What is the most appropriate response by the PMHNP?
You have had some difficult medication side effects that negatively impact
your life and relationship.
How can the PMHNP support adherence for this client?
Patient adherence is the patient’s behavioral response to health care
provider’s treatment recommendation and medication prescription. (Panahi
et al., 2022). Adherence to a treatment plan is associated with positive
health outcomes such as reduction in rehospitalization, symptom control,
increased quality of life, increased survival rate and productivity (Rashidi et
al., 2020). Some factors that drive patient adherence include patient’s socio-
economic status, healthcare access, provider-patients discordance, and
patient’s chronic health condition (Panahi et al., 2022). The PMHNP could
support adherence for this client by involving the patient in the treatment
decision making process, reviewing the possible side effects of prescribed
medication(s) that they jointly agreed upon, encourage client to schedule
proper follow-up to monitor new medication side effects and referral to social
worker to assist with housing.
What are the ethical and legal obligations for the PMHNP in the
above situation?
The ethical obligation of the PMHNP in this situation should be the same as
with any other patient. The American Nurse Association (ANA) code of ethics
for nurses provide ethical guideline to guide our practice. The provision
includes providing care with compassion and respect, commitment to the
patient and protecting the rights of the patient, among others (American
Nurses Association, n.d.).
Patients with schizophrenia may become agitated, have poor impulse
control, or decreased social sensitivity when ill (Boland & Verduin, 2022).
impulsivity may include suicide or homicidal attempts. PMHNP, as mandated
reporters are required to report threats of violence to law enforcement
(Wisconsin Department of Children and Families, n.d.).
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?
PMHNP must practice self-care at all times but especially when working with
patients that might be challenging. Self-care could be physical (nutrition,
exercise, sleep), mental (mindfulness, self-talk therapy), emotional (gratitude
journal), spiritual (religion, meditation, nature, yoga), intellectual (reading,
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