Description

Mark is a 37-year-old client with a 15-year history of schizophrenia. When he was first diagnosed, he was prescribed a second-generation antipsychotic medication. He complained about drowsiness and difÏculty concentrating. He experienced a 40 lb. weight gain over a year. His girlfriend complained about his reduced sex drive and ended their relationship. He tried several different medications alone and in combination but found the side effects intolerable. He stopped taking his medications and started self- medicating with alcohol. Over time, he experienced several relapses and his condition declined markedly. He lost his housing and began living in his car. After being involuntarily committed following a psychotic episode, he was referred to the PMHNP at the outpatient clinic. When he presented for his appointment, he told the PMHNP that he stopped taking his medications due to their side effects.

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  What is the most appropriate response by the PMHNP?

• How can the PMHNP support adherence for this client?
• What are the ethical and legal obligations for the PMHNP in the above situation?
• Goals that are not mutually shared between providers and patients can be very challenging, both clinically and 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?