Author Question: A patient with paranoid schizophrenia and anosognosia has had several hospitalizations. He responds ... (Read 57 times)

lindiwe · **on:** Jul 19, 2018

A patient with paranoid schizophrenia and anosognosia has had several hospitalizations. He responds quickly to antipsychotic medication but stops taking the medication soon after discharge.

Discharge planning will include follow-up at the mental health clinic, placement in a group home, and daily attendance at a psychosocial day program. Which medication strategy will most likely be used as he transitions from hospital to community? a. Administer a second-generation antipsychotic to help negative symptoms.
b. Prescribe a long-acting intramuscular antipsychotic medication.
c. Involve the patient in the decision about which medication is best.
d. Prescribe a quick-dissolving formulation to reduce cheeking..

Question 2

The client's physician has recommended hospitalization for severe depression and has made arrangements for her to be admitted Monday morning. After discussing the plan for her treatment with the physician, the client refuses to be hospitalized.

This refusal is called 1. noncomplaints.
2. noncompliance.
3. noncomplacence.
4. noncooperation.

Benayers · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
Persons with paranoia and anosognosia are at high risk for treatment nonadherence, so the strategy needs first and foremost to address that risk. Of the options here, involving the patient in the decision is best because it will build trust and help establish a therapeutic alliance with care providers, an essential foundation to adherence and an even greater concern given his paranoia. Intramuscular depot medications can be helpful for promoting adherence if other alternatives have been unsuccessful, but IM medications are painful and less likely to be accepted by a paranoid person. All of the other strategies also apply but are secondary to trust and bonding with his providers.

Answer to Question 2

2
Delimitation of noncompliance