Ryan lives in this home and he is 25 years old and has Down syndrome. He also experiences grand mal seizures which are m

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Ryan lives in this home and he is 25 years old and has Downsyndrome. He also experiences grand mal seizures which are managedwith medication. Ryan was diagnosed with Schizophrenia 6 months agoand started taking medication. Ryan had experienced someundesirable side effects with his antipsychotic medication. Ryanhas recently met with his psychiatrist. In considering all of thechallenges that Ryan has, his medications were reviewed and changedas of two days ago. The doctor changed Ryan’s medications forSchizophrenia and for his seizures. His medications are now asfollows:
Ryan’s new medications after the review
Tegretol 600 mg PO OD
Dilantin 200 mg PO OD
Ativan 1 mg OD PO and Q AM
Zyperexa 10 mg PO Q AM and 15 mg q Bedtime
Ferimax 1 capsule daily
Sennokot 1 tablet at bedtime
Vitamin C 100 mg PO daily
John who also lives in the home, is 32 years old, has a mildintellectual delay as well as regular episodes of serious,aggressive behaviors. John gets agitated from staff coming andgoing at shift change, when families (or anyone that is new) cometo visit and when his housemates leave the home to go to the localday program. John takes medications daily as directed (and hastaken medication for many years) and meets with the psychiatristonce per month. John’s support worker takes him to all of hisappointments. John’s medication is due to be reviewed thisFriday.
You (as the staff) have concerns about John as he continues tobe aggressive. Last night, it was reported by the overnight staffthat he threw a folding chair at a staff member during shift changeat 7pm. He was also yelling and screaming throughout the night. Youare concerned that John medications are no longer working and thathe will continue get more aggressive. You have also observed John‘shuffling’ when he walks and at times he has a minor tremor in hisleft hand that seems to be getting worse.
John’s Current Medications
Seroquel 20 mg PO q PM
Clozaril 50 mg PO twice a day
Clonazepam 2 mg PO OD and 1 mg PRN twice a day
Calcium 1000 mg PO OD
Multivitamin 1 tablet daily
The other gentleman that lives in the home requires more medicalsupport than John and Ryan. There are two staff on in the home pershift – with one staff only for the overnight shift (7pm-7am).
In Thursday morning report (from the overnight shift) it isreported that Ryan had a fever and woke up at 3am hallucinating andcomplaining of stiffness in his arms. Since there was a standingorder in place for PRN Tylenol, the female night staff decided(after her own careful assessment) that she would follow theprotocol and administer Tylenol 325mg PO 2 tabs. She reported thatRyan is still sleeping at present.
As the day goes on, you notice that Ryan has a fever again andnow he is complaining of muscle stiffness in his arms and legs andnow, he is clutching his chest and reporting that it is difficultto breathe. While Ryan is experiencing difficulty, John has beendrowsy for most of the afternoon and he is now sleeping, sitting upin a chair in front of the television.
1. Describe the treatment that can be given for what Ryan isexperiencing?