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http://projects.csail.mit.edu/courseware/?term=my-school-friends-essay my school friends essay Key considerations include viagra online safe. •• involve families in the education and treatment plans because family psychoeducation may decrease relapse, improve symptomatology, and enhance psychosocial and family outcomes. 46 •• be clear that there is no cure for schizophrenia and that medication can be effective to decrease and improve many symptoms. •• explain common and rare but dangerous side effects. •• stress the importance of medication and treatment adherence for improving long-term outcomes. •• decision making on the best course of treatment should be a shared process. Outcome evaluation developing a good working alliance with the patient is essential. In the absence of a solid therapeutic relationship, patients are frequently reluctant to share their beliefs, personal experiences, and life goals. Symptom monitoring many assessments are available to objectively rate positive and negative symptoms, level of function, and life satisfaction. The most commonly used scales include. •• positive and negative symptom scale (panss) •• brief psychiatric rating scale (bprs) •• clinical global impression (cgi) scale using these scales on a regular basis, particularly when switching medications or changing doses, is a more reliable means of monitoring symptoms. Symptom assessments cannot capture the full range of possible improvements, but they can be useful in deciding whether a medication is having substantial benefit. Side-effect monitoring regularly monitor for side effects and overall health status. 47,48 perform orthostatic blood pressure measurements before initiating antipsychotics and regularly throughout treatment. Ask about impaired menstruation, libido, and sexual performance chapter 37  |  schizophrenia  579 table 37–10 monitoring protocol for patients on second-generation antipsychotics baseline personal or family historya weight waist circumference blood pressure fasting plasma glucose fasting plasma lipids x x x x x x 4 weeks 8 weeks 12 weeks quarterly x x x x x x x annually every 5 years x x x x x of obesity, diabetes, dyslipidemia, hypertension, or cardiovascular disease. Data from refs. 49 and 50, with permission (50). A regularly. Encourage patients to have annual eye examinations because several antipsychotic medications have been associated with the premature development of cataracts. At baseline check body weight, fasting glucose, glycated hemoglobin, and lipid profile, and repeat these measurements 4 months after initiation of medication and then yearly. 49,50 for patients at higher risk of developing diabetes and those who gain weight, check body weight more often (table 37–10). Perform baseline electrocardiography for patients with preexisting cardiovascular disease or risk for arrhythmia. With clozapine therapy, there is a risk for the development of agranulocytosis, which is greatest in the first 6 months of treatment. Required monitoring of white blood cell counts is described in table 37–8. Commonly used rating scales to monitor for eps include the simpson angus scale (sas) and the extrapyramidal symptom rating scale (esrs). Akathisia is commonly monitored by the barnes akathisia scale (bas). The emergence of dyskinesias could represent the emergence of td. Monitor patients on sgas for td at least annually, and patients taking fgas at each visit. The most commonly used instrument to measure these symptoms is the abnormal involuntary movement scale (aims). Patient care process patient assessment.

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undergraduate history thesis example •• review the patient’s chief complaint, presenting symptoms, and history, including family psychiatric history. Assess organization of thoughts and range of affect. Assess presence of mood disturbance, likelihood of harm to self or others, and presence of hallucination, paranoia and/or delusions of control.

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