication side effects Medication side effects are known contributors to poor med mental illness. Low level of social involvement Low level of social involvement is a contributor to poor me mental illness.
Financial constraints Financial constraints may decrease adherence due to inabi Alcohol dependency Alcohol dependency does affect compliance to medication Edward is alcohol dependent. Living alone Living alone is a known contributor to poor medication adh Lack of awareness Lack of awareness is a significant reason why individuals w about illness fail to take their medication (anosognosia) Scenario 4 ou correctly selected 4 out of 6 actions: Stat us Label Explan Remove from the line It is an important safety response for Edward and product line. Ask Edward a take a 10-minute break Suggest Edward leave for the It is not appropriate response by the occupational break. The nurse should immediately assess his s It is not appropriate response by the occupational day day. The nurse should immediately assess his sym Ask Edward to come to the The nurse should assess Edward’s symptoms in th occupational health clinic for of care for Edward based on his symptoms. Stat us Label Explan further evaluation Report symptoms to Edward’s The occupational health nurse should first assess healthcare provider his health clinic and develop a plan of care for Edward based care care may include a consult with Edward’s mental Inquire about the specific It is important to know what specific symptoms Ed symptoms Edward’s co- workers observed