Essay Dexter MacQuoid Case Study – Psychotic Disorder – Nursing Assignment Help

Assignment Task:

Scenario 

Dexter MacQuoid is a 21-year-old male who has recently presented to the emergency department experiencing distressing auditory hallucinations and paranoid delusions after taking amphetamines. Dexter’s previous psychiatric history reveals that he began taking amphetamines when he was 15 years old. When taking amphetamines he experienced auditory hallucinations, delusions and paranoid ideas along with long periods of wakefulness. These symptoms appeared to be related to the physiological effect of the amphetamine use, as when the effects of the amphetamine wore off then so did the psychotic symptoms. However when Dexter was 17 years old he began using amphetamines on a daily basis resulting in an increase in auditory hallucinations and paranoid delusions. He was admitted to a mental health facility for the first time and a DSM 5 diagnosis of ‘Substance/Medication-Induced Psychotic Disorder’ was made. By the age of 18 Dexter had stopped taking amphetamines but continued to experience psychotic symptoms. Following several admissions to hospital with increasing psychotic symptoms the DSM 5 diagnosis of ‘Schizophrenia’ was made. 

Today he has been bought to hospital by his parents, who report that he has become increasingly paranoid and suspect he is experiencing auditory hallucinations, as he seems to be responding to unseen stimuli. He has not been keeping up with his university studies and has not attended class for the last 4 weeks. He spends most of his time in his room and has not been going out with his soccer mates as he usually does. He will only eat pre-package food, as he believes the supermarkets are putting “mind controlling drugs” into the fruits and vegetables and meat to keep customers returning to the store. Dexter’s mum is very concerned about him as he seems to be losing weight and he has been neglecting is personal hygiene. She is unsure if he has been taking his prescribed medication and he missed his last clinic appointment with case manager. She doubts that he has been using substances as he has not been out of the house to obtain them. 

Answer the following questions Please short answer format to demonstrate understanding (do not use essay format). 

Question 1.

a) Describe in brief the pathophysiology of Substance/Medication-Induced Psychotic Disorder.

b) Identify other neurotransmitters associated with Schizophrenia and briefly discuss how the function of each neurotransmitter identified is altered in this disorder to produce the symptoms of Schizophrenia.

c) Describe how auditory hallucinations manifest and describe the areas of the brain that are thought to be involved in auditory hallucinations. 

Question 2. 

Describe the clinical nursing care and interventions for Dexter when he is first admitted to hospital (i.e. the first 24 hours). 

Question 3

List three different medications which may assist in the alleviating Dexter’s symptoms as describe in the case study above; then describe two side effects for each medication identified and the biological reasons for each side effect identified.