This slide contains information regarding Community Mental Health Nursing. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Paranoid schizophrenia is characterized by predominantly positive symptoms of schizophrenia, including delusions and hallucinations. These debilitating symptoms blur the line between what is real and what isn't, making it difficult for the person to lead a typical life.
This slide contains information regarding Community Mental Health Nursing. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Paranoid schizophrenia is characterized by predominantly positive symptoms of schizophrenia, including delusions and hallucinations. These debilitating symptoms blur the line between what is real and what isn't, making it difficult for the person to lead a typical life.
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
Beliefs about mental illness have been characterized by superstition, ignorance and fear. Although time and advances in scientific understanding of mental illness have dispelled many false ideas, there remain a number of popular misconceptions.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Mental Health Nursing
Psychiatric Nursing
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur
The basic about the principles of psychiatric nursing , what all are the basic we have to follow while providing care to the psychiatric patients in hospital and in the community area
Beliefs about mental illness have been characterized by superstition, ignorance and fear. Although time and advances in scientific understanding of mental illness have dispelled many false ideas, there remain a number of popular misconceptions.
obsessive-compulsive disorder is a mental disorder whose main symptoms include obsessions and compulsions, driving the person to engage in unwanted, often-times distress behaviors or thoughts. The obsessions are usually related to a sense of harm, risk or injury. The common Obsessions include concern about contamination, doubt, fear of loss or letting go, fear of physically injuring someone.It’s treatment is done through a combination of psychiatric medications and psychotherapy.
Obsessive-Compulsive Disorder (OCD) is a common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.
An obsession is defined as an idea, impulse, or image which intrude into the conscious aware repeatedly.
Mental Health Nursing
Psychiatric Nursing
Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental Health Nursing
Ph. D Coordinator
Seedling School of Nursing,
Jaipur National University, Jaipur
Presentation on Mood Disorders: Major Depressive Disorder, Bipolar I Disorder, etc.
Presentation for doctoral program class at Saybrook University, San Francisco. Fall 2009
· Referral information Client reported that she has been struggli.docxalinainglis
· Referral information: Client reported that she has been struggling with her mental health and symptoms have been worsening since last year. Being recommended by CMH to agency. Client said she wants to "Getting to what I used to be, being able to get to a functioning level, take care of my child and work". Specifically need therapy, case management.
· History of presenting problem(s):
· She reported that she sleeps all day, has difficulties getting out of bed, has low energy, low motivation and has been unable to attend work, has been hopelessness, worthlessness, isolating and not able to tend to her activities of daily living. Stated that she has been endorsing symptoms of depression for "quite a while" and the past several months things have been worsening.
· She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019. She also has history of suicide attempts prior to the most recent attempt stating that in the past she "has many overdoses mostly on pills that were prescribed and Tylenol". She reported a history of self-harming thoughts and behaviors. Stated that in the summer and fall of 2019 she has cut self and prior to that she hasn't cut herself since her early 20s.
· Client works at a Senior day program in Ypsilanti and has housing at this time however is at risk of losing employment and housing due to her worsening symptoms and inability to care for herself.
· Bio-psycho-social-spiritual history:
· Biological domain: Client is a 35years old female-single with two children. White. She reported that she was previously on the following: Paxil, Celexa, Lexapro however all have been discontinued and uncertain why.
· Psychological domain: Denied any auditory of visual hallucinations or paranoia. She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019 with an attempt in august.
· Social domain: Born and raised in Dexter by both parents. Her parents are still together and alive. She has three siblings (two brothers and a sister) and client is the middle child. She stated that her siblings and her "get along but aren't super close". She reported a history of sexual assault.
She shares custody of her 4years old son with her ex. Her son has been staying mostly with his father due to her worsening depression. She stated that she hopes to get better soon so he can return to her home. She stated that when she spends time with her 4 years old son she feels "drained" after her son leaves. She worked at the senior center after earned a Bachelors in Social Work at EMU. Is at risk of losing her employ.
· Referral information Client reported that she has been struggli.docxodiliagilby
· Referral information: Client reported that she has been struggling with her mental health and symptoms have been worsening since last year. Being recommended by CMH to agency. Client said she wants to "Getting to what I used to be, being able to get to a functioning level, take care of my child and work". Specifically need therapy, case management.
