Elimination When asked about his typical elimination pattern, the patient stated that he voids several times daily, and typically has one bowel movement per day. The patient denied any concerns nor expressed any problems regarding his usual pattern of bowel/bladder elimination. He also denied any symptoms such as pain, bleed, unusual appearance or pattern. Furthermore, he has previously experienced dysuria and hesitancy by record. No treatment regarding elimination is implied at this time. There were no labs drawn in respects to the patient’s fluid or electrolyte status.
Activity Exercise In February of this year the patient did present to a local emergency department, with a chief complaint of chest pain. However, he left the emergency
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According to the patient his financial status, and “lack of a formal diagnosis and treatment” are the two current stressors in life. When asked about the extent to which the patient feels accepted and valued in life, the patient stated, “I do, and that’s all I have to say”. The patient then reported turning to his ex-wife, who he also identifies as his best friend, when asked about who he turns to in a time of crisis. Later in the interview the patient also stated that he wished a Rabbi would come and visit him during his hospitalization, and that he believes that Rabbis may be bias and prejudice against mental health. Furthermore, the patient denied satisfaction with his professional support, stating that although he feels that his male provider is “adequate”, he believes he would benefit more from a female provider. He also denied the use of self-help or support group, stating, “I am an autodidactic, also known as a polymath, so that’s my support and self-help”. Although his medical records did state that he has a past history of suicidal attempts, and his recent request to be shot by police at the time of admission, he denied both a history and/or present suicidal or homicidal
Karmen is a 50-year-old married who told her psychiatrist that she was considering suicide through overdosing on Advil. She complains of severe back pain that has left her with a “poor mood”. She talked about the injury for a long period of time. When doctors did not validate her injury, she described feeling abandoned. Karmen had gained weight and was upset about that. She did not take making suicidal comments seriously and often just used them as a threat towards her husband. She craved the attention of the doctors, and was flirtatious with the person who interviewed her. Karmen’s husband said that she talked about suicide on a regular basis. Karmen became sexually active early in life and has always gone for older men.
Mary has suffered with her illness for over 10 years. She has previously been diagnosis with a Cluster B type Personality Disorder. Mary comes across as narcissistic, self-engrossed and can be very demanding at times. Mary suffers from anxiety and is prone to panic attacks in relation to her PD diagnosis. At times Mary has been known to make ...
Major current stressors in patient H’s life are normal for a girl of her age; attending college at a prestigious university, a new puppy, and friends. Patient H also is suffering from a variety of mental illnesses (this will be discussed later), and her family majorly stresses her. Patient H is an only child and therefore has had her parents
The LPN-Team Lead contacted the social worker about Dr. Sundaram’s patient. The patient is a single, Caucasian grandmother and mother of two; she is alert and orientated to person, place and time. The patient reports that she lives with her 16 year old daughter and 3 month old granddaughter. The patient states that she works two jobs, one full-time and one part-time job and she assist with the care of her new granddaughter while her daughter is a work. The patient report that she is feeling (angry) and hurt because her boyfriend of 11 years cheated on her when she was in the hospital and left her a month ago; this and the loss of her child last year at 6 months gestation in addition to her CHF, COPD and influenza appears to have left the patient feeling of depression and hopelessness. The social worker noted that the patient scored a 19 on her PHQ-9, although she denies thoughts of suicide at this time. The patient states that she suffers from insomnia and gets approximately 2-3 hours of non-continuous sleep a night.
Client Profile: Lane Bronson is a 55 year old male with a history of angina, hypertension, Type 2 diabetes, COPD, and sleep apnea. He comes to the physican’s office complaining of worsening shortness of breath. His skin tone is grey, and his angina is worsening. Previously stable, he now does not get relief from rest or nitroglycerin. The physician called 911 and had Mr. Bronson directly admitted to the hospital.
At the onset of assessment by a staff-counseling psychologist, the woman seemed to relax and share some of her thoughts and feeling. As the assessment process continued, the psychologist was able to ascertain that the issue with depression appeared to be a relevantly recent development. Additionally, the depression appeared to be the result of heighten conflicts between the woman and her husband pertaining to alleged extra material affairs. In conversation with the psychologist, the woman claimed to feel “overwhelmed”; her husband filing for divorce triggered the feelings she inferred, which reportedly lead to her breakdown. However, the psychologist has since discovered that the husband denies the affairs and attributes this to the depression. Additionally, the husband claims that the termination of the marriage is a result of the deterioration of his wife’s mental state.
J.P., a 58 year old female, presents to the Emergency Room on March 18th. She has a past medical history of cervical cancer, atheroembolism of the left lower extremity, fistula of the vagina, peripheral vascular disease, neuropathy, glaucoma, GERD, depression, hypertension, chronic kidney disease, and sickle cell anemia. She complains of right lower extremity pain accompanied by fatigue, a decreased appetite, increased work of breathing, burning urination, and decreased urine output for three days. Upon admission, a complete physical assessment was performed along with a blood and metabolic panel. The assessment revealed many positive and negative findings.
The nature of the disorder makes it difficult to treat, since patients are convinced that they suffer from a real and serious medical problem. Indeed, the mere su...
Douglas Anthony in one of the hospital in Orlando Florida on July, 2015 this patient brought to the hospital. Patient was having severe pain in the upper part of the body and was crying in the waiting room. Receptionist and other hospital members were busy in dealing with other patients. Mr. Douglas had to wait for long time to get register in electronic record of the hospital. He was sent to the emergency room where doctor examined him for stomach pain. While checking Mr. Douglas Doctor asked him about the medical history of the stomach pain. Due to language and communication problem doctor referred him to physician with his case history. Physician checked him and send him for the Lab tests. After reading the test reports physician diagnosed him for cardiovascular
David Rosenhan questioned whether these characteristics of mental health “reside in the patients or in the situations and contexts in which the observ...
There are few telltale signs of what Shelly Gregory copes with on a daily basis. On closer observation, one may notice the odd way she holds the right side of her abdomen when she walks or the way she tilts her body to the side when she sits on a chair for too long.
Diagnosis, therefore, must rely not only on a formal clinical interview but on information provided by collaterals, including parents, teachers and community advisors. The patient's premorbid personality must be taken into account, as well as any obvious or subtle stress or trauma that may have preceded the clinical state. The therapeutic alliance is very important since the ad...
Noonan, M. M. (1998). Understanding the "difficult" patient from a dual person perspective. Clinical Social Work Journal, 26(2), 129-141.
Those who have experienced with cognitive health issues will be able to recognize how an able body with an irregular mindset can hold their lives back right under the surveillance of the people around them. Having been struggling with major depressive disorder for years, I am able to witness the changes that occur within my life and the effect of the absence of “equilibrium” (Sartorius. 662) that an individual needs in order to conciliate with oneself. Through the journey to recovery, I learn that in order to overcome the problem, one must first learn to acknowledge the issue, and explore the different actions that can be taken to treat it with. In the perspective of someone who is aiming to become a healthcare provider, it is a never ending cycle of learning how to better improve the ways to take care of each patient, and most oftenly, the patient’s emotion has great effects on how their diseases can be treated. It is beneficial to view “the disease with the person who has it” (Sartorius. 663) in order for doctors to progress through the treatment, as this method “improve the practice of medicine” and provides a more “realistic” and “humane” (Sartorius. 663) connection between the two parties. Ultimately, both the caregiver and the receiver gains experience from the improved
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.