A client was prescribed olanzapine (Zyprexa) four weeks ago to treat symptoms of schizophrenia. The client's family has noted only a small improvement in symptoms and asks about changing to another treatment
Which response by the nurse is the most appropriate?
1. "The client will need to see a psychotherapist in conjunction with the medication for there to be a major improvement in symptoms."
2. "It might take 6–8 weeks to see definite improvement in most symptoms."
3. "It might take 8–12 weeks to begin seeing improvement on this therapy."
4. "There should have been improvement within 1–2 weeks."
Correct Answer: 2
Rationale 1: Psychotherapy is an essential component of treatment for clients with psychosis to return to society, but this is not the best answer. There should be a major improvement in symptoms with medication alone.
Rationale 2: By 6–8 weeks, definite improvement should be noted in most symptoms.
Rationale 3: After 8–12 weeks of therapy, if there has not been substantial improvement, the health care provider will need to explore reasons for lack of response and might need to change the medication.
Rationale 4: After 2–4 weeks (not 1–2 weeks), there is usually improvement in mood, socialization, and ability to provide self-care.
Global Rationale: By 6–8 weeks, definite improvement should be noted in most symptoms. Psychotherapy is an essential component of treatment for clients with psychosis to return to society, but this is not the best answer. There should be a major improvement in symptoms with medication alone. After 8–12 weeks of therapy, if there has not been substantial improvement, the health care provider will need to explore reasons for lack of response and might need to change the medication. After 2–4 weeks (not 1–2 weeks), there is usually improvement in mood, socialization, and ability to provide self-care.
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