Psychiatric Mental Health Nursing: Paranoid Schizophrenia - Term Paper Example

Psychiatric Mental Health Nursing: Paranoid Schizophrenia Introduction In medical term, psychosis has become a recurrent condition that severely disrupts an individual’s brain functioning thus, affecting personal perceptions, thoughts, emotions and behavior. This is because, most of the patients diagnosed with paranoid schizophrenia experience psychosis that is evident in disordered thoughts, speech and difficulty in distinguishing perceptions of reality (Paris & Tyrer, 2006). More so, as individuals grow up, they are more likely to develop mental disorders that require consistent medication. Even though, patients who suffer from such conditions are born normal, they later on develop some form of withdrawal as they behave as if they are alarmed and depressed about certain normal conditions by experiencing their own hallucinations (Hersen, 2011). Demographic Data As a mental condition, paranoid schizophrenia changes an individual perspective of different ideas and focuses on an indication that occurrence of paranoid schizophrenia as one of the DSM-IV disorders experienced significantly has lower incidences (Barlow, 2012). Nonetheless, research on cases reported related to diagnosed and treated cases of paranoid schizophrenia shows that the incidence of the occurrence of the mental disorder is higher in males as compared to the females who live in urban communities and among migrants. More significantly, the occurrence of paranoid schizophrenia has been associated with individuals who are most likely in their adolescence stages as the most common time of onset amongst males patients is between eighteen and twenty-five years while among female patients, it is between twenty-five years to mid-thirties (Tasman et al., 2007). Reason for Presentation More than often, cases of mental disorder such as paranoid schizophrenia are associated with considerable personal, mental and social disruption. More significantly, health care physicians who deal with conditions of paranoid schizophrenia associates the mental disorder with a severe disturbance in an individual’s mental logical condition, personality and behavioral tendencies (Rotenstein et al., 2007). Over the years, paranoid schizophrenia has been classified as a DSM-IV disorder. This is because it is a long-term disorder that affects all interpersonal situations of an individual especially when it is not treated earlier. Majority of people suffering from this disorder tends to have a consistent mental disorder that affects the way individual’s think, talk and behave, as they relate with other people. In most cases, these individuals become increasingly hostile and angry (Hopwood et al., 2009). History as reported by others In most cases, patients are diagnosed to have mental disorders that are as a result, of disintegration of the thinking process, as their behaviors suddenly change as they experience an inability in their distinction of happenings of external reality from internal fantasy (Bergman, Young, Zimmerman, & Chelminski, 2007). Most commonly, patients suffering from mental disorder as a result, of deficit in psychosis experience have an inability to differentiate the external world information that is normal to other people from information that originates from distortions of their inner world of the mind, abnormal sensations and hallucinations that exist in their brain (Tyrer et al. 2010). More than often, such characteristics of psychosis are closely associated to be a common feature of schizophrenia. This is because, health cases associated with paranoid schizophrenia have got psychotic symptoms that comprise of features of mood disorders, organic mental disorders, schizophreniform disorder, delusional disorder schizoaffective disorder, atypical psychosis, brief reactive psychosis and induced psychotic disorder (Sturmey, 2009). . Past Mental Health/Mental Illness History In most health cases, the occurrence of schizophrenia have been identified to have similar symptoms as the disorder develops gradually and disrupts an individual mental, personality and physical condition. More so, as a mental condition classified as a DSM-IV disorder, it is best understood as a group of disorders with similar clinical profiles as patients portray similar behaviors (Sturmey, 2009). In addition, patients suffering from paranoid schizophrenia show consistent changes especially in their thought disturbances in clear senses. This is because, paranoid schizophrenia is characterized by symptoms such as increased cases of hallucinations, bizarre behavior, delusions and deterioration in the general level of functioning as compared to an individual past conduct (Barlow, 2012). More considerably, the onset and course of psychosis as a disorder that could be associated with paranoid schizophrenia can be viewed as changes undertaken by individuals towards stress vulnerability. However, a continuous case is accompanied by a variety of psychological, biological and social factors that can influence vulnerability to paranoid schizophrenia (Paris & Tyrer, 2006). More significantly, the cases of psychotic disorders according to practitioners who special on mental disorder are more likely to result from increased levels of drug use as individuals experience intersection of high stress and vulnerability levels. Comprehensive