| Course | NUR-3450 Nursing Care of Clients with Alterations in Behavioral Health |
|---|---|
| Module | Module 3 |
| Paper type | Behavioral health paper: schizophrenia and antipsychotic treatment |
| Length | About 1,007 words, 6 pages |
| Format | APA 7 student paper |
| School | Thomas Edison State University |
| Program | B.S.N., Accelerated Second Degree |
| Updated | October 2026 |
Free sample paper for NUR 3450 Module 3
Thirty Pounds and a Stopped Pill: Side Effects, Choice and Staying on Treatment
Student Name
B.S.N., Accelerated Second Degree, Thomas Edison State University
NUR-3450: Nursing Care of Clients with Alterations in Behavioral Health
Mentor Name
Month Day, Year
Thirty Pounds and a Stopped Pill: Side Effects, Choice and Staying on Treatment
The Patient
Mr. Okonkwo is invented for this paper. He is 26 and was diagnosed with schizophrenia at 21. He had been stable for two years on olanzapine, working part time at a grocery store and living with his mother. Over that time he gained 30 pounds and was told he had prediabetes. Embarrassed by his weight, he stopped his medication three months ago. He came to the emergency department with his mother after he stopped sleeping, became convinced that neighbors were recording him and barricaded his bedroom door.
Why Antipsychotics Matter
Schizophrenia involves positive symptoms such as hallucinations and delusions, negative symptoms such as reduced motivation and expression and cognitive difficulties. Antipsychotic medications reduce positive symptoms and lower the risk of relapse. Few things predict relapse as strongly as stopping medication, and each relapse can bring hospitalization, lost work and strained relationships.
The CATIE Trial
Lieberman et al. (2005) randomly assigned nearly 1,500 people with chronic schizophrenia to olanzapine, quetiapine, risperidone, ziprasidone or the older drug perphenazine. The main outcome was stopping the assigned drug for any reason. Overall, 74 percent stopped before 18 months, whether for poor effect, intolerable side effects or their own choice. Olanzapine had the longest time before discontinuation but was associated with more weight gain and increases in blood sugar and lipids. Perphenazine, a first-generation drug, performed about as well as most newer drugs.
Comparing 15 Antipsychotics
Leucht et al. (2013) pooled 212 trials to compare 15 antipsychotics against each other. Clozapine came out ahead on benefit, with a few others close behind, yet for most drugs the gaps in benefit were small. Differences in side effects were much larger. Olanzapine, zotepine and clozapine caused the most weight gain, while haloperidol, ziprasidone and lurasidone caused the least. Haloperidol caused the most movement side effects. Sedation and effects on heart rhythm also varied widely.
| Source | Key finding | Meaning for Mr. Okonkwo |
|---|---|---|
| Lieberman et al. (2005) | Most patients stopped their drug within 18 months; olanzapine caused more weight gain | His stopping is common, not unusual |
| Leucht et al. (2013) | Small differences in effect; large differences in side effects | Choosing a drug with less weight gain is reasonable |
Nursing Diagnoses
The student identified disturbed sensory perception related to psychosis, risk for nonadherence related to side effects and stigma and risk for unstable blood glucose related to antipsychotic treatment and weight gain.
Care During the Acute Phase
In the first days, the student spent short, regular periods with Mr. Okonkwo, spoke clearly and calmly and did not argue with his beliefs about the neighbors, instead acknowledging that he seemed frightened. The student helped him with sleep and nutrition and watched for signs of agitation. The team restarted an antipsychotic.
A Shared Decision
When he was calmer, the psychiatrist, nurse and student met with Mr. Okonkwo and his mother. Using Leucht and colleagues' findings, the psychiatrist explained that several medicines worked about as well as olanzapine with less weight gain. Mr. Okonkwo chose aripiprazole after hearing its side effect profile. The student noted how much more engaged he became when his own concern, his weight, was treated as important.
Monitoring
Antipsychotics require metabolic monitoring. A consensus statement from four professional groups set the schedule the unit follows: weight at the start and at each early visit, then every three months, with waist size, blood pressure and fasting glucose checked at the start, again at three months and every year, and lipids at the start and three months (American Diabetes Association et al., 2004). The student also checked for movement side effects, such as an inner restlessness, rigid muscles or shaking hands, and taught Mr. Okonkwo to report them.
Adherence Support
The plan included a weekly pill organizer, linking medication to brushing his teeth, a nutrition and exercise group at his outpatient clinic and a conversation about a long-acting injectable form if he preferred not to take daily pills. His mother learned the early warning signs of relapse, such as poor sleep and suspiciousness.
Stigma and Self-Image
Part of what made Mr. Okonkwo stop his medication was how he felt about his body and about having schizophrenia at all. He said he did not want to look like someone who was sick. Stigma, both from others and from within, makes people hide symptoms and avoid treatment. The student listened without minimizing his feelings and connected him with a peer support group run by people living with serious mental illness, where he met others who had found a medicine that worked for them. Hope that recovery is possible is part of treatment.
His Mother's Role
His mother had carried much of his care. The student taught her the early warning signs of relapse, how to raise concerns without arguing and whom to call. She also received information about a family education program offered free by a national mental health organization in her county.
Evaluation
After two weeks his hallucinations had faded, he slept through the night and he could name the early warning signs of relapse and his medication's side effects.
