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Psychological effects of drug abuse
Psychological effects of drug abuse
Psychological effects of drug addiction
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Mr. Farley is a 52 year old veteran who presented to the ED with a BAC of .42 and requesting detox treatment. Mr. Farley denies suicidal ideation, homicidal ideation, and symptoms of psychosis to ED staff. However, after initially denying suicidal ideation, upon discharge and sobering up from several hours in the ED and being given fluids, nursing staff informed patient he was up for discharge, at which point he asked for Ativan to help with his withdrawal symptoms. He was informed he would not be prescribed this medication and reasons why, he then expressed he could not be discharged because he was now a threat to harm himself. It should be noted Mr. Farley was seen 2 weeks ago and upon discharge reported the same. He expressed he was homelessness …show more content…
Farley reported he was staying in the local Comfort Inn where his truck was parked, however did not have any money due to spending majority of it on alcohol. TACT informed him that he could contact the local shelter, which was contacted by staff. Asheboro shelter of hope informed Mr. Farley they would come pick him up at 8am 6/21/17. Mr. Farley continues says, "Well you can't discharge me if I'm suicidal?" This morning TACT assessed patient and confronted this behavior, at which point patient admitted to malingering and stated, "Well I just wanted to get into the Salisbury so I can get some help. I just didn't want to go to the streets." He continue to expressed experiencing fleeting suicidal ideation over the course of the past 10 years. Mr. Farley reports homelessness and chronic alcoholism as the primary stressors contributing to his current distress. He describes depressive symptoms as tearfulness, hopelessness, worthlessness, despondency, guilt, insomnia, and poor appetite. Mr. Farley denies suicidal ideation, homicidal ideation, and symptoms of psychosis. Patient does not appear to be exhibiting signs of agitation, aggression, or responding to internal …show more content…
Patient has a history of abusing other substances and was very med seeking for benzos and opiates in the ED ("I don't want yall to give me nothing if it ain't IV Ativan and Morphine"). He reports drinking a 1 gallon of wine daily. He denies other drug use and this was confirmed by his most recent drug screen which was negative for substances with a BAC of .42. Upon arrival patient was put on detox protocol with Ativan scheduled every 6 hours. Upon assessment this morning patient denies any withdrawal symptoms. After TACT confronted him about malingering and patient admitting this, TACT then began to discuss discharge options. When TACT asked Mr. Farley about withdrawal symptoms he only expressed
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.
Let’s answer this question point blank: No, Chris McCandless, the ‘adventurer extraordinaire’, was not a suicidal human being. Was that too blunt? Got high off of it? Need explanation? Ok, well here are the reasons why; he knew the risks of taking the perilous journey to go “Into the Wild”, if he wanted to die, he would’ve done it sooner and the friendships that he made with people and his notebook (journal?) were far too strong. Those three reasons are why I think he didn’t end his life.
There are a lot of ethical standard that can be apply to this scenario, the most and most important one avoiding harm (Standard 3.04). The psychologist should take a reasonable step to avoid harming the patient especially when it is foreseeable. Before referral, the psychologist has known that the patient was abusing Xanax, she had taken 17 mg in the 30 hours when she should have only taken 2.5 mg, her behavior is very unreliable and she was not overtly suicidal or homicidal but the tendancies were there. Practicing within the boundaries of competent (Standard 2.01), the psychologist was knowledgeable enough to know that the client was in danger of harming herself or others. The psychologist took the necessary precautions to avoid harm by referring her to an inpatient facility. The psychologist cooperated with another professional (Standard 3.09) when it was needed which was in the best interest of the client. The psychologist should be aware of HIPPA rules when cooperating with the other professional. The patients written authorization on release of PHI should be communicated to the other professional. This brings us to the pressing issue for the psychologist right now; the psychologist wants to check on the status of the client, but the facility will neither confirm nor deny her stay there. The psychologist can fax the release form but, with the condition that it should be communicated to the inpatient clinic as confidential on the fax cover. The mistake the psychologist made was not getting a full release from the client, this should have been discussed during informed consent (Standard 3.10). This should also have been done as early as feasible before services and the psychologist had ample time since the client has been coming for several weeks. Even though this patient might be in a heightened emotional state due to her unreliable state before
He had his normal antipsychotic as regular medicine but soon he started hallucinating and his agitation increased. I then reported to my buddy RN and after looking at medication chart for patient, we discovered that doctor had written another PRN medication for the control of agitation which was a schedule 8 drug. These drugs are always locked and checked by two RN’s or one RN and an EN. Two enrolled nurses are not allowed to check alone. My preceptor asked me to check this PRN medication with her but I told her that I could not administer and check locked schedule 4 and 8 drugs as it is out of my scope of practice. I showed her ECU document that was signed by me before going to any placement which clearly indicated the prescribed medicine out of my scope of practice and guidelines stated that as a student I could not be a second
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
