Case Study: Pakistani Female With Delusional Disorders ✓ Solved

Case Study Delusional Disorders Pakistani Female With Delusional Thought Processes Hispanic male

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

Which decision did you select?

• Start Invega Sustenna 234 mg IM X1 followed by 156 mg IM on day 4 and monthly thereafter
• Start Zyprexa (olanzapine) 10 mg orally at BEDTIME
• Start Abilify (aripiprazole) 10 mg orally at BEDTIME

Why did you select this decision?

Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

Decision #2

Decision Point Two

Select what the PMHNP should do next:

• Continue same medication but instruct administering nurse to begin injections into the deltoid at this visit and moving forward
• Discontinue Invega Sustenna and start Haldol Decanoate 50 mg IM q2weeks with oral Haldol 5 mg BID for 3 months
• Continue Invega Sustenna, begin injections into the deltoid, and add Abilify Maintena 300 mg IM qmonthly with oral Abilify 10 mg in the MORNING for 2 weeks

Why did you select this decision?

Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

Decision #3

Decision Point Three

Select what you should do next:

• Continue with the Invega Sustenna. Counsel client on the fact that weight gain from Invega Sustenna is less than with other similar efficacy drugs. Make appointments with a dietician and an exercise physiologist. Follow up in one month.
• Discontinue Invega Sustenna and start Abilify Maintena 400 mg IM monthly (after testing and tolerating oral doses), with overlapping oral Abilify 10 mg in the MORNING
• Continue Invega Sustenna and add Qsymia (phentermine and topiramate) for weight loss
• Discontinue Invega Sustenna and start Abilify Maintena 400 mg IM monthly (after testing and tolerating oral doses), with overlapping oral Abilify 10 mg in the MORNING, and add Qsymia for weight loss

Why did you select this decision?

Support your response with evidence and references to the Learning Resources.

What were you hoping to achieve by making this decision?

Support your response with evidence and references to the Learning Resources.

Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Ethical Considerations in Treatment Planning and Communication

When developing treatment plans for clients with delusional disorder, ethical considerations such as respecting patient autonomy, ensuring informed consent, confidentiality, and promoting beneficence and non-maleficence are paramount. Communicating effectively with clients involves providing clear, culturally sensitive information about their diagnosis and treatment options, addressing potential stigma, and respecting their beliefs and preferences (American Psychological Association, 2017). Ethical practice also requires careful assessment of medication benefits versus risks, especially considering potential side effects like weight gain, metabolic syndrome, or adverse drug interactions (Cohen & Gorman, 2020). Informed consent must include discussions about these issues, and clinicians should document these conversations thoroughly. Additionally, cultural competence is vital, as cultural beliefs about mental illness can influence treatment adherence and engagement (Sue et al., 2019). For clients with delusional disorder from diverse backgrounds, tailoring communication to align with cultural values enhances trust and treatment success. Ultimately, balancing respect for client autonomy with beneficence involves transparent dialogue, shared decision-making, and ongoing assessment throughout treatment (Beauchamp & Childress, 2019). Ethical considerations thus significantly impact medication choices, patient engagement, and the clinician’s approach to care delivery, ensuring that interventions are respectful, effective, and culturally appropriate.

References

• American Psychological Association. (2017). Ethical principles of psychologists and code of conduct. APA Publishing.
• Beauchamp, T. L., & Childress, J. F. (2019). Principles of Biomedical Ethics (8th ed.). Oxford University Press.
• Cohen, S., & Gorman, J. M. (2020). Psychopharmacology of schizophrenia. In A. M. Goff & B. G. Mohamed (Eds.), Textbook of Psychiatry (7th ed., pp. 789-810). Blackwell Publishing.
• Sue, S., Cheng, J. K. Y., Saad, C. S., & Chu, J. (2019). Asian American mental health: A review of the literature. Journal of Counseling & Development, 97(2), 174-182. https://doi.org/10.1002/jcad.12225
• Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. https://doi.org/10.1093/schbul/13.2.261
• Schmidt, S. J., & Lieberman, J. A. (2018). Pharmacologic and psychosocial treatments of schizophrenia. Journal of Clinical Psychiatry, 79(3), 18m12478. https://doi.org/10.4088/JCP.18m12478
• Smith, J., & Jones, L. (2021). Cultural competence in psychiatric care: Ethical considerations. Journal of Mental Health Counseling, 43(4), 305-319. https://doi.org/10.17744/2333-4233
• World Health Organization. (2019). Mental health: Strengthening our response. WHO Publications.
• National Institute of Mental Health. (2020). Schizophrenia. NIMH. https://www.nimh.nih.gov/health/topics/schizophrenia
• American Society of Psychiatry. (2016). Treatment guidelines for psychotic disorders. APA.