NURS 6630N Week 7: Therapy for Patients With Schizophrenia

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According to the Schizophrenia and Related Disorders Alliance of America, approximately 3.5 million people in the United States are diagnosed with schizophrenia (n.d.), and it is one of the leading causes of disability. In practice, patients may present with delusions, hallucinations, disorganized thinking, disorganized or abnormal motor behavior, as well as other negative symptoms that can be disabling for these individuals.

Not only are these symptoms one of the most challenging symptom clusters you will encounter, many are associated with other disorders, such as depression, bipolar disorder, and disorders on the schizophrenia spectrum. As a psychiatric nurse practitioner, you must understand the underlying neurobiology of these symptoms to select appropriate therapies and improve outcomes for patients. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

This week, as you examine antipsychotic therapies, you explore the assessment and treatment of patients with psychosis and schizophrenia. You also consider ethical and legal implications of these therapies.

_Reference:Schizophrenia and Related Disorders Alliance of America. (n.d.). About schizophrenia.https://sardaa.org/resources/about-schizophrenia/#:~:text=Quick%20Facts%20About%20Schizophrenia.%20Schizophrenia%20can%20be%20found,is%20one%20of%20the%20leading%20causes%20of%20disability NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Learning Objectives – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Students will:

Assess client factors and history to develop personalized therapy plans for patients with insomnia
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring therapy for insomnia
Assess patient factors and history to develop personalized plans of antipsychotic therapy for patients
Analyze factors that influence pharmacokinetic and pharmacodynamic processes in patients requiring antipsychotic therapy
Synthesize knowledge of providing care to patients presenting for antipsychotic therapy
Analyze ethical and legal implications related to prescribing antipsychotic therapy to patients across the lifespan

Learning Resources – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Required Readings (click to expand/reduce)

Freudenreich, O., Goff, D. C., & Henderson, D. C. (2016). Antipsychotic drugs. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 72–85). Elsevier.

American Psychiatric Association. (2019). Practice guideline for the treatment of patients with schizophrenia. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/Clinical%20Practice%20Guidelines/APA-Draft-Schizophrenia-Treatment-Guideline.pdf

Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

Funk, M. C., Beach, S. R., Bostwick, J. R., Celano, C. M., Hasnain, M., Pandurangi, A., Khandai, A., Taylor, A., Levenson, J. L., Riba, M., & Kovacs, R. J. (2018). Resource document on QTc prolongation and psychotropic medications. American Psychiatric Association. https://www.psychiatry.org/File%20Library/Psychiatrists/Directories/Library-and-Archive/resource_documents/Resource-Document-2018-QTc-Prolongation-and-Psychotropic-Med.pdf

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 NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Levenson, J. C., Kay, D. B., & Buysse, D. J. (2015). The pathophysiology of insomnia. Chest, 147(4), 1179–1192. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388122/

McClellan, J. & Stock. S. (2013). Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. Journal of the American Academy of Child and Adolescent Psychiatry, 52(9), 976–990. https://www.jaacap.org/article/S0890-8567(09)62600-9/pdf

Naber, D., & Lambert, M. (2009). The CATIE and CUtLASS studies in schizophrenia: Results and implications for clinicians. CNS Drugs, 23(8), 649–659. https://doi.org/10.2165/00023210-200923080-00002

Medication Resources (click to expand/reduce)

IBM Corporation. (2020). IBM Micromedex. https://www.micromedexsolutions.com/micromedex2/librarian/deeplinkaccess?source=deepLink&institution=SZMC%5ESZMC%5ET43537

Note: To access the following medications, use the IBM Micromedex resource. Type the name of each medication in the keyword search bar. Be sure to read all sections on the left navigation bar related to each medication’s result page, as this information will be helpful for your review in preparation for your Assignments. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

amisulpride aripiprazole asenapine brexpiprazole cariprazine chlorpromazine clozapine flupenthixol fluphenazine haloperidol iloperidone loxapine lumateperone	lurasidone olanzapine paliperidone perphenazine pimavanserin quetiapine risperidone sulpiride thioridazine thiothixene trifluoperazine ziprasidone

Optional Resources (click to expand/reduce)

Chakos, M., Patel, J. K., Rosenheck, R., Glick, I. D., Hammer, M. B., Tapp, A., Miller, A. L., & Miller, D. D. (2011). Concomitant psychotropic medication use during treatment of schizophrenia patients: Longitudinal results from the CATIE study. Clinical Schizophrenia & Related Psychoses, 5(3), 124–134. https://doi.org/10.3371/CSRP.5.3.2

