On January 10, 2018 Dr. Caywood was interviewed at his offices and stated the following: He has treated Laurie Davis and her parents off and on for 20 years. Laurie has undergone a number of surgeries related to her lumbar disc disease, and has been referred to other doctors over the years for assessment and pain management. He has also referred her for psychiatric evaluation and treatment. Laurie was last seen in his offices by the nurse practitioner on December 27, 2017 about and asked about the psychiatric referrals. She said she declined the appointments as there were no openings until May or June 2018 and Laurie felt that was too long to wait. To his knowledge she has not followed through with seeking additional treatment for her
psychological and addiction problems but does see Dr. Deborah Kraus on occasions. According to his medical file, Lauri is currently prescribed the following: Keppra for seizures, Seroquel for bipolar disorder, Xanax XR for anxiety, Gabapentin for nerve pain and seizures, Lisinopril as an ace inhibitor, Risperdal as an anti-psychotic, Vimpat for seizures, and Diclofenac for arthritis in her back. Dr. Caywood does not have a pain management contract with Laurie. The last drug screen was done last summer after Laurie had been hospitalized for over-dosing on Tylenol 3 she was prescribed for neck pain and headaches. I asked if he and Laurie discuss her addiction issues. Dr. Caywood said “about a thousand times”. Her parents has expressed concern to him, and Laurie’s refusal to get help. Her parents have already said they do not want to force her to leave their home. Dr. Caywood was aware Laurie’s son may be moving back into the home after his release from prison, as Laurie herself had expressed concerns. Dr. Caywood feels, as a physician he has given as much advice and voiced as many opinions and concerns as is appropriate.
A 38-year-old single woman, Gracie, was referred for treatment of depressed mood. She spoke of being stressed out due to conflicts at work, and took a bunch of unknown pills. She reported feeling a little depressed prior to this event following having ovarian surgery and other glandular medical problems. She appeared mildly anxious and agitated. She is frequently tearful, but says she does not have any significant sleep or appetite disturbance. She does, however, endorse occasional suicidal ideation, but no perceptual disturbances and her thoughts are logical and goal-directed.
How do the issues facing those doing strategic planning differ from those doing tactical planning? Can the two really be
It was about three months ago I was working in the psychiatric emergency room when I inherited a patient from the night shift nurses. This patient was a 17 years old female with a history of bipolar and schizophrenia, came to the emergency room after having an altercation
Bipolar Disorder, an illness in the brain where it controls someone or something to have mood swings, depression, and thoughts on others and other things. Bipolar Disorder is the common name for Borderline Personality Disorder, it can be distressing, not only for the person with the disorder, but for the people around them. Persons with Bipolar Disorder have a difficult time controlling their emotions and many times are in a state of upheaval. Childhood experiences or a brain dysfunction are potential reasons why. Bipolar Disorder can be changed or helped by medication, therapy, and counseling. Bipolar is not an illness that can stand alone it is changed by other variables. Bipolar Disorder, is something not to be mess with. In (MANNING, JS.
In today’s society, there has been a drastic change from what took place in healthcare in the late nineteenth century. Society has also learned from stories like Jane. Advances in psychiatric treatment have brought relief to many patients afflicted with illnesses similar to
Mrs. Baker is a 56 year old female who presented to the ED with homicidal ideation without a plan. She express having auditory hallucination. Mrs. Baker reports the loss of a friend and her pets as the primary factors contributing to her distress. She does not appear to be exhibiting signs of agitation, aggression, or responding to internal stimuli. At the time of the assessment Mrs. Baker denies feelings of suicidal ideation, however still endorses thoughts of harming "everybody who gets too close." She reports the onset of her depressive symptoms started almost 2 weeks ago and auditory hallucination occurred over the past two day. She denies visual hallucinations. Mrs. Baker states, "My family has seen me crying and depressed this week, I told my son-N-law and daughter why I came to the hospital today." Mrs. Baker reports her uncle died about 2 weeks ago and a close friend who she saw just 2 years ago died yesterday 8/19/16. She also expresses last Monday she had to give up her pet dog and a few cats because of live conditions. Mrs. Baker reports overwhelming thoughts of possibly harming her grandchildren. She expresses feeling unsafe being around them. Mrs. Baker reports this morning waking up and cooking breakfast for her grand children and herself as well as eating breakfast with them. She reports also watching a movie with the
Per the previous therapist, referral form states, "Clt was hospitalized on 3/30/16 for panic attacks and suicidal ideations associated with ongoing bullying." Clt meets medical necessity as evidenced by the following impairments: Clt showed impairment at school as evidenced by making statements daily (i.e. 5x/week) to Mother that no one at school liked her and stating that she did not want to go to school. Clt developed symptoms in response to being bullied at school. Mother reports that Clt seems hesitant to engage with peers at her new school. Mother reports impairment in Clt at home in that Clt frequently seems sad and irritable and cannot get certain thoughts out of her mind (~4x/week) and is hesitant to speak with her about the bullying for fear that Mother will go speak with the school.
