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What is the most appropriate response by the PMHNP?

November 10, 2022
Christopher R. Teeple

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 difficulty 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?
What are the ethical and legal obligations for the PMHNP in the above situation?
Goals that are not mutually shared between providers and patients can be very challenging, both clinically and emotionally. What steps can the PMHNP take to promote their personal emotional and mental health when working with clients whose health choices are likely to lead to adverse health outcomes?
Integration of Evidence: The student post provides support from a minimum of one scholarly in-text citation in addition to the textbook.
Engagement in Meaningful Dialogue: The student responds to a student peer and course faculty to further dialogue.
Peer Response: The student responds substantively to at least one topic-related post by a student peer. A substantive post adds content or ingishtes or asks a question that will add to the learning experience and/or generate discussion.
Faculty Response: The student responds substantively to at least one question by course faculty. The faculty question may be directed to the student, to another student, or the entire class.
Professionalism in Communication: The student presents information in a logical, meaningful, and understandable sequence, and is relevant to the discussion topic.
Grammar, spelling, and/or punctuation are accurate.
Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 10 words). The quote must add substantively to the discussion.
Reference Citation: The student provides references that have complete information as required by APA Style (0-1 errors). In-text citations are included for all references AND references are included for all in-text citations (zero errors).
Wednesday Participation Requirement: The student provides a substantive response to the graded discussion question(s) or topic(s), posted by the course faculty (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.
Total Participation Requirement: The student provides at least three substantive posts (one to the initial question or topic, one to a student peer, and one to a faculty question) on two different days during the week.

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