· History of presenting problem(s):
· She reported that she sleeps all day, has difficulties getting out of bed, has low energy, low motivation and has been unable to attend work, has been hopelessness, worthlessness, isolating and not able to tend to her activities of daily living. Stated that she has been endorsing symptoms of depression for "quite a while" and the past several months things have been worsening.
· She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019. She also has history of suicide attempts prior to the most recent attempt stating that in the past she "has many overdoses mostly on pills that were prescribed and Tylenol". She reported a history of self-harming thoughts and behaviors. Stated that in the summer and fall of 2019 she has cut self and prior to that she hasn't cut herself since her early 20s.
· Client works at a Senior day program in Ypsilanti and has housing at this time however is at risk of losing employment and housing due to her worsening symptoms and inability to care for herself.
· Bio-psycho-social-spiritual history:
· Biological domain: Client is a 35years old female-single with two children. White. She reported that she was previously on the following: Paxil, Celexa, Lexapro however all have been discontinued and uncertain why.
· Psychological domain: Denied any auditory of visual hallucinations or paranoia. She reported that she currently doesn't have any thoughts of hurting self however has a history of suicidal thoughts including attempts. Stated that she has had suicidality all throughout the Fall of 2019 with an attempt in august.
· Social domain: Born and raised in Dexter by both parents. Her parents are still together and alive. She has three siblings (two brothers and a sister) and client is the middle child. She stated that her siblings and her "get along but aren't super close". She reported a history of sexual assault.
She shares custody of her 4years old son with her ex. Her son has been staying mostly with his father due to her worsening depression. She stated that she hopes to get better soon so he can return to her home. She stated that when she spends time with her 4 years old son she feels "drained" after her son leaves. She worked at the senior center after earned a Bachelors in Social Work at EMU. Is at risk of losing her employ ...
Case Study Treatment PlanIntroductionStellaOscarIntroductionFor yo.docxketurahhazelhurst
Case Study Treatment PlanIntroductionStellaOscarIntroduction
For your course project, you will develop a treatment plan for one case study subject that you select from two possible candidates. These potential clients are ethnically diverse and are struggling with psychological disorders, which may require medication.
During the course of this project you will:Evaluate client information.Review possible assessment techniques.Offer a diagnostic impression.Review various behavioral and pharmacological treatments.Discuss the legal and ethical ramifications of the disorder and proposed treatments.Review the impact of diversity issues on various disorders and their treatments.Develop a suggested treatment plan for the client.
You will select one of the case studies presented on the next page of this presentation as your client for this treatment plan project. Then you will use the Case Study Treatment Plan Template, provided in the Resources to complete your assignments for this project. Each section of the template includes a description of the type of information you will need to include. You should type your paper directly into this template, save it as a Word document with your name, and then submit it to the assignment area.Stella's Case Study
Stella is a 38 year old biracial (African American and Native American) woman who has just been assigned to you as a client. You are currently working as a counselor for your county community mental health agency. You received the following information about her as background and history.
Stella is the only child of a Caucasian couple who are now deceased. She was adopted as an infant in a closed adoption, so that none of her birth parents' records are available. The only informal information that Stella remembers her parents telling her is that her mother was 16 years old at the time of Stella's birth and had been raped while at a high school football game.
Stella currently lives in a small city of 150,000 people where she is employed as a book-keeper for the local meat packing plant. She has worked there for 3 years. Her educational background includes an associate's degree in accounting and continuing education in tax preparation. Before working for this plant, she was employed as a tax preparer for a national company. She enjoys her work, saying that numbers are easier to get along with than people.
She has been married to her husband (Doug) for 18 years and has a 16 year old son (Tyrone), who is currently a junior in high school. Her son plays baseball on the school team and is a solid B student. Her husband is a long distance truck driver. He is often away from home for two weeks at a time. He is then at home for 3 to 4 days before he leaves on another trip. Stella reports that she stays at home and feels "blue" when her husband is on the road. Although there have been some problems in the marriage due to Stella's mental health concerns, the couple seems committed to each other and to staying in t ...