Bio-Psychosocial Assessment More than often, as physicians carry out comprehensive bio-psychosocial assessment they ensure that the diagnoses of such medical conditions are properly evaluated. In most cases, the specialists dealing with mental cases adopt the biopsychosocial model to explain phenomena such as depression, hallucination and unexpected abnormal changes in behavior by carrying out examination of all relevant psychological and social factors associated with the disorder. Based on assessment of the biological factors, the cases of depressed individuals who eventually end up with psychological and mental disorders are often significantly disturbed by the endocrine hormone, immune, and neurotransmitter system functioning in an individual (Nemade Reiss & Dombeck, 2007). In addition, cases of depression especially among adolescents who are growing can make a person more vulnerable to developing a range of physical disorders. More so, cases of genes influencing transmission of disorders caused by depression have been evident as patients who suffer from physiological and mental disorders are most likely to have a family history of such cases (Hersen &Beidel, 2011). More considerably, research indicate that cases of mental disorder like paranoid schizophrenia has been found to have inheritance levels because a person who has the disorder is often more likely to have genes influence as transmission of them DSM-IV disorder is commonly found within a close relation in a family (Koenig, 2007). Physical Assessment Vital signs Assessment More than often, the occurrence of paranoid schizophrenia has been associated with several vital signs (Nemade Reiss & Dombeck, 2007). An assessment of Simon’s medical case as explained by his mother, Vera shows signs that include the presence of visual hallucinations as the mother explains how he smashed down the television claiming broadcasts about him had been made available to the entire city, which was not true. In addition, he had come up with delusions based on his beliefs on eating organically produced foods as he has a false believe that other types of foods will kill him because it has poison. More significantly, Simon has shown continuous levels of anxiety on issues that relate to medication as he indicates that he is not ready to take medications that are similar to the one his cousin took. He also refuses to sit down, as he is impatient and does not like the fact that he is hospitalized, as he believes that he is not sick. Simon also expresses anxiety as he looks up instantly to any sounds or movements as he either stares at the ceiling or at staff members while portraying abnormal shaking of his hands and other parts of the body (Barlow, 2012). His reaction alternates between being intrigued to afraid and hostile. In addition, Simon’s mother attributes to increased anger levels in Simon’s behavior as he has become violent as a result of mild irritations for example, when watching television thus, expressed increased fury and rage. It is also clear that, Simon shows some form of detachment as he isolates himself from the social world, as he seems both physically and emotionally reserved (Paris & Tyrer, 2006). He has developed an irregular pattern of going to his workplace as he remains reserved in the and remote from going on outings to the pub or to football games with his friends as he did before and has instead preferred to spent lengthy time in his bedroom playing music loudly. In addition, Simon had shown a higher level of aggression and violence over the recent pasts as his mother explains that he has become violent and quarrels more frequently when asked questions (McGilloway et al., 2010). He also shows signs of condescension as he feels patronizing to know things other people do not and subsequently assume such a manner. More significantly, Simon emphasizes that he is not suffering from any medical condition that could keep him in hospital as he claims that he was told what the doctors were going to do. Weight Assessment Even though, there is no clear information on Simon’s weight, his mother explains that he has lost a significant amount of weight because he often does not eat for several days. Height Assessment No information is given based on Simon’s height in the case study. Past Medical History Assessment Simon’s family has a past medical history on paranoid schizophrenia. This is because his maternal cousin was treated for a similar disorder based on diagnosis of schizophrenia. Mental status examination (MSE) Appearance, Behavior & Attitude In most cases, individual’s with mental disorder especially those associated with paranoid schizophrenia change their personal appearance physically, behavior and attitude (Koenig, 2007). More so, Simon physical appearance has changed as he is unkemptly dressed in dirty jeans, a torn flannelette shirt and walks barefoot. He has also changed his hairstyle as he has a patch of matted and dreadlocked hair at the back of his head and has had a number of piercings in his nose, ears and lips. More than that, his mother seems disturbed by his change in behavior, as he has portrayed a consistent level of poor hygiene because he does not shower, change clothes or shaving regularly. As a result, Simon’s hygiene status has significantly diminished as exhibited by body odour, unchanged clothes and matted hair. Speech The effects