The presenting patient is a thirty-eight-year-old, Caucasian male, who was involuntarily admitted to Acadia Hospital on March nineteenth, with the admitting diagnoses of schizoaffective disorder and bipolar type. Police brought the patient to the emergency department after the patient was found dancing in and out of traffic, shirtless in fifteen-degree weather, and threatening employees and customers in local shops. Upon police custody the patient reportedly requested that they retrain him, for their comfort, and shoot him. Following medical clearance from the emergency department the patient was admitted, while displaying characteristics of grandiosity, psychosis, and reports of threating behaviors in the community. The patient has no known …show more content…
However, this is the patient’s first psychiatric admission. His current allergies include: penicillin, which results in erythema; sulfa drugs, which result in a rash; periorbital, with unknown reactions; Clindamycin, which causes nausea and vomiting; angiotensin-converting-enzyme inhibitor, which causes unknown reactions; and lastly Phenobarbital, which results in unknown reactions. The patient is currently prescribed: 50 mg of Indomethacin, 1 mg of Clonazepam, 50 mg Losartan, 1 puff of Albuterol, 0.1 mg of Clonidine, 112 mcg of Levothyroxine, 90 mcg of Budesonide Flexhaler, 40 mg of Ziprasidone, and medical marijuana. His current over the counter medications include: 1000 mg of Extra Strength Tylenol as needed, an unspecified dosage of Fish-Oil daily, and 1 tsp of Metamucil daily. He denied the use of any herbal supplements or recreational drugs. The patient is currently prescribed individual, group, and milieu therapies as complementary therapies at this …show more content…
Furthermore, there was no documentation regarding past routine healthcare visits found in his medical record, besides the names of his previous healthcare providers.
His immunization status was also unknown. However, a Tuberculin skin test was preformed, and a negative result was verified prior to admission at Acadia Hospital. In regards to childhood immunizations the patient stated, “I had Roseola as a child, and febrile seizures due to
Does one really know the definition of psychological instability? Perhaps it has an existence at the mental institutional treatment sanitarium here in southern California. The patient of evaluation, Holden Caulfield, a seventeen year old Caucasian male, weighs approximately 120lbs with a skinny, lanky stature and is 6 feet and 2.5 inches tall. Caulfield has crew-cut hair that is graying on the right side. The patient was an occasional drinker and smoker but has now cut cold turkey due to being institutionalized. Frequently drastic mood swings have been documented, as well as, emotional breakdowns, evident sexual frustration, deep depression, clear resentment, a rebellious attitude, signs of being socially inept and abnormal immaturity for a boy of his age. Based on professional observation, it is obvious that the patient exhibits some bipolar and multiple personality characteristics; his obsession with finding the flaws in the people and world around him has contributed to putting him in a dangerously depressive state.
What is the purpose of each of the medications the patient is on? Why is this patient receiving them?
Polypharmacy is the “concurrent use of several differ drugs and becomes an issue in older adults when the high number of drugs in a medication regimen includes overlapping drugs for the same therapeutic effect”(Woo & Wynne, 2011, p. 1426). The patient is currently taking several medications that can potential interact with each other, perform the same therapeutic effect, and creating side effects. The following is a list of her medications and their indications:
Symptoms/Focus: Dr. Andrew Bourgeois at Simi Valley Emergency Room requested an evaluation of client by the Crisis Team for Suicidal Ideation and Grave Disability. Client placed a call to EMS on his own behalf on the evening of 05/14/2017. Client requested to be picked up from in front of a restaurant and taken to Simi Valley Emergency Room due to suicidal ideation with a plan to "cut head with a saw". Client stated to Dr. Bourgeois that his depression had increased over the last 3 days. Client denied drug or alcohol use, but was positive for amphetamine in the hospital toxicology screen. Client had been seen at Simi Valley ER and
In 1989, Andrew Goldstein was admitted to a psychiatric hospital from a physical altercation with his mother; there he was diagnosed with Schizophrenia. In 1999, Andrew Goldstein, at a New York subway killed Kendra Webdale by pushing her into an oncoming train. Three weeks before the fatal altercation with Kendra Webdale, Andrew Goldstein was released, after committing himself to a New York hospital. Goldstein committed himself into the hospital due to “severe schizophrenia” (Frontline, A Case of Insanity). Even though the hospital, that Goldstein was released from, noted in their records that Goldstein was described as “thought-disordered,” “delusional,” and “psychotic” (Frontline) nonetheless, he was still release and referred to an outpatient therapy, after less than a month of being there.
