James Mason Ihuman Case Exam with Solutions 2024

JAMES MASON IHUMAN CASE EXAM WITH SOLUTIONS 2024

• What complications can you anticipate with this kind of patient? (At least 3) Confusion Talks to self Aggression towards others • What are the top three priorities for this type of patient? Assess mental health Assess danger to self and danger to others Assess substance use and medication use • How does this patient usually present? Irritable Confused Mumbles to self and easily distracted Unable to focus • What do you know about the pathophysiology of this disease? Dopaminergic, glutamatergic and GABAergic neurotransmitter systems are affected in schizophrenia and interactions between these receptors contribute to the pathophysiology of the disease • What medications are usually prescribed for this condition? Anti-psychotics to tame psychosis Risperidone Aripiprazole Olanzapine Clozapine s Date of Care: 11/14/20 PT: J.M.. (initials) Age: 21 Sex: M Admit Date: 11/14/2020 Diagnosis: Schizophrenia Surgery: N/A Anesthesia Type: i N/A t u a t i o n Allergies: NKDA Height/Wt.: (Latestsinceadmit) 147.0 Code Status: full Advance Directive: none Psychosocial: Paranoid behavior, over hallucinations, question of pharmacological adherence, recent psychosocial stress. Medically stable and appropriate for treatment Consulted by Dr. Hunt, psychiatry. Attending Physician: (initials)K.A Consulting Physicians: (specialties) N/A Shift Goals: Assess mental status. Provide medication treatment and education on medications. Refer to occupational health, assess harm to self and others. Medical History: Schizophrenia a c k g r o Surgical History: u none n d MRSA Screen Complete: Y N NA Isolation: no Vaccinations: (Vaccine hx and admins) n/a Core Measures: none Risk/ Safety: Risk for Manic episodes Activity: moderate Neurological function: A&O X 4 s s e s s m e n t Pain: (include detailed pain assessment) 0 out of 10 Ordered med: Lorazepam 1mg Aripiprazole mg Non opioid analgesic for headache B A Cardiac Function: T: 98.6, HR: 68, BP: 122/70, o2: 98% Vital Signs: VTE Prophylaxis: n/a (ST, OT, PT, EEG, EKG, Echo, MRI, CT) Laboratory/ Radiology/ Respiratory Therapy Orders: Bloodwork and urine results Diagnostic Test results (during hospitalization) n/a Select Orders: (Include response to meds after administration) Responds well to medications Positive for Canabis PRN Med. Use: (Current shift) Glucose accucheck order: 91 none I nsulin coverage order: none Blood Glucose: (Latest 4) n/a Labs results (Last 24 hours) Include normal range and identify if low or high Wbc:9478 RBC:4.9 HGB:14 HCT:42 NA:142 K:3.9 GLU:89 BUN:18 CR:0.8 CA:9.1 Thyroid: normal Lab work is within normal limits Re c o m m e n d a t i o n Restraints: (Type, ordered / renewed) none Order: n/a Elimination GU: Patient can eliminate I ntake and Output: normal Skin: turgor skin is warm and dry, intact, non-tinting. Diet: regular Supplements: none Gl Prophylaxis: n/a Elimination Gl: normal Respiratory Function: unlabored Vent/Sat/O2: 98% room air Antibiotics: none IV Access/ IV Solution: none Clinical Reasoning Questions to Promote Nurse Thinking (Formulate and reflect before and after report, but BEFORE seeing patient the first time) Please see other forms per. professor Caring and the “Art” of Nursing • What is the patient likely experiencing/feeling right now in this situation? He is most likely feeling frustrated with having to be at the mental hospital again. He may be irritable and annoyed with staff or others. Probably wants to smoke weed and is upset about being in a controlled environment. Seems to be confused with some questions and may wonder why he needs treatment. What can I do to engage myself with this patient’s experience, and show that he/she matters to me as a person? I can introduce myself and let him know I am there to support him. Allow the patient a safe place to talk about his emotions and reasons why he feels anxious. I can help direct his thoughts to positive self-love. Do a therapeutic exercise or spend some time with him. Help him to find things he likes and enjoys about himself. Give him compliments and ideas on how to apply treatments towards his condition