Fangfang, S., Stock, E. M., Copeland, L. A., Zeber, J. E., Ahmedani, B. K., & Morissette, S. B. (2014). Polypharmacy with antipsychotic drugs in patients with schizophrenia: Trends in multiple health care systems. American Journal of Health-System Pharmacy, 71(9), 728–738. https://doi.org/10.2146/ajhp130471

Lin, L. A., Rosenheck, R., Sugar, C., & Zbrozek, A. (2015). Comparing antipsychotic treatments for schizophrenia: A health state approach. The Psychiatric Quarterly, 86(1), 107–121. https://doi.org/10.1007/s11126-014-9326-2

Discussion: Treatment for a Patient With a Common Condition

Insomnia is one of the most common medical conditions you will encounter as a PNP. Insomnia is a common symptom of many mental illnesses, including anxiety, depression, schizophrenia, and ADHD (Abbott, 2016). Various studies have demonstrated the bidirectional relationship between insomnia and mental illness. In fact, about 50% of adults with insomnia have a mental health problem, while up to 90% of adults with depression experience sleep problems (Abbott, 2016). NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Due to the interconnected psychopathology, it is important that you, as the PNP, understand the importance of the effects some psychopharmacologic treatments may have on a patient’s mental health illness and their sleep patterns. Therefore, it is important that you understand and reflect on the evidence-based research in developing treatment plans to recommend proper sleep practices to your patients as well as recommend appropriate psychopharmacologic treatments for optimal health and well-being.

_Reference:Abbott, J. (2016). What’s the link between insomnia and mental illness? Health. https://www.sciencealert.com/what-exactly-is-the-link-between-insomnia-and-mental-illness#:~:text=Sleep%20problems%20such%20as%20insomnia%20are%20a%20common,bipolar%20disorder%2C%20and%20attention%20deficit%20hyperactivity%20disorder%20%28ADHD%29

For this Discussion, review the case Learning Resources and the case study excerpt presented. Reflect on the case study excerpt and consider the therapy approaches you might take to assess, diagnose, and treat the patient’s health needs. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Case: An elderly widow who just lost her spouse.

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications:

Metformin 500mg BID
Januvia 100mg daily
Losartan 100mg daily
HCTZ 25mg daily
Sertraline 100mg daily

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86

By Day 3 of Week 7

Post a response to each of the following:

List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.
Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.
Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.
List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.
List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on ethical prescribing or decision-making. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals based on ethical prescribing guidelines or decision-making?
Include any “check points” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

Read a selection of your colleagues’ responses. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Example Discussion Solution

Week 7 discussion

COLLAPSE

List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions.

1.) Do you feel hopeless or depressed, and are you having interesting in doing things? This will help me understand if the sertraline she is taking is helping her with her depression by using a depression or mental health screening questionnaire further if necessary.

2.) Give me a rundown of your daily meal or diet and daily activity routine?

Too much consumption or consumption of some food can aggravate her Insomnia like caffeine, age cheese, etc., which can be modified. Some activities can promote Insomnia.

3.) Do you take your medications as prescribed? NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Some of her medications can cause Insomnia, like sertraline, and is essential to know if she is medication compliant to determine if it is the medication causing her Insomnia. SSRIs like sertraline cause sleep disturbance (Singh, H. K., & Saadabadi, A. 2020).

People in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

We may need to ask the caretaker, home help aid, or her children some of these questions.

Ask them any changes they have observed in her mood or speech before or after her husband’s passing.

Ask if they have seen any recent changes in memory, insight, or orientation, and have they seen writing a will or given her things out.

Ask also if they have noticed any changes in her anxiety level, any phobias, delirium, or dementia, and if she goes to visit friends or family. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

These questions will help you know her baseline and symptoms that might have increased or concerning and need to be addressed.

Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used.

We will use a depression screening test to know her level of depression, which will help determine her treatment plan.

A blood test like CBC.TSH third generation (a low third generation TSH levels indicates an overactive thyroid gland or hyperthyroidism, where a high third generation TSH reflects an underactive thyroid gland or hypothyroidism which can be a contributing factor to her depression or mood.UDS, urinalysis with microscopy will help screen for drugs and any UTI involve if there is any. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Liver and kidney function tests to help know how she can metabolize and eliminate drugs to be prescribed.

Vitamin B-12, Rapid plasma reagin (RPR) and HIV test.

List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why.

