Schizoaffective Disorder

Description

SARAH   Client Profile Sarah: is a 34-year-old female. Born in Hungary, she married an American and came to this country when she was 25 years old. About a year later, Sarah began a series of admissions to psychiatric facilities. She was diagnosed with major depression and later with Schizoaffective Disorder. About a month ago, Sarah stopped keeping outpatient appointments, stopped taking her medication, stopped bathing, and stopped eating, but was sleeping all the time. Sarah’s mood symptoms suddenly became less noticeable, and she began wandering her yard after dark,    saying the neighbors were in the trees. Sarah began to carry a gun to protect herself against the neighbors, who she thought were out to kill her. When she started to fire the gun into the trees, her brother got a court order to have Sarah committed for treatment.   Case Study: Two deputies, one male and one female, and her brother have brought Sarah to the psychiatric hospital to be admitted. The nurse does an assessment on Sarah and discovers Sarah has been on risperodone (Risperdal) liquid, valproic acid  (Depakote), and venlafaxine (Effexor XR). The psychiatrist orders these medications to be continued. At first the nurse is unable to get Sarah to sign consent forms to take the medication, but after a few days, she does sign the forms. By this time, her pregnancy test has come back negative, and she is started back on her usual medication. The nurse finds Sarah to be somewhat tangential with loose associations. When the nurse assigns Sarah to attend a medication class, she refuses. When asked to interpret a proverb, she refuses. Sarah begins to talk about her food being poisoned and being “king” of the hospital. She claims to have subjects to take care of the food and those who try to poison it. Sarah tells the nurse that she has been hospitalized eight times previously at another psychiatric facility. The nurse sends a signed release of information form to the designated psychiatric facility requesting copies of Sarah’s latest psychosocial assessment, treatment plan, and discharge summary. The requested information reveals that Sarah’s discharge diagnosis at that facility was Schizoaffective Disorder, Bipolar Type. After three weeks on medication, Sarah no longer seems to have hallucinations and delusions. The psychiatrist is ready to discharge Sarah, but her Depakote level comes back low. A nurse discovers Sarah has been cheeking her morning dose and sometimes her evening dose of Depakote and has been putting the medicine in a pair of shoes. Sarah hands the nurse an envelope with two hundred dollars and the words “Thank-you nurse” written on the outside. About this time the nurse notices that Sarah has suddenly become hyperverbal, hyperactive, intrusive, and sexually suggestive to peers and staff.   Please answer the questions on the following page accurately and thoroughly. You may use your textbook, classroom notes, as well as, you may need to look information up from outside sources.  Please also refer to the case study grading rubric. Please use a separate sheet of paper to answer the questions. Please have the question and answer on your answer sheet.       1.     What is Schizoaffective Disorder, symptoms, types, and what is needed to achieve diagnosis? (10 points)   2.     Do Sarah’s symptoms match those of Schizoaffective Disorder, and if so, how? (5 points)   3.     On what basis do you think Sarah was court committed? Give examples specific to Sarah. (5 points)   4.     Why was Sarah’s medication delayed? Why did the nurse not start it on admission? (5 points)   5.     Does Sarah have hallucinations and/or delusions? What makes you think so? (5 Points)   6.     If Sarah does have hallucinations and/or delusions, how should the nurse respond?(5 points)   7.     Discuss the current theories of etiology, treatment, and prognosis of Schizoaffective Disorder. (5 points)   8.     What are the possible explanations for the client giving the nurse an envelope with money in it? How would you respond to this gift offer if you were the nurse? Please explain cultural considerations relating to this action. (10 points)   9.     Please explain each of the medications prescribed to Sarah. Please include drug class, mechanism of action, common side effects, normal dosage, contraindications, important patient teaching, and nursing considerations. (5 points each drug, for a total of 15 points)   10.  Write 3 nursing diagnoses for this client? (Please write the nursing diagnosis correctly). For each nursing diagnosis, please write 4 nursing interventions. (30 points – Each nursing diagnosis with 4 interventions is worth 10 points each)   2 Points – Uploading to drop box in time (DUE: November 22, 2020 3 Points – Correct grammar, spelling, punctuation   REMEMBER TO PLEASE USE A SEPARATE SHEET FOR ANSWERS – PLEASE INCLUDE QUESTION AND ANSWERS ON YOUR ANSWER SHEET.   PLEASE REFER TO THE GRADING RUBRIC FOR THE CASE STUDY  Criteria Assessment Assessment Assessment Case Study: Question 1:  Disorder Description The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information (5) points The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information. (10) points Case Study: Question 2: Clients Symptoms matching disorder The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information (2.5) points The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information. ( 5 ) points Case Study: Question 3: Court Commitment The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information (2.5) points The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information. (5) points Case Study: Question 4:  Why medications delayed The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information (2.5 points) The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information. (5 pts )  Case Study: Question 5: Hallucinations/Delusions The question is not answered correctly utilizing information from the case study. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information (2.5) points The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information. (5) points Case Study: Question 6: Nurse response to hallucinations/delusions   The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information ( 2.5 ) points  The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information.  (5) points  Case Study: Question 7 : Etiology, treatment, prognosis The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information ( 2.5 ) points  The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information.  (5) points  Case Study: Question 8 : Cultural considerations   The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information ( 5 ) points     The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information.  (10) points  Case Study: Question 9 : Medications   The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information ( 2.5 points per drug for a total of 7.5 points)  The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information.  (5 points per drug for a total of 15 points)  Case Study: Question 10 : 3 Nursing Diagnosis with 4 interventions each. Each diagnosis with interventions is worth 10 points each for a total of 30 points   Nursing Diagnosis must be written completely. Nursing problem___r/t__aeb___ The question is not answered in full, with all parts being addressed. (0) points The question is answered partially, with only portions of the question being addressed. The response is vague and partially correct, and does not show complete understanding of information ( 5 points each total 15 points ) The question is answered fully, with all portions of the question fully addressed. The response is thorough and complete, showing understanding of the information.  (10 points each total 30 points) Grammar, punctuation, and spelling Case Study The case study contains greater than 1 error in sentence structure, grammar, and/or spelling.  (0) points The case study contains one error in sentence structure, grammar, and/or spelling.                  (1) point The paper contains no errors in sentence structure, grammar, and/or spelling                (3)  points Case Study turned in on time The case study is not turned in to the drop box by the deadline. Case studies will receive no (0) points in this category, additionally, each day the case study is late, (10 points) will be deducted from the overall case study grade. No partial points.               (0) points The case study is turned in to the drop box by the (2) point