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
This slide is special for master students (MIBS & MIFB) in UUM. Also useful for readers who are interested in the topic of contemporary Islamic banking.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
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A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
1. NURSING CARE AND MANAGEMENT OF PSYCHIATRIC
PATIENT WITH BIPOLAR AFFECTIVE DISORDER
Group Members :
Viviana ak Incha
Nur Ainina bt. Mohd Fadzil
Lai siang Wei
Semester 5 / July 2011 Intake
Subject
: Psychiatric in Nursing
Subject Code
: NENS 5262
Lecturer’s Name
: Madam Chin Nyuk Chin
2. CONTENT
Introduction
Definition
Causes
Sign and symptom
Patient’s Biodata
Patient’s Current History
Referral Source
Family History
Personal History
Social History
Premorbid Personality
Previous Medical History
Mental Status Examination
Mental Status Examination -reverseManagement :
Medication
Divertional Therapy
Psychoeducation
Nursing Care Plan
Conclusion
References
Appendix
PAGE
3. INTRODUCTION
We choose Bipolar Disorder for our case study during attach at Hospital Sentosa. We
find out the case when first patient re-admitted at 12/8/13 in Male Acute 1.Brought by his
brother. Patient names Mr.A.R, 40 years old, Malay. His brother brought him to Sentosa
and request to admit plus the patient also wanted to admitted because apparently not well
at home (voluntary, under Borang 1).
His brother and others family member noticed that patient always hanging around with
village boys and lossy money.
Throughout our observed, during interview Mr. A.R, his was talkative, flight of ideas,
and non-stop singing.
We have chosen this case study because our patient able to talk relevantly. Besides
that, he was admitted to Male Acute 1 . So, it will be easier for us to interview. Other than
that, we can make this case study presentation as part of our revision.
4. Definition Of Bipolar Disorder
is
a
chronic
,recurrent
illness
characterized
(expansiveness,elation,agitation,hyper-activity)
by
episodes
of
mania
,hypomania,depression
,and
concurrent mania & depression (mixed episodes) with periods of normal mood and
functioning in between the episodes.
(Mental Health Nursing,sulaigah baputty-sabtu hitam-sujata sethi,pg.176)
is a mood disorder characterized by mood swings from (exaggerated feeling or wellbeing ,stimulation and grandiosity in which a person can lose touch with reality)to
depression overwhelming worth,which can include suicidal though & suicide
attempts.
(www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001924/#asadam_000926.disease.causes.
)
sometimes called manic-depressive disorder. Bipolar disorder is associated with
mood swings that range from the lows of depression to the highs of mania.
(http://www.mayoclinic.com/health/bipolar-disorder/DS00356)
5. Causes Of Bipolar Affective Disorder
unknown
but genetics do seem to be involved. Relatives of people with bipolar effective and
depression are more likely to be affected.
abnormal brain structure & brain function.
6. GENERAL SIGNS & SYMPTOMS
MANIC
DEPRESSED
mood swings
feeling of sadness or hopelessness
depression
lost of interest in pleasurable or
Manic episodes
increase activity level
talkactive,
ideas that moves quickly from one
subject to the next
(flight of ideas)
excessive irritability ,aggresive
behaviour
reckless sex,spend lot of money
usual activities
difficulty sleeping ,early-morning
awakening
difficulty concentrating
7. BIODATA
Name : Mr. A.R
Age : 40 y.o
Religion : Islam
Race : Malay
Address : No. 52 ,Kampung Gersak,Petra Jaya, Kuching
Occupation : Unemployed
Status : single
Admission Status : Voluntary (Borang 1)
No. Of Admission : 23 (19 July 2013)
Diagnosis : Bipolar Affective Disorder (BAD)
8. PATIENT CURRENT HISTORY
History from brother :
During Home Leave 19/7/13 until 11/8/13 ,the patient always hangout and
gambling with village boys until back home lately.
History from patient :
Cannot sleep around 2-3 days (hyperactive)
Feel hopeless because lost a lot of money because of gambling
Increasing in smoking
Not taking alcohol anymore
During our interview, the patient was talkative, flight of ideas and non-stop singing. The
patient also spoke relevantly. Sometimes patient not cooperative with activities been
conduct.
9. A. REFERRAL SOURCE :
Patient was brought to Male Acute 1 at Hospital Sentosa Kuching (HSK) by his
brother on 12th of August 2013. So, he was admitted
Chief complaint ; his brother claimed that patient was not well at home and like to
wonder around at night.
Patient’s history of present illness ; according to his brother patient was drank
alcohol brought by the village boys , scolding everyone at home , gambling and become
more aggressive. Upon losing money he likes to disturb people at home.