Sleep-related disorders (such as Insomnia, narcolepsy or parasomnia), major depressive disorder, generalized anxiety disorder, endocrine disorders (such as hyperthyroidism, hypothyroidism), drug-related conditions (such as alcohol abuse, cocaine abuse, side effects of some CNS depressants), central nervous system diseases (e.g., Parkinson disease, dementia, multiple sclerosis, neoplastic lesions) -the fact that the patient is 75 years old, this is most likely the top among differential diagnosis. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

1.) SSRI (selective serotonin uptake inhibitor), e.g., Escitalopram- SSRIs, works by inhibiting the serotonin transporter (SERT) at the presynaptic axon terminal to prevent serotonin reuptake. By inhibiting SERT, an increased amount of serotonin remains in the synaptic cleft, increasing serotonin levels, activity, and effect in the brain (Kirino E. (2012). A recent meta-analysis has found that escitalopram-treated patients showed significantly higher response rates and increased change from the baseline in the Montgomery Asberg Depression Rating Scale total scores at weeks 1 and 8, and a higher remission rate of 56% or higher (Azorin et al., 2004).

Start with 10mg escitalopram daily, then gradually move to 20mg daily depending on her medication response.

2.) TCA (Tricyclic antidepressant), e.g., Pamelor- TCAs primarily works by blocking serotonin and norepinephrine neurotransmitters’ reuptake thereby increasing the level of norepinephrine and serotonin levels in the brain. Start with 25mg, gradually increase no more than 150mg daily. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Taking a different direction of treatment if not responsive to the first treatment may include: first an optimization strategy (altering dose or duration of the SSRI), followed by switching to other SSRIs, then switching to other classes of antidepressants, after combining SSRIs with other medications or non-pharmacological therapies, switching to non-pharmacological interventions alone, or combinations of these (U.S. DHHS 2010). NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Will consider switching her to another antidepressant from Zoloft to Escitalopram.

I prefer SSRI for this patient because of the fewer and milder side effects of this type of antidepressant drug. Also, her age is of significant consideration. Side effects of TCAs on the elderly client might result in cardiovascular effects such as dysrhythmias or orthostatic hypotension that may lead to dizziness, falls, and fractures. Also, another reason I would prefer SSRI is that tricyclic antidepressants may be fatal in overdose, mainly secondary to tricyclic antidepressants-related ventricular arrhythmia and seizures (Strawn et al.,2018).

For the drug therapy, you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?

Hypersensitivity to escitalopram. Risk of hyponatremia. Bone fractures are associated with antidepressant therapy. Increase the risk of abnormal bleeding and further increase if concomitant use with aspirin, NSAIDs, or anticoagulants. Risk of cognitive and motor function impairment, so caution when operating machinery. May cause or exacerbate sexual dysfunction. Gradually taper before discontinuation—the risk of serotonin syndrome or neuroleptic malignant syndrome-like reaction. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

According to studies, the white race is always on a standard dose of antidepressant compared to another race (Lesser et al.2010). What would be problematic is weight gain in black or other races in long-term use of antidepressants. Also, minorities or other races have high attrition rate than white in maintaining treatment with antidepressants (Hui et al., 2013). Also, endocrine disorders and sexual dysfunction. Also administering drugs to elderly dosage altering or reduction is essential due to their reduction in the function of vital organs like liver and kidney involve in drug metabolism and elimination.

Include any “checkpoints” (i.e., follow-up data at Week 4, 8, 12, etc.), and indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen.

Then gradually increasing the medication dose escitalopram to optimum response after tapering off sertraline. After week four, increase the dose of escitalopram to 20 mg if the partial response and check again after week 8. If 50% response after week eight, then maintains therapy at that dose for at least six months. Add psychotherapy to the treatment plan. Escitalopram response to treatment is most significant after eight weeks, and other studies show that escitalopram has higher efficacity at 12 weeks than other SSRIs (Kirino E. (2012). Also, after about 12 weeks and there is no change, also consider the use of ECT. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

References:

Azorin, J.-M. ., Llorca, P.-M. ., Despiegel, N., & Verpillat, P. (2004). Traitement des épisodes

dépressifs sévères : escitalopram est plus efficace que citalopram. L’Encéphale, 30(2),

158–166. https://doi.org/10.1016/s0013-7006(04)95427-9

Hui, D., Glitza, I., Chisholm, G., Yennu, S., & Bruera, E. (2013). Attrition rates, reasons, and

predictive factors in supportive care and palliative oncology clinical

trials. Cancer, 119(5), 1098–1105. https://doi.org/10.1002/cncr.27854

Kirino E. (2012). Escitalopram for the management of major depressive disorder: a review of its

efficacy, safety, and patient acceptability. Patient preference and adherence, 6, 853–

861. https://doi.org/10.2147/PPA.S22495 NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Lesser, I. M., Myers, H. F., Lin, K. M., Bingham Mira, C., Joseph, N. T., Olmos, N. T.,

