Reference no: EM132815201

Terresa, 24 years old, presents to an outpatient crisis center with complaints of hearing voices and seeing things on television that aren't really there." Her husband Anthony accompanies her and reports that his wife's behavior has become increasingly odd and frightening. "She is not sleeping and believes that someone is poisoning her. He urged her to come to the clinic. The couple has been married for 2 years. They have no children, although Anthony reports that they were going to start a family before Teresa's recent symptoms. They live in the urban neighborhood where they both grew up. Extended family on both sides lives nearby. Teresa reports a history of psychiatric problems that began at age 18 during her first semester living at college. She had her "first breakdown," came home, was hospitalized, and did not return to school. She believes that she recovered from what she calls "my psychosis," but was intermittently plagued with auditory and visual hallucinations. After the first breakdown, Teresa began working with a private psychiatrist her parents paid for the treatment.

During the 6 years of care, the psychiatrist attempted several drugs for the hallucinations. Teresa reports that she was taking clozapine (Clozaril) approximately 1 year ago and was much better," even taking college courses again. However, she adds that her psychiatrist retired 2 months ago. This development, coupled with a 45-lb (20.4 kg) weight gain, caused her to stop taking the drug. Health care team members note Teresa's increasing paranoia and vague threats toward Anthony. They recommend a brief hospitalization. Teresa reluctantly agrees. During admission, the hospital psychiatrist prescribes clozapine for Teresa. At discharge 7 days later, the client agrees to visit the clinic nurse for help in managing her medication. Teresa also begins to attend a therapy group for women and resumes college
classes.

Reflection and Critical Thinking

• What teaching will the nurse need to address with Anthony or other family members?
• What steps should the nurse take to develop an ongoing relationship that allows Teresa to discuss her concerns about medication, rather than abruptly discontinuing it in the future?
• What teaching points should a nurse consider for this client, a woman of childbearing age with severe psychiatric problems?

Reference.

Psychiatric- mental health nursing. Wanda K Mohr 8th edition