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    Clinic Assignment Help


     Essay 1: Techniques to obtain clinical history from patients

    Patients who are dependent on drugs such as cannabis are found be affected negatively as these drugs impact the dopamine system. The negative effects of cannabis involves development of repulsive and impulsive behaviour. The harm to the brain is long term and patients seem to become less interactive. In case of Angelo, he has become less responsive and his family have disclosed about his high cannabis uptake. Without proper communication, the healthcare staff cannot treat them properly.
    The research have shown that such patients who become unresponsive over time should be treated properly because they are at the extent of severe conditions. The nurses are required to treat them with utmost compassion. Angelo’s condition can only be treated if the nurses keep patience with him. With time, it is possible to initiate healthy communication. One way to promote effective communication is to talk with respect and indulge open-end questions (Komendziński et al, 2016). The patient-centred care is one important way of communicating with the patients. If this is included while communicating with the patient, they will be more comfortable in explaining themselves. Furthermore, the nurse or the doctor should make the person feel that whatever he is saying can be correct and once he believes that whatever he is saying does make sense then he will be more responsive (Komendziński et al, 2016). Motivational interviewing is another way to indulge in healthy communication with the patients who are not very responsive. Cognitive behaviour theory is indulged in the motivational communication where the patient is made comfortable and he is not considered as a mad man (Levy & Williams, 2016). The family members and friends of the patient can also be indulged in the intervention to know about the history of the patient. 
    Thus it can be concluded that getting into communication to know about the history of the patient, the healthcare personnel should keep patience and try to know him without judging his behaviour. Angelo’s situation is not very good therefore, the nurse should start slowly instead of burdening him with questions that would further irritate him. In this way, they can identify the history of the patient to treat him further. 
     
    Essay 2: Psychotic presentation
    Psychosis is defined as a clinical situation where the person hear things and tend to lose contact with the real life. People get into a state of hallucination and schizophrenia where they tend to see and hear things that do not exist in reality. Angelo’s father overheard him talking to himself shows that he was suffering from psychosis. Its occurrence can be related with high cannabis intake in the past. It is important to look after such patients and present their situation because it can be disastrous in future as the mood swings can create havoc and they can be self-harming and destructing. 
    Angelo’s history manifests that he feels television rays control his feelings. These symptoms clearly show that he is a patient of psychosis. Arciniegas (2015), have shown that the psychosis is generally caused due to the substance use and degenerates the nervous system of the patient. The primary features for psychotic presentation in this report are shown to be delusions, déjà vu and so on. It is further extended to the treatment and identified that psychosocial interventions can be effective in the treatment. Another similar research by Bonaccorso et al (2018), have associated the occurrence of psychotic disorder with cannabis misuse. The research used PANSS scale to identify the presentation of the disease and shown illusions and hallucination as main identifying hallmarks of it. Angelo’s medical history showed the overly use of cannabis, a drug that disconnects the person from the reality of the world and sees bizarre events. The presence of the psychotic disorder can also be detected as the thoughts formulating capacity is disturbed greatly and the patient can also include depression. Another presentation of the disease in the lost in the productivity of the patient shown by Simon et al (2018). In this research, they showed that the people are not as effective as they were before. 
    It has been identified in case of Angelo also that his productivity in the work he does was reduced as observed by the friends and family. The facts that can be summarized in the case is that the hallucination, delusions, déjà vu, lost contact with reality and so on are some of the major symptoms that presents the disease and it can be treated only if diagnosed earlier. Furthermore, the conclusion made here as a nurse are that his onset of the psychosis can be related with the overly use of the cannabis drugs. 
     
     
    Essay 3: Symptoms and implication in schizophrenia
    Schizophrenia is a clinical condition that alters the normal though process of the people and they start hallucinating about events that really do not exist. It is identified that schizophrenia can be genetic or epigenetic and they affect the brain severely (Birnbaum & Weinberger, 2017). The symptoms of the medical condition can be both positive as well as negative therefore, a number of modern implications are under trials. 
    The initial stage of the illness include the exaggerated effects on the thinking capabilities. The person starts seeing or hearing bizarre things that do not actually exist. The positive symptoms may include the hallucination, concentration trouble, confused thoughts, delusions, etc. They are however not severe. When severity exist the condition starts further deteriorating. The negative symptoms include repulsive and impulsive behaviour. The patient may cause self-harm or harm to others, restrict himself from communicating with people about feeling and they lose the tendency to express their feelings and also become emotionally flat and withdraw themselves from the social life. Angelo has withdrawn himself from communicating with people. A lot of research has been carried out for the treatment of this clinical illness. Bartholomeusz et al (2015), focused on the use of the oxytocin, a hormone that puts a positive impact on the patient. They found that the use of the drug is effective in remediating the schizophrenic symptoms in the patients. The research however, indicated that the hormonal treatment has diverse impact based on the demographic factors. A cognitive behaviour theory (CBT) is another effective implications to be used in the treatment as suggested by Ganguly, Soliman & Moustafa (2018). It modulates the thinking process of the person and they start feeling good about themselves. This self-help implication can be used with pharmacological treatment thus the patient may get relief. Another effective implications identified in the treatment of schizophrenia is by the identification of the biomarkers such as PAXgene biomarker of chemokine expression (Hughes, Connor & Harkin, 2016). 
    The biomarkers are specific biological molecules that are manifested in the illness. Later, after identifying the biomarker, a required treatment can be implied. However, it is a novel implication and most of the research is under trials stage. So, it can be concluded that schizophrenia can be treated and its recurrence can be prevented with the use of the effective implications of treatment. 
     
    Essay 4: Neurotransmitters in the development of schizophrenia
    Schizophrenia is a mental illness where the neurons do not communicate effectively such as depression manifests low level of serotonin secretion in the body. A schizophrenic person may have disrupted levels of the neurotransmitters such as norepinephrine, dopamine, GABA, glutamate, etc. (GILL & GRACE, 2016). 
    Howes et al (2016), have focused the research on the study of the dopamine in the development of schizophrenia. They found that the dopamine levels were elevated in the patients with this illness because of the upregulation of the genes that lead to the synthesis of the hormone. These hormones are the basic hormones that fluctuates in the patients experiencing schizophrenia and psychosis. The elevated levels of the hormone does not let the patient to experience any pain and sometimes they hallucinate. Brisch et al (2014), have also focused on the role of dopamine in the development of the disease. They found out that the elevated release of the dopamine in the subcortical region lead to the development of delusions and hallucination that are the positive symptoms of the disease. It further explained that the high levels of serotonin led to the manifestation of both, the positive and negative symptoms in schizophrenia. When the level of these neurotransmitters increase from normal concentration then they exaggerate the normal functions of the brain and thus mostly the person hear or see non-existing things. Another important neurotransmitter that is found in the development of schizophrenia is GABA. This neurotransmitter is required in the brain to reduce the activity of the upregulated neurons in the nervous system. The level of GABA are found to be reduced therefore, it fails to control the effect of the neurotransmitters such as dopamine and serotonin. Therefore, schizophrenic conditions arise in the patients (Jonge et al, 2017). The levels of GABA in the brain are found to be destructed due to the substance abuse such as cannabis. 
    Therefore, a few facts can be summarized in this part. Firstly, it is very important that the level of the neurotransmitters to not fluctuate from the normal levels otherwise the communication between the neurons will be affected and the mental illness such as schizophrenia can develop. The important neurotransmitters studied here are dopamine, serotonin, GABA, etc. whose changed levels marked the onset of the illness.