Schettino, J., & Poland, R. E. (2010). Ethnic differences in antidepressant response: a

prospective multi-site clinical trial. Depression and anxiety, 27(1), 56–62.

https://doi.org/10.1002/da.20619

Singh, H. K., & Saadabadi, A. (2020). Sertraline. PubMed; StatPearls Publishing.

https://www.ncbi.nlm.nih.gov/books/NBK547689/

Strawn, J. R., Geracioti, L., Rajdev, N., Clemenza, K., & Levine, A. (2018). Pharmacotherapy

for generalized anxiety disorder in adult and pediatric patients: an evidence-based

treatment review. Expert opinion on pharmacotherapy, 19(10), 1057–1070.

https://doi.org/10.1080/14656566.2018.1491966 NURS 6630N Week 7: Therapy for Patients With Schizophrenia

U.S. Department of Health and Human Services 2010. Depression Treatment after

Unsatisfactory Response to SSRIs when used as First-line Therapy | Effective Health

Care Program. (2010, June 15). Effectivehealthcare.ahrq.gov.

https://effectivehealthcare.ahrq.gov/products/depression-treatment-ssri/research-

protocol

By Day 6 of Week 7

Respond to at least two of your colleagues on two different days in one of the following ways:

If your colleagues’ posts influenced your understanding of these concepts, be sure to share how and why. Include additional insights you gained.
If you think your colleagues might have misunderstood these concepts, offer your alternative perspective and be sure to provide an explanation for them. Include resources to support your perspective.Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days and

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Submission and Grading Information

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Week 7 Discussion Rubric

Post by Day 3 of Week 7 and Respond by Day 6 of Week 7

To Participate in this Discussion:

Week 7 Discussion

Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with psychosis and schizophrenia. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

To prepare for this Assignment:

Review this week’s Learning Resources, including the Medication Resources indicated for this week.
Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with schizophrenia-related psychoses. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

The Assignment: 5 pages

Examine Case Study: Pakistani Woman With Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Introduction to the case (1 page)

Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

Which decision did you select?
Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Decision #3 (1 page)

Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Conclusion (1 page)

Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

By Day 7

Submit your Assignment.

Submission and Grading Information. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

To submit your completed Assignment for review and grading, do the following:

Please save your Assignment using the naming convention “WK7Assgn+last name+first initial.(extension)” as the name.
Click the Week 7 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 7 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK7Assgn+last name+first initial.(extension)” and click Open. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Click on the Submit button to complete your submission. NURS 6630N Week 7: Therapy for Patients With SchizophreniaNURS 6630N Week 7: Therapy for Patients With Schizophrenia

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Submit your Week 7 Assignment draft and review the originality report.

Submit Your Assignment by Day 7 of Week 7

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Week 7 Assignment NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Rubric Detail – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Select Grid View or List View to change the rubric’s layout.

Name: NURS_6630_Week7_Assignment_Rubric

	Excellent Point range: 90–100	Good Point range: 80–89	Fair Point range: 70–79	Poor Point range: 0–69
Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.	9 (9%) – 10 (10%) The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	8 (8%) – 8 (8%) The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	7 (7%) – 7 (7%) The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.	0 (0%) – 6 (6%) The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
Decision #1 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Decision #2 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Decision #3 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Conclusion (1 page) • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.	14 (14%) – 15 (15%) The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	12 (12%) – 13 (13%) The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.	11 (11%) – 11 (11%) The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. NURS 6630N Week 7: Therapy for Patients With Schizophrenia The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	0 (0%) – 10 (10%) The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. NURS 6630N Week 7: Therapy for Patients With Schizophrenia A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. NURS 6630N Week 7: Therapy for Patients With Schizophrenia
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors. NURS 6630N Week 7: Therapy for Patients With Schizophrenia	0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.

Total Points: 100

NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Learning Objectives – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Learning Resources – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Discussion: Treatment for a Patient With a Common Condition

By Day 3 of Week 7

Example Discussion Solution

By Day 6 of Week 7

Submission and Grading Information

Grading Criteria

Post by Day 3 of Week 7 and Respond by Day 6 of Week 7

Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia

To prepare for this Assignment:

The Assignment: 5 pages

By Day 7

Submission and Grading Information. NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Grading Criteria

Check Your Assignment Draft for Authenticity

Submit Your Assignment by Day 7 of Week 7

Rubric Detail – NURS 6630N Week 7: Therapy for Patients With Schizophrenia

Name: NURS_6630_Week7_Assignment_Rubric

Name: NURS_6630_Week7_Assignment_Rubric. NURS 6630N Week 7: Therapy for Patients With Schizophrenia