Mental Health Scenario

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NSB223 - Case Study

This Case Study will be undertaken as a group activity and is designed to deepen your knowledge about mental illnesses, and to test your understanding about the nursing care of people suffering from such conditions. It will also assist you to express your ideas through class presentation and in writing.

You as a small group of 3-4 students are asked to choose one of the following scenarios and answer the questions listed below. The manner in which you as a group choose to present your case study is up to groups consensus. What is important is that your address each of the criteria listed on the Criteria Reference Assessment sheet.

As you will be working in groups each groups is required to complete a groups contract. A group contract is concerned with the group identifying and agreeing to what needs to be done and who will be responsible for the group tasks such as convening meetings, preparing the presentation, undertaking a literature review etc.

An Adult Male with Mania
Luis is a 42-year-old married father of two who has been compulsorily admitted with bipolar disorder, manic episode. Luis was brought to hospital by the police. He had been out on the street running around in circles and banging his body against objects such as cars, fences and posts. He has been admitted on five other occasions with depressive and manic episodes.

Luis is a finance officer, which is a lowly position in the large accounting firm where he works. The firm is undergoing a major restructure and it is likely that a number of employees will be made redundant.

Luis is of dark complexion, with greying black hair. He is 1.8m tall and weighs 90kg. On admission he was dressed neatly in a bright multicoloured shirt and shorts. He was wearing multiple gold and silver chains around his neck and even had some wrapped around his wrists.

Luis is always on the move. He speaks quite fast and his thoughts sometimes seem unconnected. He approaches the nurse and announces loudly “I am really rich. Australia would go to the dogs without me, because I advise the Treasurer how to run the country’s finances. I can make you rich too.” He also falsely claims to be the chief accountant for various Australian media magnates. Luis always speaks loudly and sometimes shouts at the nurses and other patients.

Luis tells the nurse that he feels “great. I’ve got so much energy and I don’t need any sleep at all.” He arises from bed very early and, to pass the time, sings loudly in the day room. When asked by the nurse not to disturb other patients he abuses her. He gaily shouts good morning to any other person he sees and tries to entice them into his room. When others ignore him or refuse, he becomes irritable.

He talks incessantly during meals and makes many offensive personal remarks to the staff and patients. Any personal material other patients confide to him, he discusses loudly at the table. However, he rarely sits at the table for very long.

He has insinuated that the resident doctor has a serious drinking problem and that the nurse in charge of the ward is having sexual relations with several of the female patients. He himself frequently asks the female nurses for sexual favours. His wife is very distressed by his behaviour. He has been phoning her, accusing her of “treachery” and demanding a divorce so he can marry one of the nurses. He has proposed to the nurse by letter.

Luis spends much of the rest of the day phoning the taxation office and wasting their time informing them about various people he says are avoiding tax. He also phones the senior partner in his firm claiming that one of the junior partners is committing fraud. He is also in contact with a number of lawyers about this same colleague. He has been prescribed Valproic Acid; Clonazepam and Olanazapine.

Required Reading: Chapter 16
Additional Reading: Chapters 4, 11, 22, 24, 25

A Young Adult Male with Schizophrenia
Cormac, a 24...
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