Dear writer, I need to answer following 5 objectives after watching the simulation (I described simulation after objectives). Simulation is on paranoid schizophrenia. Each answer has to be related to the simulation and chapters from the books I scanned and uploaded. You can use additional material, but the main focus has to be the chapters I uploaded. The books used are : Varcarolis, Fondation of psychiatric health nursing 8th and also Manual of psychiatric nursing care planning 6th.
- Discuss the DSM-V Diagnostic criteria for schizophrenia.
- Discuss three of the neurobiological findings that indicate that schizophrenia is a brain disorder.
- Define and outline nursing interventions that are specific for the hallucinating and delusional client.
- Differentiate between the positive and negative symptoms of schizophrenia.
- Self-evaluation of the paper, and personal understanding of the disease proses, and what has to be done for establishing better communication with acutely ill patient with paranoid schizophrenia. Examples of therapeutic communication. (Fully addresses and evaluates own learning objectives. Has awareness of own biases, strengths and weaknesses. Self- assesses progress. Builds on prior experiences. Analyzes why learning objective not met. Describes learning that has occurred as well as learning needs that need to be addressed. States the rationale as to why an alternative action would have been better)
Responses has to be: (Responses stimulate detailed further thought or questions. Consistent use of correct terminology. Explores alternative ways of interpreting and responding to the event). Consistent use of citations from textbook and other course resources. Uses relevant examples, rationales are supported and documented. Integrates knowledge gained from the course.
Simulation Dereck Jones:
20-year-old Dereck Jones admitted in acute inpatient psychiatric evaluation unit. His appeared disheveled, unshaved, has body odor, agitated, has severe anxiety, and has flat effect every time he experiencing delusions and hallucination. He is a college student at the end of freshmen year. Parents accompanied him to the hospital after Dereck called them and said that Taliban soldier following him with the gun. During initial nursing interview, the nurse was trying to ask what brought him to the hospital, and what was happening recently. Dereck responded that he seeing Taliban soldier following him everywhere for 2 months already, and that soldier standing outside the office right now, and trying to put thooughts into his head. The nurse responded that she doesn’t see anybody but it must be scary, and they will try to do everything possible for Dereck to feel safe (therapeutic communication).
Dereck parents in a separate interview said when he was a child that he had odd believe that he can channel energy from inanimate object (prodromal stage of schizophrenia). Dereck is good student and got scholarship, and everything was good until now. Dereck college friend mention that Dereck was acting unusually for the last 6 months, last week it got progressively worst and he started putting sheets over the windows in the dorm, and not eating or sleeping for days. It happened right before his chemistry exam which might’ve been the trigger. He doesn’t have any girlfriend and have one best friend in college, his roommate. Dereck doesn’t use drugs nor alcohol, and his physical exam 9 month ago was good.
At this moment Dereck in acute psychotic stage of paranoid schizophrenia, he is having difficulty in functioning, his disorganize, experiencing hallucinations (hearing voices in his head and seeing soldier with the gun) and delusions (believing that someone trying to follow him everywhere and putting thoughts in his head. “thought insertion”)
History: Dereck uncle was diagnosed with schizophrenia at the age of 19, and was hospitalize at least twice. (genetic predisposition, neurotransmitters dysregulation, biochemical difference in the brain cause Dereck to perceive things different …).
He was put on medications: (Quetiapine, 2nd generation Antipsychotic), and alprazolam (benzodiazepine) to calm anxiety down fast. Medication can have lots of side effects, so it is a priority that the nurse has to monitor Dereck for the first 48 hours.
On day 2 hospital stay, Dereck had hallucination and saw a Guy in the corridor talking about him, but nurse refocused Dereck from unreal to the real. (“Dereck It must be very scary, but I didn’t see anyone in the corridor”) After 48 hours when Dereck feel better the nurse can try to establish self-care: hygiene, nutrition, sleep…
On day 6, Dereck felt much better, he couldn’t believe that he behaved that way.( because his support group was very good : family, friend …) people with strong support group have better chances for recovery.
DESCRIPTION OF THE SIMULATION
This simulation focuses on caring for Derek Jones, a client with schizophrenia, paranoid type, who is acutely psychotic. the scenario takes place in an acute psychiatric care unit and provides the student learner with information about the nature, symptoms, and etiology of paranoid schizophrenia. Derek’s treatment requires specific nursing care that focuses on rapid symptoms reduction, physiological stabilization, management of acute psychotic behaviors, family intervention and planning for long-term follow- up.