lOMoARcPSD|1709022
lOMoARcPSD|1709022
Mark is a 37-year-old client with a 15-year history of schizophrenia. When he was first diagnosed, he
was prescribed a second-generation antipsychotic medication. He complained about drowsiness and
difÏculty concentrating. He experienced a 40 lb. weight gain over a year. His girlfriend complained
about his reduced sex drive and ended their relationship. He tried several different medications alone
and in combination but found the side effects intolerable. He stopped taking his medications and
started self- medicating with alcohol. Over time, he experienced several relapses and his condition
declined markedly. He lost his housing and began living in his car. After being involuntarily committed
following a psychotic episode, he was referred to the PMHNP at the outpatient clinic. When he
presented for his appointment, he told the PMHNP that he stopped taking his medications due to
their side effects.
Application of Knowledge: The student post demonstrates the application of knowledge.
What is the most appropriate response by the PMHNP? How can the PMHNP support adherence for
this client?
The current guidelines for treating schizophrenia recommend the use of antipsychotic medications as a
crucial part of long-term maintenance therapy. However, adherence to these medications remains a
significant challenge for clinicians treating individuals with schizophrenia. Nonadherence can be due to
various factors such as lack of insight, negative attitudes towards medication, the chronic nature of the
illness, complex treatment regimens, medication side effects, cost, and poor social functioning (Cahaya
et al., 2022).
The PMHNP needs to first listen to Mark express his reasons for not adhering to his medication regime.
It's essential for the PMHNP to be empathetic and non-judgmental, establishing a rapport of trust and
concern. Ensuring Mark's basic needs, such as housing and food, are met should be the first plan of
action. The PMHNP should also assess Mark's support system, socioeconomic status, and access to
healthcare. Non-adherence among patients with schizophrenia and schizoaffective disorders has been
associated with cognitive impairment, depression, substance abuse, inadequate or fragmented care,
lack of family support, cultural influences, and lower socioeconomic status (Cahaya, et al., 2022).
The next steps involve educating Mark on his medications, including the risks, benefits, and side
effects, as well as the consequences of not taking his meds. It's crucial to educate him on the positive
effects of adhering to his medication regimen. Current guidelines for schizophrenia care recommend
antipsychotics as an essential part of long-term maintenance treatment. However, non-adherence to
antipsychotic medication is more prevalent in people with schizophrenia, which may increase the risk
of relapse, rehospitalization, suicide, and death. Non-adherence to treatment has an impact on disease
progression, leading to disease complications, disruption of physical and social functioning, and
decreased quality of life for people with schizophrenia (Cahaya et al., 2022).
The PMHNP and Mark should work together to create a plan of care that suits him. Collaboration
among health professionals such as psychiatrists, psychologists, psychiatric nurses, and pharmacists can
lead to better treatment for people with schizophrenia. Different interventions have their advantages
and disadvantages, and they can be used alongside antipsychotic therapy, which remains the primary
lOMoARcPSD|1709022
Mark is a 37-year-old client with a 15-year history of schizophrenia. When he was first diagnosed, he
was prescribed a second-generation antipsychotic medication. He complained about drowsiness and
difÏculty concentrating. He experienced a 40 lb. weight gain over a year. His girlfriend complained
about his reduced sex drive and ended their relationship. He tried several different medications alone
and in combination but found the side effects intolerable. He stopped taking his medications and
started self- medicating with alcohol. Over time, he experienced several relapses and his condition
declined markedly. He lost his housing and began living in his car. After being involuntarily committed
following a psychotic episode, he was referred to the PMHNP at the outpatient clinic. When he
presented for his appointment, he told the PMHNP that he stopped taking his medications due to
their side effects.
Application of Knowledge: The student post demonstrates the application of knowledge.
What is the most appropriate response by the PMHNP? How can the PMHNP support adherence for
this client?
The current guidelines for treating schizophrenia recommend the use of antipsychotic medications as a
crucial part of long-term maintenance therapy. However, adherence to these medications remains a
significant challenge for clinicians treating individuals with schizophrenia. Nonadherence can be due to
various factors such as lack of insight, negative attitudes towards medication, the chronic nature of the
illness, complex treatment regimens, medication side effects, cost, and poor social functioning (Cahaya
et al., 2022).
The PMHNP needs to first listen to Mark express his reasons for not adhering to his medication regime.
It's essential for the PMHNP to be empathetic and non-judgmental, establishing a rapport of trust and
concern. Ensuring Mark's basic needs, such as housing and food, are met should be the first plan of
action. The PMHNP should also assess Mark's support system, socioeconomic status, and access to
healthcare. Non-adherence among patients with schizophrenia and schizoaffective disorders has been
associated with cognitive impairment, depression, substance abuse, inadequate or fragmented care,
lack of family support, cultural influences, and lower socioeconomic status (Cahaya, et al., 2022).
The next steps involve educating Mark on his medications, including the risks, benefits, and side
effects, as well as the consequences of not taking his meds. It's crucial to educate him on the positive
effects of adhering to his medication regimen. Current guidelines for schizophrenia care recommend
antipsychotics as an essential part of long-term maintenance treatment. However, non-adherence to
antipsychotic medication is more prevalent in people with schizophrenia, which may increase the risk
of relapse, rehospitalization, suicide, and death. Non-adherence to treatment has an impact on disease
progression, leading to disease complications, disruption of physical and social functioning, and
decreased quality of life for people with schizophrenia (Cahaya et al., 2022).
The PMHNP and Mark should work together to create a plan of care that suits him. Collaboration
among health professionals such as psychiatrists, psychologists, psychiatric nurses, and pharmacists can
lead to better treatment for people with schizophrenia. Different interventions have their advantages
and disadvantages, and they can be used alongside antipsychotic therapy, which remains the primary