History from patient ; troughout our interview session on the 14 th of August 2013,
the patient spoke Malay with us. Patient is also able to attend his activity of daily living
independently. His sleep pattern was not regular, he always sleeps late at night around
3am to 4am and woke up around 12nn to 1pm.
Patient’s appetite was good and normal. Patient claimed that every meal, he will
eat two plate of rice. Besides that , his toilet habits was perform well and oral hygiene is
poor.
Before admission , his family had brought him to see “Bomoh” at around 15 years
ago at Petra Jaya. Other than that , he also had “mandi air bunga dengan rempah” at
Kpg. Tupong Tengah in few years ago.
He was also admitted to Hospital Sentosa on 30th of January 2013 which the 22nd
of admission ; the treatment given to patient are Tab. Clonazepam, Tab. Quetiapine, Tab.
Sodium Valporate, Tab. Amlodipine , Tab. Metformin and Tab. Simvastatin.
10. B. FAMILY HISTORY
According to case note, patient having moderate strong family history of mental
illness. His uncle from his mother’s side was positive history of mental illness. His uncle
ever admitted for the past few years ago but already discharged from Sentosa Hospital ;
being as a outpatient and still taking the medication as prescribed by the doctor.
11. Patient stays with parent and ten siblings. He is the 9th among his siblings. Patient
was stayed with mother and the 5th sister with his brother-in-law.
Patient’s father was dead few years ago due to stroke and asthma. His mother
was 75 years old and diagnosed Diabetes Mellitus under treatment.
Patient’s 1st brother ; 53 years old ; married ; work at the airport. Patient’s 2 nd
brother ; 51 years old ; married ; work at hospital as PPK. Patient’s 3rd brother ; 50 years
old ; married ; work as engineer. Patient’s 4th brother ; 49 years old ; married ; work as
personal assistant with a Dato’. Patient’s 5th sister ; 47 years old ; married ; work as
telekom officer. Patient’s 6th brother ; 46 years old ; married ; work as driver BERNAS.
Patient’s 7th sister ; 45 years old ; married ; work at the RHB Bank. Patient’s 8th brother ;
43 years old ; married ; work at Kompleks Belia & Sukan. Patient’s youngest sister ; 38
years old ; married ; work as Telekom officer.
There are no social standing in patient’s family ; economic status of the family is
moderate about RM2000/- ; from the brothers and sisters who supply to the mother every
month.
12. C. PERSONAL HISTORY
Mr. A.R was a Malay , born on 9th July 1973 at Sarawak General Hospital with
normal delivery. He has no neurotic problems since birth. He is healthy. He completed
secondary school at SMK Tun Abang Haji Openg for Form 1 till Form 5. On 1997 , he
pass with seven subjects in SPM. He was not active at school and like to do his own work
alone.
After Form 5 , patient did not work for a few years. Patient just stayed at home and
hang around with village boys. On 2002, patient doing part time job at Banquet as a waiter
for two years. Patient was earned around RM30-40 per day from the part time job.
On 2005, patient work at coffee shop for 3 to 4 years. Patient helped his cousin to
sell “Laksa Sarawak”. After that, patient quit again as he felt his salary is insufficient to
support his daily expenses. Patient was earned between RM 600 to RM 800 per month.
On 2012, patient was worked as a guard at condominium area. He only worked for
8 days because he engaged in a police case by history of stealing. Patient also was being
fired by his employer. After that, he worked at a hotel on and off for a few months. He quit
again and not doing any job until now.
Patient sexual experience was having reckless behavior. He claimed that , he was
done sex with many partner and also with the psycho people at the outside. He was
started sex experience since 14 years old and addicted with porno CD. He also often to
masturbate.
13. D. SOCIAL HISTORY
Recently, the patient present home was concrete double-storey house. That house
is not a rent house but their own house. Mr. AR’s friend are mostly the village boys. His
friends are likes gambling also. So, they’ll influence Mr. AR to gambling and lossy money.
During home leave on 5th to 11th August 2013, almost every night he went out play
‘Olo’ and cards. His religious affiliation , he’s Muslim but never practice it.
He also smoked since 14 years old. He smoked on demand because he will
smoked as long the cigarettes have in his hand.
