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HLTH 1037 Mental Health

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Aim:

The purpose of this assignment is to explore the personal and social implications of mental illness, as well as, the ethical, legal and clinical practice implications related to a person experiencing mental illness being admitted to a medical ward. Using a recovery and person-centred approach, explore the issues raised in the case study and how you can support this person during your early shift. Case Study Instructions: You will be provided with a number of important documents related to this case study of a person who experiences a major mental illness. These documents are contained in a folder on the learnonline course page. Please access these documents in order to complete this case study.

Assessment Task Scenario

You are a newly registered nurse working in a large metropolitan hospital on an early shift in a busy medical ward. You have been allocated Adam Citizen to care for as a 1:1 special in a single bed side-room. At 07:00 AM you are given the following hand-over by the night duty RN: Adam is a 29 year old man admitted yesterday post overdose of Diazepam, Lithium Carbonate and Quetiapine. Adam has a diagnosis of Bipolar Disorder and is currently on an Inpatient Treatment Order – Level 1 which requires review today.

Overnight Adam has been occasionally drowsy, but at other times very restless and agitated. His conversation has some delusional content at times. Adam appears confused and is likely to be experiencing a delirium related to the intentional overdose of prescribed medications.

Adam has an intravenous line of normal saline one (1) litre over eight (8 ) hours – started four (4) hours ago. His pulse rate and blood pressure has been within normal limits. I suggest you check her vital signs four (4) hourly until he is reviewed by the treating Medical team. Adam's behaviour has not presented any significant safety problems overnight in the ward. However, when Adam presented to the Emergency Department he was in a severely agitated state and a Code Black (Aggressive incident & security response) was initiated. Because of Adams fluctuating sensorium he is to be considered 'at risk' and steps are needed to ensure his safety. Adam is not to be given any medication unless severely agitated. The Consultation-Liaison psychiatry team are aware of his admission to the medical ward and will review Adam later this morning. They told me that over the next few hours it is likely that Adam will become more alert and is likely to be more distressed and agitated. I was asked to tell you to call for the Consultation-Liaison psychiatry team if you have any concerns.” In a parting comment the night duty Registered Nurse states: "I don't know why we are wasting our time looking after a man who wants to kill himself when there are plenty of sick people out there who need hospital beds". Following this handover you have the time to review Adam's admission notes where you find the following documents which highlight past and recent information.

Emergency Department Mental Health Assessment Private Psychiatrist letter to Mental Health case manager Letter from employer to Mental Health case manager Letter from Mother to Mental Health case manager Recent letter from identified client to Mental Health case manager

HLTH 1037 Mental Health

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