VII.

MEDICAL MANAGEMENT

Medications
Biperden 2mg PRN Date Ordered: January 11, 2012 Specific Indication: Relief of symptoms of extrapyramidal disorders that accompany phenothiazine therapy Nursing Precaution: Decrease dosage or discontinue temporarily if dry mouth makes swallowing or speaking is difficult. Give with meals if GI upset occurs; give before if with dry mouth; give after if nausea occurs. Ensure that patient voids just before receiving each dose of drugs if urinary retention is a problem.

Medications Cont.
Chlorpromazine 25mg TID PO Date Ordered: February 2007 Specific Indication: chronic psychoses, particularly when accompanied by increased psychomotor activity. Nausea and vomiting. Nursing Precaution: Monitor BP and pulse prior to and frequently during the period of dosage adjustment. Monitor I&O ratios and daily height. Assess patient for signs and symptoms of dehydration.

Medication Cont.
Haloperidol 5mg BID PO Date Ordered: February 2007 Specific Indications: For chronic psychotic disorderschizophrenia Nursing Precaution : Assess mental status prior to and periodically during therapy. Observe patient carefully when administering medication, to ensure that medication is actually taken and not hoarded.

Therapy
MUSIC THERAPY Music Therapy (MT) is the clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program. MT with seriously mentally ill clients is a psychotherapeutic method that uses musical interaction as a means of communication and expression. The aim of therapy is to help people with mental illness, including serious mental illness (e.g., schizophrenia or like illnesses) to develop relationship and to address issues they may not be able to using words alone. MT sessions include the use of active music making, music listening, and discussion. MT includes both individual and group therapy. Musical activity diminishes negative symptoms and improves interpersonal contact. These positive effects of music therapy could increase the patient's abilities to adapt to the social environment in the community after discharge from the hospital.

Therapy Cont.
ART THERAPY The artistic drawings of psychiatric patients have been of increasing interest to mental health professionals over the last hundred years. In the 1870's Simon speculated on the relationship between the art of psychotics and their illnesses. Freud and Jung made observations about the symbolism of art work. By the 1940's Naumberg developed a system of art therapy relying heavily on psychoanalytic theory that is now a therapeutic discipline in its own right. In the inpatient milieu art therapy is commonly offered in conjunction with other therapies that make up the inpatient experience. The art therapist often shares the information gained with the primary therapist when the art work aids in elucidating conflicts, defences, and thought content that may not have been verbalized by the patient. Rarely does the psychiatrist use art therapy as his primary mode of therapeutic intervention.