When the practices in the healthcare delivery system or organization threaten the welfare of the patient, nurses should express their concern to the responsible manager or administrator, or if indicated, to an appropriate higher authority within the institution or agency or to an appropriate external authority” (3.5 protection of patient health and safety by acting on questionable practice, ANA, 2015). The example of the practice is a patient discharge from the rehab facility to the Personal care unit with pending PT/INR results, which turned out to be critical. The admitting nurse demonstrated moral courage by questioning physician who wrote discharge orders and the nurse who completed discharge. Rehab physician refused to address lab results and referred the patient to the PCP. Admitting nurse raised a concern to administration to review discharge protocol and deviation from safe practice. Nurse acted on behalf of the patient and requested readmission to rehab based on patient’s unstable medical
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
B.V. is a 42 year old male patient admitted for severe angina chest pain. He previously had coronary artery bypass surgery a month ago. His incision site from the surgery was dry, intact with no inflammation present. He currently was not on any pain medications upon admission. He tested positive for hepatitis C and was homeless. He had a history of drug and alcohol abuse and left hip replacement. He is currently taking medications for hypertension and diabetes through Medicare. When getting report on the patient, the nurse stated that the patient kept asking for pain medications every hour but didn’t look like he was in pain. He was in a comfortable position in bed while laughing and watching television. The previous nurse thought the patient just wanted pain medication since he is previous drug addict. This situation reminded me of what I learned in Medsurge about trusting your patient if they
At my internship site, Harbor Oaks Hospital has its own Suicidal Ideation Treatment Center (“Suicidal Ideation Treatment Center in New Baltimore, MI,” n.d) that offers a number of services that would benefit those who are having thoughts of ending their life. During intake, a doctor or a psychiatrist would assess them before the nurse would examine the individuals’ symptoms. If they are at a high-risk of killing themselves and/or being hostile, then they would be placed into precaution (C. Ritchey, personal communication, May 24, 2018). For treatment interventions, the selections include art therapy, motivational interviewing, individual, group, or family therapy, didactic behavioral therapy, and pharmaceutical methods. There is also an incorporation
He reports a desire to donate his organs in an effort to “make up for the lives” he took the night of the accident. Tim reports self blame for the accident, as he was texting and veered into oncoming traffic. Tim reports having dreams about the accident and that he sees his wife lying on the pavement. Tim reports difficulty staying asleep and waking up with a feeling of “panic” several times a night. When asked if he feels present in traumatic event during the day, Tim reported “no.” However he reports an effort to not think of the accident. He reports that it is “frustrating” when memories of the accident “pop” into his head during the day. He reports getting “angry” when he thinks of the accident. Additionally, Tim has limited social supports, isolates himself, and is facing financial hardship due to unemployment.
Shawn presents with the symptoms of an alcohol addiction as evidenced by three DUI arrest as well as four emergency visits. He as suffers form depression. I noticed that Shawn was talking at a fast paste. He may be suicidal but it isn’t indicated and will be assessed.
Gender. One of the most consistent findings with regards to the epidemiology of suicidal behavior is its gender distribution. Since the 1990s, the examination of suicide data in the United States has consistently shown the ratio of male to female completed suicides is approximately three to one (Rogers, 1990). Recent data revealed that the ratio of male to female suicide is four to one (AFSP, 2014). In general, males are more likely to commit suicide than females (CDC, 2015), even though females are more likely to experience many risk factors that increase suicide risk, for instance, females are more likely as males to suffer from depressive.
D-This writer met with the patient as she was placed on HOLD. The patient apologized for meeting with this writer late due to a bit of a traffic. The patient began to get emotional during the session while discussing her commitment to her recovery process and how much of a change of not using has impacted her life. The patient says, " Charlene, girl,....When I stopped using, It had open my eyes. My children are doing great and my husband are getting along great. My husband is so proud of me, Charlene. I did a lot of fucked up shit in my relationship and this man, stood by my side through it all. I am so grateful. I always love coming here, especially talking you, girlfriend." There was joy and laughter during the counseling session. This writer provided support and motivation to the patient recovery process. Furthermore, the patient stated that she hasn't been using since last UDS result and ensure that her next UDS result for the month of May would be negative. The patient is also aware during the discussion of the risk of not producing a negative and being consistent with it. This writer discussed about treatment violation Step 1 next month, not to deter the patient, but more so of a wake up call if a negative is not produced. This writer also discussed options about seeking higher level of care such as an IOP, at which the patient decline the suggestion because she prefer attending group's at this
Suicide, it's not pretty. For those of you who don't know what it is, it's the
Suicidal tendencies in adolescents begin around the ages of 10 through 19, with warning signs, prevention, treatment, and the causes and effects it has on the human psyche. Suicide is when someone decides to take his or her own life because and are suffering from a painful mental treatable illness and have lost hope in who they are. Because when hope is lost, some feel like suicide is the only solution to truly make the adolescents pain go away permanently. Scientific evidence that shows the people who have committed suicide had a diagnosable treatable mental disorder or substance abuse disorder (The National Institute of Mental Health, 2010). Those people might have been suffering from illness such as depression, mood disorders, personality disorders and or suffering from bullying. Being a victim of bullying can be linked to suicidal thoughts as well as behavior in adolescents. Other causes might also include having family problems at home, problems at work, school and or with school peers. Suicide is a serious problem though it not only affects the victim, but it also affects family members, loved ones, along with friends.