Caroline Collin is a 38 year old, Caucasian female, who is seeking services because she has being experiencing fears lately. Caroline reports that she has being experiencing quite a few different fears. having difficulties driving, she becomes nervous when she drives herself, and she does not like to stand while she at the store because of her fears. Caroline also reports that her fears are interfering with her work and her daily functioning and she cannot control her fears. Caroline appeared to be exhausted as evidenced by staring into space when she was greeted. Caroline’s clothes seems to be appropriate for her job as a registered nurse working in a hospital, she was wearing blue scrubs.
Everybody has their own list of strengths, some may be obvious, where others may not be. After Thomas J. passed away, Vada was overwhelmed with grief. Shelly saw this and told Harry to stop hiding and running away from his daughters emotions. She stated that life isn’t just death and not to ignore the living, especially his daughter. After this conversation, the support that Vada received from her father increased. Which in return helped strengthen Vada’s support system overall. Another strength would be that the family does care about each other, even though they may not always show it.
In this case study, one day of care for a 28 year old, male patient on a low secure psychiatric unit will be examined and discussed. The main focus will be on implementation and evaluation of the nursing process. These areas will be covered under; physiological, psycho-sociological and pharmacological aspects of the patient’s care. Although, the case study is discussed using third person expression, the care discussed is what was implemented and evaluated by myself, a second year student nurse, under supervision from a qualified member of staff.
Brian, a 34-year-old mechanic, was brought to the Psychiatric emergency services by his wife and has been diagnosed with psychosis. The key concern of Brian’s altered mental health will be identified and discussed. Also, this case study will identify and discuss interventions to address his inability to trust. Some potential impacts to him and his family will be discussed including the consideration of stigma and discrimination. Lastly, the relevant legal and ethical issues to this case study are discussed.
During her early career she has practiced as a psychiatric nurse in acute care and in community settings. She is faculty member in department of Nursing at the California State University at Los Angeles, professor
Jodie Wheeler is a patient under my care that was initially evaluated on 05/14/2015. She was scheduled for urgent cervical spine surgery performed on 05/21/2015 due to cervical spinal stenosis with myelopathy; as well as degenerative changes and a herniated disc. Please contact the office with any questions or concerns at (508)
As we discussed Bipolar Disorders in adults, I find myself assessing the disorder very carefully. Not only did we discuss Adult bipolar disorders, we also studied Major Depressive Disorder (MDD) as well. As in one of the case studies, one of the “clients” who were diagnosed with MDD exhibited a behavior that I initially assumed was associated with a manic episode of Bipolar I Disorder. She would spend massive amounts of money and was in debt to her company as a result of using her company’s credit card. We discussed that without historical information on the client; a diagnosis of Bipolar 1 Disorder would not be appropriate. I would be interested to know if this supposed client’s symptoms would change over the course of time.
Madeleine Leininger worked as an instructor, staff nurse, head nurse, and a director of nursing services at St. Joseph’s Hospital in Omaha (Alligood, 2014). She commenced the first psychiatric graduate nursing program at the University of