Case Study: Examine Pakistani Woman with Delusional Thought Processes Case Study: Examine Pakistani Woman with Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the clients pharmacokinetic and pharmacodynamic processes. At each decision point stop to complete the following: ORDER INSTRUCTIONS-COMPLIANT NURSING PAPERS Decision #1 Which decision did you select? Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different? Decision #2 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different? Decision #3 Why did you select this decision? Support your response with evidence and references to the Learning Resources. What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different? Also include how ethical considerations might impact your treatment plan and communication with clients. Delusional Disorders Pakistani Female With Delusional Thought Processes Hispanic male BACKGROUND The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an ?arranged? marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as ?brief psychotic disorder.? She was given this diagnosis as her symptoms have persisted for less than 1 month. Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was ?out of control? which resulted in his calling the police and her subsequent admission to an inpatient psych unit. During todays assessment, she appears quite calm, and insists that the entire incident was ?blown out of proportion.? She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an ?American wife? instead of her. She tells you that she knows this because the television is telling her so. She currently weighs 140 lbs, and is 5 5? SUBJECTIVE Client reports that her mood is ?good.? She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down. You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits. Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman. MENTAL STATUS EXAM The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures,?or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be ?listening??to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation. The PMHNP administers the PANSS which reveals the following scores: -40 for the positive symptoms scale -20 for the negative symptom scale -60 for general psychopathology scale Diagnosis: Schizophrenia, paranoid type ORDER INSTRUCTIONS-COMPLIANT NURSING PAPERS RESOURCES ? Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261-276. ? Clozapine REMS. (2015). Clozapine REMS: The single shared system for clozapine. Retrieved from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf ? Paz, Z., Nalls, M. & Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal. 13. 625-629. Decision Point One Select what the PMHNP should do: Start Zyprexa 10 mg orally at BEDTIME Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter Start Abilify 10 mg orally at BEDTIME . Case Study: Examine Pakistani Woman with Delusional Thought Processes Order Now

 

ADDITIONAL INFORMATION 

Delusional Thought Processes

Introduction

Delusional thought processes are those that involve a person’s perception of reality. They are most often associated with psychosis or schizophrenia, but can occur in any mental illness. Delusions can be either persecutory (e.g., persecution from others) or grandiose (e.g., believe oneself to be a celebrity; believe one has special powers). In some cases, delusions may be mixed types of delusional disorder which incorporate elements from each classification—for example, someone who believes they’re being followed by government agents may also have fears of being poisoned or drugged without knowing why.

10 Common Delusional Thought Processes

• Delusions of reference: This is when a person believes that another person or thing is responsible for their misfortune. For example, someone might believe that their boss is trying to get them fired because he doesn’t like their work ethic. This can be caused by stress and anxiety, but it’s not just stress-related thinking—the person also has a specific belief system in mind (for example: “If I work hard, I’ll get promoted”).

• Delusions of persecution: People who have these types of delusions believe they are being persecuted by other people or entities. They may feel trapped and helpless as well as threatened by danger or harm coming at them from both inside (they have been harmed) and outside (they think others are out to get them). These individuals often develop paranoia over this perceived persecution; they will often accuse others of being behind everything bad that happens to them—even things that aren’t true!

Somatic delusions

Somatic delusions are a symptom of schizophrenia and can include the following:

• The person thinks they have a serious physical illness when they don’t.

• The person doesn’t realize that their symptoms are actually just part of the delusion.

Erotomania

Erotomania is a delusion in which the affected person believes that another person, usually of higher status, is in love with them. It is one of the most common forms of jealousy and it occurs more commonly in women than men. The onset can occur at any age but it typically begins during adolescence or early adulthood.

Grandiose delusions

Grandiose delusions are delusions of inflated worth, power, knowledge or identity. They may involve the belief that one has special powers, talents or abilities which are not accepted by others; and that one is destined for greatness.

The main features of grandiose delusions include:

• Belief in exceptional intellectual ability (e.g., being a genius);

• Self-confidence;

• The need for constant attention from others because they are believed to be superior;

• A feeling of being special among other people (e.g., “I am better than you”).

Delusional jealousy

Jealousy is a common emotion that is often misunderstood. While jealousy can be healthy and motivating, it can also lead to delusional thinking. People with delusional jealousy are often convinced they have been cheated on or broken up with by their partner, even when there’s no evidence of this happening. This pattern of thinking will make them feel unsafe in their relationship, causing them to act out against the person they believe has been unfaithful or betrayed them—which may include violence or other harmful behaviors such as stalking.

