Schizophrenia

The nurse documented that the patient has a long term history of asthma and schizophrenia; the patient has a tendency to stop all psychiatric medication which affect her ability to be complacent with her asthmas medication, causing her asthma to be worst.

Patients with schizophrenia can relapse; however, teaching the patient effective interpersonal coping and health care maintenance can help to lessen the possibility of relapsing.

Good health maintenance is important when treating patients with schizophrenia. Health includes teaching the patient about the medications and the side effects, effective coping strategies such as strategies of relieving stress and stressful situations. In addition, the family should be educated to on what to expect and to prevent the patient from relapsing and the importance of medication and treatment compliance. A good support system consisting of friends, families and medical providers helps to keep the patient on track and can prevent a relapse. The support team should be able to identify symptoms that indicate that the patient is not taking their medications as well as motivating the patient to maintain compliance.

Medications

Ziprasidone (Geodon) antipsychotic, used for treating paranoid thinking, hallucinations, and agitation. Rationale for prescribing is to treat the patient symptoms of hallucinations caused by schizophrenia. Inhibits the reuptake of serotonin. Side effects headache, dizziness, weight gain and constipation. Adverse reaction- increase risks for QT intervals, patients with bradycardia, hypokalemia, hypomagnesemia are at risk. Educate patient to avoid tasks that requires alertness, motor skills until drug effects are known.

Methylprednisone- Anti-inflammatory, decreases inflammation- asthma. Rationale for prescribing this medication is to alleviate the symptoms of asthma; patient has expiratory wheezing.Side effects-insomnia, heartburn, anxiety, abdominal distention, mood swings, constipation, diarrhea. Adverse effects- hypocalcemia, hypokalemia, muscle wasting, CHF, nausea, fever, headache, severe, arthralgia, dizziness, anorexia. Take with food-milk, do not change, or stop drugs or change dose. Notify physician immediately of fever, sore throat, muscle aches, sudden weight gain, edema, avoid exposure to disease, trauma. Maintain follow up visits, lab test are important.

Beclomethasone-antiflammatory, inhibits bronchoconstriction, long term control of bronchial asthma; which the patient has. Side effects throat, irritation, dry mouth, hoarseness, coughs. Adverse effects- acute hypersentivity reaction, severe branchospasm, rarely occurs. Patient teaching-medication must be tapered off, do not stop suddenly, maintain oral hygiene, and rinse mouth with water immediately after inhalation. Contact physician if sore throat or mouth occurs.

Salmeterol-bronchodilator relieves bronchospasm, reducing airway resistance.