Patient drank alcohol since 2005,such as Cap Apek but he took it on-off. On 2007,
he took “Royal + cola + ice” . Before the admitted into Male Acute 1 ward , patient had
took beer such as “Dexter (1 can) and Tsingtao (1can)” .
14. E. PREMORBID PERSONALITY
Before patient was sick , he was prefer more being alone and not socialize with
other people accept his family ; but its also limited. He only very closed with his 5 th brother.
He also very kind and polite towards others as claimed by his brother upon our interview.
F. PREVIOUS MEDICAL HISTORY
Upon our interviewed and referral from the patient’s case note, below are the medical
history of patient ;
Bipolar Disorder type 1
Hypertension – diagnosed on 8/3/12
Non Insulin Dependent Diabetis Mellitus (NIDDM) -8/3/12
Hypercholesterolemia -8/3/12
Hypertension , Non Insulin Dependent Diabetes Mellitus and Hypercholesterolemia are
being diagnosed on the 8th of March 2012.
15. MENTAL STATUS EXAMINATION
General Appearance and Behavior :
During interview on 14th of August 2013 (Day 3 of admission) , we had done an
assessment on patient in Male Acute 1. Patient’s general appearance and behavior are
talkative, flight of ideas and tidy. Patient also attentive and aware to surrounding activity.
His physical appearance are tough, tall, dark skin and many freckles. Patient was
well dressed and clean. Patient also able to maintain eye contact during conversation.
His facial expression; smiling and happy but patient walk is unusual gait.
There were presence of poor manner because he just grab the things that he want
to take without any permission. He able to co-operate during interview session eventough
easily distracted occasionally.
Talk
Patient’s spoke Malay and sometime in English during interview session. The
volume is normal but in rapid rate. The speech is clear and relevance. He has no loose
or clang association.
Moods
Patient mood state is happy during interview. His affective response is appropriate
and having inconsistency of mood. He denied any suicidal thoughts.
Thought Content
There are present of delusion which patient says that he’s a “pengarang cerita”.
He denied any feelings of influence, passivity, depersonalization, repetitive dreams or
phobias.
16. MENTAL STATUS EXAMINATION –reverse-
Orientation
Place
Patient able to tell us where he is now.
Q : Mr.AR, do you know the name of this place?
A : Of course, this is Hospital Sentosa.
Person
Patient able to recognise us during our interview.
Q : Mr. AR, do you know who we are?
A : Ya, you are nurse from ICATS.
Date
Patient able to state the date.
Q : Mr. AR, do you know what date is today?
A : Ya, it's 14th August 2013.
Memory
Remote Memory :
Pt able to tell us where he’s secondary school.
Nurse : “kamu bersekolah di mana dulu?”
Patient : “kat Smk Tun Abg Hj Openg lah.”
Recent Memory :
Good & able to remember our names in the second
time we meet on 16 August 2013.
Five Minute Memory
Test :
Patient able to recall 3 items out of 3 items after 5
minutes.
Items : nurse watch, name tag & note book.
17. Information and Vocabulary
In estimation of intelligence level, patient able to tell us what his medication is on;
able to explain or state the medication and time to be taken. He also had explain to us
the function of his medication and the effect if not taking it. Eventough its not proper well
said in medical term but he able to says it in his own words.
Abstraction
In proverb test, patient able to explain “bagai menatang minyak yang penuh” ;
where he explained it “seorang ibu akan menjaga anaknya dengan penuh kasih sayang.
Walau apa pun yang terjadi ibu tetap sayang dengan anaknya.”
Attention and Concentration
Patient able to concentrate well during interview. We’re perform some test with
patient which are;
Serial seven test : Patient’s being instructed to minus 7 from 100 and continuously minus 7 from
the answer.
Remarks : Patient able to give fast answer.
Digit span test : We instructed patient to count number in reverse that is 10 to 1 .
Remarks : Patient able to count number in reverse from 10 to 1.
18. Judgement
Patient able to make decision and conclusion when asked about his response if
confront with a serious situation.
Nurse : “ Mr. A.R,apa kamu akan buat jika kamu lihat kawan kamu tercedera dekat wad?”
Patient : “ Saya panggil misi lah.”
Insight
Patient is aware of his condition that is Bipolar Affective Disorder. He know the
consequences if he is not comply with his treatment. He just need a better understanding
of his illness.
