You need to choose from one of the two (2) following case studies and provide a 1000 word Medication management plan for the chosen individual. -The assignment is to be presented in a question/answer format, and not as and essay (i.e. no introduction or conclusion). -Each answer must be supported with citations. -You should follow the recommended formatting for academic papers http://students.acu.edu.au/308971 . -You will need to reference according to APA referencing. -Students must provide in-text referencing and a reference list must be provided at the end of the assignment. A minimum of (6) six academic references and (2) two websites are required for this assessment task A marking guide has been made available on the unit outline to support your response. Please include the following areas in your management plan: • What physical health considerations should be considered before giving this medication to the consumer? • Provide a rationale for the use of this medication to the consumer. • What are the side effects / adverse effects of this medication? And how will you manage these effects? • How is medication management influenced by recovery principles in mental health? CASE STUDY: Daniel Daniel is a 31-year-old male who currently lives in a community care residential unit (CCU). Daniel was diagnosed with schizophrenia at the age of 19 years. He had a traumatic first admission to mental health services and was bought into the inpatient ward via police. On admission he was displaying positive signs of schizophrenia, and he was responding to auditory hallucinations. He expressed paranoid delusions that his parents were not his parents but imposters, who were trying to ‘kill him’. He was also suspicious of the neighbours, and as a result had been isolating himself from everyone. He was agitated and distressed on admission and was concerned the admission was unsafe for him. Since this admission, Daniel has had numerous admissions (10 in total) to acute mental health services, as an involuntary client. For three years after his diagnosis, he was case managed by the Early Psychosis Team. He was then referred to the Mobile Intensive Support Team for 6 months and in the past 7 years, he has had periods of case management with the local Adult Community Mental Health Team. Daniel has been trialled on various antipsychotic and mood stabilisers to help manage his symptoms. However, on several occasions prior to admission, he had ceased taking his medications. On his last admission to an acute mental health services, the Consultant Psychiatrist and the treating team made a collaborative decision to commence Daniel on a depot medication. He was trialled on oral olanzapine and then commenced on Olanzapine Depot injection. His current dose is 210mg fortnightly. The medication is administered via injection by mental health nurses at the specialist clinic associated with the Mental Health Unit at his local hospital. Family History: Daniel’s parents live in the family home and usually have Daniel stay with them on weekends when he is well enough. Daniel is their second child. His older sister Meg is married with two children and lives nearby. She is supportive. Medical History: Daniel has asthma and this is managed with Ventolin puffer PRN. Daniel has been diagnosed with schizophrenia and is currently being managed on an antipsychotic medication – Olanzapine Depot – 210mg fortnightly. Current Mental State Examination Observation Appearance & Behaviour: - Fair complexion, short cropped blonde hair and blue eyes. - Overweight in appearance, height 172cm - Scar 5 cm length middle of right cheek fell on branch when a child. - Slightly dishevelled in appearance, unkempt beard and hair - Needs encouragement to attend to ADL’s - Suspicious and paranoid - Irritable at times - Unusual gesturing of his arms ( waves in the air) - Difficult to engage in conversation and difficult to establish rapport - Fixed eye contact when irritable Cognition: - orientated to time, orientated to place and person - Some deficits noted in recall memory and short term memory Mood: - Daniel states he feels unhappy with the injection but does not want to end up in hospital again. Affect: - restricted affect Speech: - Poverty of speech – at times - Rate and flow of speech often slow Form of thought: - Loosening of associations - Neologisms - Thought blocking Content of thought: - Disordered thinking - Paranoid thinking at times - Continually expresses thoughts about his parents, challenges whether they are really his parents - Denies any suicidal and homicidal thoughts Perception: - Experiences auditory hallucinations of a derogatory nature - Describes hearing a male and a female voice - Often seen responding to internal stimuli Insight: - Limited insight into his illness. Judgement: - Poor judgement CASE STUDY: Lynda Lynda is a 28 year old female who has a 10 year history of bipolar disorder. She has a history of non-adherence to her prescribed medication. Lynda was admitted after her parents rang triage team expressing concern that Lynda was relapsing. They reported Lynda has poor concentration, not been sleeping, was spending money excessively and had started to become very impulsive and unpredictable. She had also been verbalising her grandiose delusion of being a member of the royal family. Family History. Lynda is an only child; her parents are very supportive and have a good relationship with Lynda. Lynda’s maternal grandmother and her aunt have a diagnosis of bipolar disorder. Lynda’s parents are active members of the carer’s group run by the local Mental Health service. Lynda will be discharged next week, and requires education on her discharge medications. Medical History NAD Lynda has a long history of bipolar disorder, first diagnosed at the age of 18, several acute admissions over a 10 year period. Lynda has been diagnosed with bipolar disorder and is currently being managed on a mood stabiliser – Quilonum SR– 450mg BD. Current Mental State Examination Observation Appearance & Behaviour: - Olive complexion with shoulder length brown hair styled - Average height (164 cm) and weight (63kg) - Dressed appropriate to weather - Wearing heavy makeup/multiple bracelets, rings, necklaces. - No distinguishing features (e.g. no scars) - Very friendly in manner, overfamiliar in conversation and gestures at times Cognition: - Orientated to time, place and person - Able to maintain concentration through interview. Mood: - Mood appears slightly elevated, - Describes herself as happy, “never been better” Affect: - Bright and reactive. Incongruent at times when discussing events leading to admission Speech: - Pressured at times, but able to be interrupted - Expansive in conversation - Loud at times Form of thought: - Logical and sequential , occasionally tangential - Not grossly thought disordered Content of thought: - Grandiosity in theme, Lynda keen to inform people that she is a member of the royal family. Perception: - No perceptual disturbances elicited Insight: - Some insight into illness, states she knows she has Bipolar and will reluctantly take medication if it means she can be discharged home and not be in hospital. Judgement: - Poor judgement