Using the following clinical scenario provide a short essay-style response to each of the four questions using
Four short essay question:
Discuss the key interpersonal skills you will use to engage with Andrew.
The doctor stated that Andrew has symptoms of a psychosis. Using correct clinical terms and the clinical cues in the scenario, discuss three important signs and symptoms that support the doctor's opinion.
Andrew asks you why he has a prescription for medication. Briefly discuss how you would respond.
The GP has requested Andrew is informed and carefully monitored over the next few weeks. Briefly discuss your plan.
In this scenario you are a new graduate nurse working as part of a small multidisciplinary team in a large metropolitan 24-hour medical clinic. Andrew was referred to the clinic by the local university counseling service. He is a 21-year old university student studying Law. In the referral the Counsellor expresses concern about a noticeable change in his general behaviour and a significant drop in his academic performance during this semester. At the GP's request, you sit in on the appointment interview. During the interview Andrew relates a number of loosely connected and implausible stories about different people in the university being ASIO spies. He also refers to technology such as a transmitter chip that has been inserted into his brain to monitor his thoughts. He goes on to describe other evidence of a conspiracy against him such as different electrical items being moved around in his apartment, and the lights outside his unit being operated to interfere with his thoughts. He also claims that other students have been discussing his activities with the lecturer to make sure he gets into trouble. Throughout the interview Andrew maintains a consistent flat monotone voice and sits calmly in his chair.
While observing and listening to his story, you also notice that he frequently looks around or past you as if looking for something. When you ask, he describes that he can hear them talking about him. There is no-one else in the room. He states that he can clearly hear other people talking about him. He is completely convinced they are real people but doesn't know who they are. The GP conducts a basic health check and concludes by informing Andrew that he is experiencing symptoms of a psychosis. The GP provides a script for risperidone 1 mg nocte. Before Andrew leaves the GP expresses concern that careful monitoring is needed for the next few weeks. The GP asks that you set up the next appointment and ensure Andrew has access to information and support before he leaves the clinic.