19. CASE MANAGEMENT
Medication :
Name of Drug
Group
Route
Indication
Side Effect
Nursing
Implications
Generic Name :
Anti-
Oral
Clonazepam
anxiety
(ON)
(0.5mg – 6mg)
Used to treat
seizures, panic
disorder and
anxiety.
Used to treat
Trade Name :
Klonopin
bipolar disorder.
Drowsiness,
dizziness
Loss of
Do not
drink
alcohol.
appetite,
nausea
Unusual risktaking
Patient’s Dosage
behavior
Confusion,
:
2mg
hallucinations
Involuntary
eye
movements
Generic Name :
Anti-
Oral
Used for the
Quetiapine
Psychotics
(ON)
treatment of
Cold sweats
getting up
schizophrenia,
Confusion
too fast
bipolar disorder
Dizziness
from a
and along with
Drowsiness
sitting or
antidepressant to
Constipation
lying
treat MDD (Major
Headache
position.
(150mg – 800mg)
Trade Name :
Seroquel
Patient’s Dosage
:
800mg
Depressive
Disorder)
Chills
Avoid
20. Generic Name :
Sodium Valproate
(1000mg –
3000mg)
Anticonvulsant
Oral
Used in the
(BD)
treatment of
Mood
epilepsy,
panic,
Stabilizers
anxiety
Trade Name :
disorder,
Epilim
migraine and
Confusion
Advice
Abnormal eye
patient to
movement
do
Extrapyramid
regular
al side effects
Memory
exercise.
Encourag
problems
e patient
bipolar
to label
disorder
Tremors
the
Weight gain
picture of
Headache
family
Lethargy
Patient’s Dosage :
Sleepiness
members
1000mg
.
Generic Name :
Calcium
Oral
Amlodipine
Channel
(OD)
Blocker
Trade Name :
Norvasc
Treats high
Swelling of
blood
ankles &
pressure or
feets
chest pain
Dizziness
(angina).
Fast, irregular
heartbeat /
Patient’s Dosage :
pulse
5mg
Feeling of
warmth
Shortness of
breath
Tightness in
the chest.
21. Generic Name :
Metformin
Oral
Used with
Decreased
(BD)
Biguanide
diet and
appetite
exercise to
control blood
Trade Name :
Glumetza
Diarrhea
Lower back
sugar in
patients with
Patient’s Dosage :
type 2
1g
diabetes.
or side pain
Muscle pain
or cramping
Painful or
difficult
urination
Sleepiness
Generic Name :
Anti-
Oral
Simvastatin
Hyperlipidemic
(ON)
Agents
Trade Name :
Zocor
Used to treat
high
Constipation
cholesterol
Insomnia
and
Joint pain
triglyceride
Mild muscle
levels in the
Patient’s Dosage :
20mg
Headache
blood
pain
Cold
symptoms
such as
sneezing,
sore throat.
22. Diversional Therapy :
The activities that we have done with the patient are :
1. Play chess – At certain moments, our patient is in mania state, during this
time, we would ask him to sit down and play chess with him. He able to focus
in the game and won several times.
2. Singing – Patient loves to sing most of the times. Whenever he saw us, he
loves to sing. He has a good voice. Even though sometimes his voice makes
us feel annoying but he loves to make us feel entertaining.
3. Musical chair – We gathered 8 patients and 2 students to play together. Our
patient sometimes do feel restless, we would play musical chair with him in
order to let him focus on the music.
Psychoeducation :
23. 1. Understanding illness :
First and foremost, we assess patient knowledge on his illness. Then, we explain
the definition, sign & symptoms of the illness.
2. Treatment :
Then, we ask the patient about his medication. We ask him by the colour of the
medication and the name if the patient remember it. We also tell him the action and
side effects of the medication and ask him which side effects he experienced as
well as teach him how to cope with the side effects. We also remind him not to take
alcohol when taking medications.
3. Prevent relapse :
In order to prevent the illness from reoccur, we advise the patient to maintain a
balance of rest and activities, regular check-up and compliance towards medication.
In addition, we also advise the patient to have balanced diet, regular exercise and
avoid alcohol. We also educate the patient of the early signs of relapse such as less
sleep, feels irritable and not feeling of taking medication.