of paranoid schizophrenia are high on the speech of an individual as one fails to communicate as they used to initially. Indeed, Simon has limited his verbal communication with family and friends, as he experiences decease in fluency and content in his speech. Mood and Affect Most of the time, individuals suffering from mental disorders behave differently, depending on their moods (Gerstein & Dyne. 2012). More significantly, Simon’s mood is highly influenced by his intake of Marijuana as he finds it satisfying. In addition, depending on his mood, Simon has a high level of physical and verbal hostility towards his friends and family as he keeps to himself. In addition, Simon avoids attending work regularly depending on his mood. Thought Process Individuals who suffer from mental conditions have a different thought process as they express their own ideas that suit them (Akhtar, 2009). As a result, Simon thinks about issues in a different way as he takes does not see a visit to a specialist as a way of helping him improve his condition as he believes that there is nothing wrong with him, and he should not be kept in a hospital ward. Thought Content In most cases, individuals who suffer from paranoid schizophrenia medical conditions have difficulty in thinking in a similar way as normal people do as they feel they are in their own world (American Nurse Association, 2007). As a result, Simon expresses a different thought content based on his medication as he feels that he is all right. He also seems reserved from exchanging idea about different issues with friends and family as he used to enjoy their company in the past. Perception Considerably, patients suffering from paranoid schizophrenia differ mentally, as they express internal inconsistency of feelings especially based on their highly variable needs there are different perceptions and behavior (Eccles & Sanders, 2009). As a result, they reserve themselves from the company of other people as they develop feelings of fear just as Simon did when entering the interview room. Cognition Individuals who suffer from paranoid schizophrenia have a problem with their cognitive state as they experience feeling of similar recognition of things as those who do not suffer from mental disorder (Bergman et al., 2007). Simon’s reaction towards different issues alternates between being intrigued to afraid and hostile. Insight & Judgment In the case where someone is in a state of mental disorder, they develop their own insights and judgment (Hopwood et al., 2009). Simon’s case causes him to develop visual illusions because the television was broadcasting information about him to the entire city. Risk assessment More than often, mental disorders associated with paranoid schizophrenia have seen risk factors like suicidal attempts, unmarried, socially isolated, and unemployment to be at high levels (American Nurse Association, 2007). More significantly, the risk factors are associated to controls and measures of social, interpersonal, and occupational functioning that make the patients isolate themselves from other people. However, the extent of risk factors being considered have declined as medics advise treatment of schizophrenia using a number of antipsychotic drugs as patients can live a normal lives, as they continue with maintenance of doses of the medications. As expressed by Simon’s mother his current state was not easy to take considering that, her son drastically changed his behavior. Nevertheless, the family will have to understand the state in which Simon is in and try to help him even though; treatment process may take a longer period. The challenge to the family is the use of behavioral family management program, as it requires the commitment of the patient and the family members to complete all the sessions successfully (Rubin, Springer & Trawver, 2010). In addition, it is hard for Simon to come into terms with the effects of the current medical condition that he is suffering from include the change of behavior as a result, of illness from paranoid schizophrenia. Above all, the client Simon will have to give up the use of marijuana as it has close relation to his current mental condition. Nonetheless, his employee should understand the current medical condition Simon is undergoing and offer him counseling and support as he recovers (Koenig, 2007). As the healthcare practitioner chosen to assist Simon, I will undertake several recoveries through medication and therapy to assist him recover fully. As a result, Simon will continue with his treatment using Olanzapine 10mg daily while continuous monitoring him, however, in case of resistance medication will shift to stronger conventional antipsychotic drugs used for treatment (Gerstein & Dyne. 2012). More so, the family method to be used remained consistent with the behavioral management approach that involves families with members who suffer from Schizophrenia cases. It is essential for Simon’s family to assist him in programs divided into suitable sessions that bring the family member and the psychiatrist together at this point his maternal cousin should be involved (American Nurse Association, 2007). In addition, it is necessary to use drug and family therapy, as one way of ensuring that Simon gets successful treatment from DSM- IV mental disorder known as Schizophrenia. 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