Therapy for Patients With Schizophrenia
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.
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%20Schizophr
enia.%20Schizophrenia%20can%20be%20found,is%20one%20o
f%20the%20leading%20causes%20of%20disability
Objectives
· 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
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). 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 importan t
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%20a
ttention%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.
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
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.
· 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?
· 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.
Note: Support your rationale with a minimum 3 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.
Week 4 – History of Religious Oppression
Choose one time period and discuss the history of religious
oppression.
1) Roman Imperial Period vs. Christianity (60 CE – 310 CE)
2) Christian oppression of pagans in Roman World (395 CE -
476 CE)
3) The Crusades (12th century – 1100s)
4) Salem Witch Trials – Massachusetts (1692-1693)
5) Expulsion of the Jews and Muslims from Spain (1490-1493)
6) Anti-Semitism in Medieval Spain, France, England, Italy,
Germany (choose one country only – 800-1392)
7) Romans versus Jews (20-200 CE)

8) Catholics vs. Huguenots in France (16th-17th centuries –
1500s-1600s)
9) Philadelphia Anti-Catholic Riot (1844)
10) Rohingya persecution Myanmar (2016-2018)
11) Kosovo Ethnic cleansing (1998-1999)
12) Rwanda Genocide (1994)
13) Muslim persecution in India (1954-1982)
14) Ottoman Persecution of Alevis (1481-1826)
15) Any of your choice with professor approval
Instructions
Answer the following questions in numerical format (#1-5). 2-3
pages. MLA format. 12 Font Times New Roman only.
All work must be properly cited and unless otherwise noted; do
not include pure opinion.
1) Outline the basic history of the event(s). You can use a
timeline or write it out.
2) Briefly describe the two opposing religions basic tenets.
3) How did the different beliefs, values and attitudes of the
cultures add to the oppression?
4) How did the outcome of the conflict influence modern
American ideas, beliefs and values?
5) Opinion – why do you think religion played such a major role
in these conflicts?