24. 4. Crisis intervention :
a) Managing stress – when feeling stress, do some exercises. We also teach the
patient to do deep breathing exercise if he feel stress.
b) Problem solving skills
i.
Identify the problem
ii.
Find a better solution
c) Follow up treatment according to the appointment.
5. Healthy lifestyle :
Avoid alcohol together with drugs that might increase the risk of relapse.
Have a healthy balanced diet. Consume more vegetables and fruits.
Exercise regularly because exercise can affect mood positively.
Have enough rest. Go to bed at the same time every night.
Regular follow-up and compliance with treatment.
25. Nursing Care Plan :
Nursing
Goal
Diagnosis
Nursing
Rationale
Evaluation
intervention
Provide
To divert
Risk for violence
Patient feels
related to the
less irritable
diversional
patient’s
when get
therapy such as
irritable when get
aggressive
along with
playing chess.
along with other
behavior.
other people
patient’s anger
To help the
OD :
patient to
patient to
• Patient looks
express his
relieve his
feelings
feelings and
irritable when
people keeps
bothering him.
anger.
Avoid expose the
To avoid
patient to
patient
SD :
predictable high
became out of
• Patient
situation.
control.
verbalize that
other patient
Administer
keeps taking
medication as
cigarette from
prescribed by
him which
doctor such as
makes him
epilim.
angry.
patient feel less
people.
Encourage
within 1 week.
After 1 weeks,
To calm the
patient.
26. Assess patient
To identify his
Knowledge deficit
Patient
regarding to
verbalize
level of
understanding
patient verbalize
illness.
understand
understand
level.
understand about
about his
towards his
his illness /
OD :
illness /
illness.
disease upon
• Patient facial
disease within
expression
1 weeks upon
seems
interviewing.
interviewing.
Explain to patient
To increase
regarding his
patient’s
disease which
knowledge on
SD :
includes
his illness /
• Patient do not
treatment.
disease.
confused.
understand his
disease upon
interviewing.
After 1 weeks,
Educate patient
To increase
on his sign and
patient’s
symptoms of his
knowledge
illness / disease.
and to prevent
relapse.
27. To maintain
After 1 week,
go to bed at the
bedtime
patient able to
hours at night
same time every
routine.
sleep for 6
after 1 week.
day.
Sleep
Patient able to
disturbance
sleep for 6
related to
hyperactive.
OD :
• Patient look
dozy in the
Advice patient to
Advice patient to
hours at night.
To avoid
pass urine before
disturb during
go to bed.
sleep.
day.
Increase daytime
So that patient
SD :
activity for patient
will feel tired at
• Patient
such as play
night.
verbalize feel
balls.
wanted to do
something at
night.
Limit the amount
So that patient
and length of
able to sleep
daytime sleeping
at night.
to half an hour.
Administer
To reduce the
medication as
sleep
prescribed by
disturbance of
doctor such as
the patient.
clonazepam.
28. Patient is
related to lack of
willing to
patient’s
patient take
patient is willing
family support.
take
medication
the medication
to take
medication
intake.
as prescribed.
medication
OD :
Supervise the
To ensure
Poor compliance
by 1 week.
After 1 week,
regularly.
• Patient has
flight of ideas
Patient
Explain the
To increase
Patient also
upon returning
verbalize
illness and
patient
verbalize
from home
understand
importance of
knowledge
understand on
leave.
the
treatment
level on his
the importance
importance
towards the
illness and
of compliance
of
patient.
treatment.
towards
• Patient look
hyperactive
compliance
SD :
towards
• Patient
treatment.
treatment.
Encourage the
To allow
verbalizes
patient to take
patient being
unable to
treatment
independently
sleep well at
unsupervised
after
night.
and regularly.
discharge.
• Patient’s
brother
verbalize
patient always
hang out at
night.
29. Conclusion :
Through this case study, we learned a lot about Bipolar Affective Disorder. We
improved our knowledge on the sign and symptoms such as distractibility, impaired
judgment and increased energy.
Besides collecting data from documentation of the staffs from Hospital Sentosa,
we also manage to gather some data from the patient through interview. During that
interview, we get to know more about him as well as his feelings.
Our patient is co-operative upon interviewing by answering the questions that we
asked him. He also sang song for us in order to entertain us.
This case study also encouraged us to read more on Bipolar Affective Disorder
(BAD). I believe this case study will help us in the future.