Experimenting with illegal drugs in the past

Case Study #1
Please make sure you have at least 2 research articles within the last 5 years and they are relevant to what you are referencing. Also DSM-5 should always be areference if you are asked to provide a
diagnosis or differential diagnoses. (References 10 points.)
Client Profile
Ben is a 68-year-old male who grew up in hill country in West Virginia. He took a few college classes
with no particular goals and lived in a commune in the 1960s. When his parents died, he married his
girlfriend, and they moved into his deceased parents home. He and his wife receive Social Security
income. Ben admits to experimenting with illegal drugs in the past, but claims he is clean now. While
suffering from paranoia for many years, his condition began to deteriorate recently, and he is now
experiencing auditory hallucinations. Ben has always refused any type of psychiatric care. Recently, Ben
has been isolating himself from his motorcycle club. He this his wife, Marie, is trying to poison him; he
also believes she is hiding money and secretly planning to leave him. Marie and some friends finally
convinced Ben to see a psychiatrist by recommending one who shares Bens interest in motorcycles.
After doing a complete physical and evaluation, the psychiatrist prescribes Haldol Decanoate, prompted
by Bens poor history of complying with medication regimens. The psychiatrist tells Ben a home health
nurse will come to his home monthly to administer the injection.
The home health nurse plans to visit Ben at his home 28-days after his first decanoate to administer his
next dose of Haldol Decanoate. When the nurse calls to verify the appointment, Marie relates that Ben
is not well. When the nurse arrives at the house, she takes Bens vital signs which are T103F, P136, R28,
BP 148/96. Ben is experiencing muscular rigidity and diaphoresis. His bed linens are damp. He has
been incontinent of urine. Ben also seems agitated and confused. His wife ask, Do you think he might
have the flu? His wife explains that Ben was nauseated the day before and his family health care
provider gave him a Compazine injection and prescribed Compazine pills. She relates that Ben took
twice as many pills as prescribed yet is still nauseated.
The nurse notes a fine tremor of Bens hands after he drops a glass of water. The nurse palpates Bens
abdomen for rebound tenderness; then she telephones Bens PMHNP. The PMHNP tells the nurse to
call emergency medical services (EMS) and have Ben transported to the hospital.
1. As Bens PMHNP what do you think his diagnosis may be? (10 points)
2. What signs and symptoms does Ben have that match the criteria for the diagnosis? (20 points)
3. Before EMS arrives, the clients wife asks the nurse about giving Ben his Haldol Decanoate. The
nurse calls you, the PMHNP, and asks if she should give the injection before Ben leaves for the
hospital. What would your response be to the nurse? Provide a rational for your answer.
(20 points)
4. What other antipsychotics are available in a ? Provide dosing for each,
including time between dosing, and possible side effects. (20 points)
5. What do you believe as Bens PMHNP is the cause of his symptoms presented in the case study?
(10 points)
6. What is the current treatment for Bens symptoms? As Bens treating PMHNP, would you
change his antipsychotic upon discharge? (10 points)

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