Jealousy can also appear in people who have bipolar disorder (manic depression) if they experience mania during which time they feel very angry at others who might hurt them but lack insight into what’s going on within themselves; this type of negativity then tends towards becoming more extreme over time until it reaches an extreme point where all forms of social interaction cease completely because none exist anymore except for those closest friends/family members who understand how important contact with others really needs too exist before losing hope completely becomes inevitable.”

Delusions of guilt or sin (persecutory type)

Delusions of guilt or sin (persecutory type)

This delusion is characterized by a sense that someone has persecuted the patient, usually because they have offended them. The patient will often attribute their actions to this persecutor, or may see it as a punishment for some unknown offense. The delusions may involve supernatural forces such as angels and devils, who are said to be responsible for harming or harming those close to the patient.

Delusions of reference (persecutory type)

Delusions of reference are when a person thinks that insignificant events or objects in their environment have a special meaning or significance specifically for them. For example, if you’re driving down the road and see a stop sign, this might trigger a delusion of reference that says “I am being stopped by police officers because I did something wrong.”

It is important to note that delusions of reference are not always associated with paranoia and may occur without any accompanying symptoms. Many individuals will experience such delusions without any apparent mental health problems at all; however, if they do become symptomatic (i..e., present with other symptoms), then it would be wise to seek professional help from someone who can assess your situation more thoroughly than just talking about it on paper will provide

Hypochondriacal delusions

An example of this is when a person believes they have an illness, but doesn’t actually have it. This can be a very common delusion for hypochondriacs. For example, you may believe that you have a serious disease when in fact you don’t (or vice versa).

Another example would be if someone believed their loved one was going to die from an illness or injury and then died before them. This is known as “death wish syndrome,” where the person wants to die because they see no purpose in living anymore and feels trapped by life’s obligations (i.e., mortgage payments).

Nihilistic delusions

Nihilistic delusions are a type of delusion where someone believes that something important or valuable is missing, such as their family or religious group. Some people who have this type of delusion may also think they have lost a body part or organ.

Nihilistic delusions can be symptoms of schizophrenia, but they can also occur in other mental health disorders like bipolar disorder, depression and personality disorder.

Delusions of control (persecutory type)

In a delusional belief, you believe that your thoughts and actions are being controlled by an external force. This can be anything from believing that someone is hypnotizing you, to thinking your thoughts are being broadcast over the radio. If a person is convinced that they have been wronged in some way, he may assume that others must have done something to him or his family in order to make them so unhappy.

Delusions of persecution often involve supernatural forces such as demons or angels who are trying to coerce us into doing something against our will (such as committing suicide). People with this type of delusion also believe that they were born into an abusive family situation and therefore deserve whatever abuses come their way because they’re worthless individuals who don’t deserve better treatment; this makes sense if we consider how difficult it would be for anyone not born into abuse situations! They also tend towards self-blame—they believe themselves responsible for whatever happens around them because “everything” is somehow connected through karma/fate etcetera

Mixed type of delusional disorder

A mixed type of delusional disorder occurs in about 10% of cases. This is when the person has two or more different types of delusions, but none are so severe as to cause them to harm themselves or others. The reason for this is not known, but it’s thought that it may be due to a combination of factors such as a brain injury and/or head injury causing damage to certain parts of the brain that control our perception and thinking processes – meaning they can no longer differentiate between fact and fiction!

Takeaway:

Delusional disorder is a serious mental illness that affects about 1% of the population. It can occur with or without other symptoms of psychosis, such as hallucinations and delusions. Delusions are false beliefs that a person holds regardless of evidence to the contrary, and they are often associated with a sense of persecution by others (e.g., being chased by invisible enemies). They may also be grandiose, meaning they believe they have special powers or abilities (godlike).

Delusions are found in many different types of mental disorders including schizophrenia, bipolar disorder, major depression and anxiety disorders like generalized anxiety disorder or obsessive-compulsive disorder (OCD).

Conclusion

While these thought processes are not always harmful, they can be very distressing for the person experiencing them. It is important to remember that this is a normal part of human life and that it does not need to be treated as a mental illness. The best thing you can do is learn more about these delusional thought processes so that you can recognize them in yourself or others when they occur.