Physical Health Beyond Weight
Life expectancy for people with schizophrenia falls well short of the general population's, largely from heart disease, diabetes and smoking-related illness. The plan therefore went beyond his weight: the student encouraged him to see his primary care provider, offered smoking cessation support and helped him plan a daily walk to work.
Limits
Trials report averages; individual responses vary. Switching medicines carries a risk of relapse during the transition. A student assists with monitoring and teaching but does not choose medications. Mr. Okonkwo is invented.
Conclusion
Mr. Okonkwo's relapse began with a side effect that mattered to him. CATIE showed that stopping antipsychotics is common and that olanzapine brings weight gain, and Leucht and colleagues showed that many drugs work similarly while their side effects differ. Treating his concern seriously, choosing a medicine together, monitoring metabolic health and building simple supports for adherence gave him a better chance of staying well.
References
American Diabetes Association, American Psychiatric Association, American Association of Clinical Endocrinologists, & North American Association for the Study of Obesity. (2004). Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care, 27(2), 596-601. https://doi.org/10.2337/diacare.27.2.596
Leucht, S., Cipriani, A., Spineli, L., Mavridis, D., Örey, D., Richter, F., Samara, M., Barbui, C., Engel, R. R., Geddes, J. R., Kissling, W., Stapf, M. P., Lässig, B., Salanti, G., & Davis, J. M. (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: A multiple-treatments meta-analysis. The Lancet, 382(9896), 951-962. https://doi.org/10.1016/S0140-6736(13)60733-3
Lieberman, J. A., Stroup, T. S., McEvoy, J. P., Swartz, M. S., Rosenheck, R. A., Perkins, D. O., Keefe, R. S. E., Davis, S. M., Davis, C. E., Lebowitz, B. D., Severe, J., & Hsiao, J. K. (2005). Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine, 353(12), 1209-1223. https://doi.org/10.1056/NEJMoa051688
NUR 3450 Module 3 instructions, in plain terms
Psychological alterations are central to the NUR-3450 catalog description, and with no syllabus available publicly, module three is planned as a schizophrenia nursing paper. Describe the patient's illness and what led to readmission, explain positive and negative symptoms in plain language and report comparative evidence on antipsychotics with their side effect profiles. Write nursing diagnoses, describe calm acute care that neither argues with nor reinforces delusions, show a shared decision about medication and set out a monitoring schedule for weight, glucose, lipids and movement side effects. Plan adherence supports with the family. Some sections assign bipolar disorder instead. Check whether a medication teaching sheet should be attached. Note physical health beyond weight, since people with schizophrenia face shorter lives from heart disease and diabetes. Mention stigma and the family's role.
How the NUR 3450 Module 3 example is put together
A fictional 26-year-old who stopped olanzapine after gaining 30 pounds is readmitted to a Paramus unit with paranoid thoughts about his neighbors. The paper explains symptoms and relapse, then summarizes the CATIE trial and Leucht and colleagues' 15-drug comparison in a table. Nursing diagnoses, calm acute care, a meeting where he chooses a medicine with less weight gain, a monitoring schedule from a professional consensus, adherence supports including a long-acting option, teaching for his mother and a section on stigma come before the evaluation and the closing sections. A section on physical health beyond weight is included. Annotations show where the patient's voice shapes each decision.
Where the marks sit in the NUR 3450 Module 3 rubric
Schizophrenia papers stand out when they describe symptoms accurately, report comparative trial evidence correctly and recast stopping medication as a response to side effects rather than a character flaw. Readers look for communication that respects the patient without endorsing delusions, a medication choice in which his concern about weight shapes the decision and a specific monitoring schedule tied to a published source. Supports such as a pill organizer, family teaching and a long-acting option show practical thinking. Leaving prescribing to the psychiatrist while amplifying the patient's voice shows awareness of scope. Attention to smoking and primary care shows a whole-person view. Peer support and family teaching show a recovery orientation.
NUR 3450 Module 3 help from the desk
Antipsychotic papers sometimes blame patients for stopping medication without asking why; start with side effects and stigma. Another frequent gap is a list of side effects with no plan to watch for them. Explain the symptoms, report CATIE and the comparative meta-analysis, avoid arguing with delusions and involve the patient in choosing a medicine. Monitor weight, glucose, lipids and movement on a schedule. Teach the family the early signs of relapse. Send us your prompt and patient, and a free first draft follows. Connect patients with primary care and smoking cessation support. Connect patients with peers who have lived experience.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Thomas Edison State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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NUR 3450 Module 3 questions, answered
Where can I find a free NUR 3450 Module 3 sample paper?
The schizophrenia nursing paper about an invented patient who stopped olanzapine, from CATIE to shared decisions, is posted here.
How often do patients stop antipsychotics?
In the CATIE trial, 74 percent stopped their assigned drug within 18 months.
Do antipsychotics differ in effectiveness?
Leucht and colleagues found mostly small differences in effect but large differences in side effects such as weight gain.
What monitoring do antipsychotics require?
Regular weights plus baseline and follow-up checks of waist size, blood pressure, glucose and lipids, along with watching for movement side effects.
How should nurses respond to delusions?
Acknowledge the patient's feelings without arguing about or reinforcing the false belief.