Pathophysiology Interrelatedness Case Study: Delusion Research Proposal

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While there is no direct indication of exactly what information or perception caused the patient to make the decision to withdraw from medication, it is clear that the patient's delusional state has prevented her from properly weighing the implications of information, which would instead demonstrate to her the immediacy of the danger of infarction because of sudden withdrawal from a medication regimen.

According to the source provided by Klatt, the risk of myocardial infarction is increased by the implications of hypertension, indicating that withdraw from one's medication as in the case of the patient in our case study can lead to the pairing of "increased intraventricular pressure and myocardial contraction." (Klatt, 1) These, in turn, can lead to the type of constricted bloodflow that is likely to invoke heart failure. Therefore, in the case study at hand, the patient is categorically at a high risk for fatality relative to her condition when on regular blood pressure medication. Also, based on Franklin's connection of delusion to heightened anxiety, and on the connection drawn in the discussion on antihypertensive drugs between anxiety and high blood pressure, it seems clear that the erratic and emotionally unstable nature of the delusional state will provoke an added strain on the cardiovascular system. The treatment modality for both myocardial infarction and high blood pressure needs to be based on the return of the patient to regular medication habits.

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The treatment modality for delusion should in this instance -- where an aversion to medication is already apparent -- should be to engage in discursive therapy with the patient. It is crucial for a therapist to help the patient identify the factors which caused her to withdraw from regular medication and to help address the reservations there demonstrated through rational discussion. This could include attempting to deconstruct the logic of this decision vs. The benefits in returning to the usage of medication. This could, and ethically should, also include discussion of other treatment approaches available with respect to the two cardiac conditions discussed. Incorporated into such a discussion would include consultation with nursing and physician personnel who can elaborate on the pros and cons of other treatment approaches in comparison.

Ultimately though, in spite of questions as to mental or rational competency, it will be the patient's decision on how treatment proceeds. Therefore, treatment of delusion and the manner in which it has distorted ideas or information relating to medication decisions is of the greatest importance in resolving the case study's primary impasse.

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