-Bardsley, M., Bell, R., and Lohr, D. 2009. The BTK Story. Retrieved December 9, 2009 from http://www.trutv.com/library/crime/serial_killers/unsolved/btk/index_1.html : This was a reliable source since it collected it’s information from police records, first hand accounts and testimony from the trial. This resource was very helpful because it presented a high-profile case of a person suffering from this disorder.
Weber, Paul. “Fort Hood Gunman Sought Mental Health Treatment.” The Associated Press News Service [Texas] 3 Apr. 2014: n. pag. NewsBank Special Reports. Web. 7 Apr. 2014.
Working in mental health is a challenge particularly when working with clients who may pose a threat to themselves or others. Given the unpredictable nature of the population it is very likely that in the course of professional practice providers of behavioral health services will encounter clients who threaten the safety of others. Ever since the unprecedented Tarasoff vs Regents of the University of California (1974) case which involved the stabbing death of college student Tatiana Tarasoff by infatuated acquaintance Prosenjit Poddar (Gehlert & Browne, 2012). Poddar disclosed to his psychiatrist Dr. Lawrence Moore of his plans to kill Tarasoff because she did not return his affecti...
Much of my skepticism over the insanity defense is how this act of crime has been shifted from a medical condition to coming under legal governance. The word "insane" is now a legal term. A nuerological illness described by doctors and psychiatrists to a jury may explain a person's reason and behavior. It however seldom excuses it. The most widely known rule in...
The initial diagnosis of Schizoaffective Disorder can be somewhat confusing. Many patients and loved ones wonder, “What does that mean?” “How is it different than Schizophrenia?” We’re here to break it down for you. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM) Schizoaffective Disorder is classified as: An uninterrupted period of illness during which there is a Major Mood Episode (Major Depressive or Manic) concurrent with the Criterion A of Schizophrenia. The Major Depressive Episode must include Criterion A1. Depressed mood. Delusions or hallucinations for 2 or more weeks in the absence of a Major Mood Episode (Depressive or Manic) during the lifetime duration of the illness. Symptoms that meet criteria for a Major Mood Episode are present for the majority of the total duration of the active and residual portions of the illness. The disturbance is not attributable to the effects of a substance or another medical condition.
The patient that I wish to discuss is Mr. P. His medical problems include Hypertension, hypercholesterolemia and depression which he is taking medications. He was a chronic chain smoker for about 25 years.
Journal of the American Academy of Psychiatry and the Law, 28. (2000): 315-324. Web. The Web. The Web. 13 Apr 2011.
It is very important to distinguish mental illness from those who commit crimes for various reasons which happens on a daily occurrence. To properly identify mental illness there must be a distinction between normality and pathological patterns of behavior. (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000). Therefore, consistency of the pattern of the person suffering with mental illness is key in understanding that there is significant problem existing versus someone engaging in deviant behavior. We are constantly bombarded by newsreels of stories of violent acts committed from individuals whose behavior prior to the incidents should have enlisted the services of a psychiatric intervention to avert such crimes.
Lars is a 27-year-old male that lives alone. He suffers from tics that seem to get worse during social interaction. He is very quiet, often not responding when spoken to. He lives next door to his brother and sister in law. He keeps to himself by refusing social interaction with coworkers and family. After a coworker shows him an online site that sells sex dolls, he orders one. Then he has an elaborate delusion that the sex doll is a woman named Bianca he met online and has a relationship with. His brother and sister in-law convince him to bring “Bianca” to see a doctor for a check up. The doctor explains to his family that he is having a delusion and they should go along with it. She explains they will not be able to convince him otherwise and after trying to convince him his brother goes along with the delusion and asks the townspeople to do so as well. This continues until Lars finds the healing he was seeking and then “Bianca” gets very sick and dies. This is when Lars no longer needs her since he has been able to bond with actual people in his life.
Six years ago I received a call from my son’s school nurse. He was complaining of having a headache. When I arrived at the school I noticed my son was confused and his face was drooping. Immediately I took him to the ER. They started doing tests and CT Scan. Before I was even told what was wrong with my son, EMT’s showed up with a stretcher. The doctor came in saying we were being transferred to Dell Children’s Hospital, CT scan showed a spot on my son’s brain. When we arrived at Dell’s we were greeted by the head of neurosurgery Doctor George. He explained that my son had to have an MRI done and took every measure to prevent him from having a stroke. After the MRI, we were told that Jarrett had a Cavernous Malformation an abnormal tangle of capillaries and small veins. They fill with blood and tissue, resulting in raspberry formation. He had tiny bleeding, but