Solution
Anju Lata answered on
May 25 2021
Running Head: Complex Nursing Practice 1
Complex Nursing Practice 1 3
CRIT3000: Complex Nursing Practice 1
Skills Assessment
Student Name:
Curtin University
Table of content
Introduction.....................................................3
Part 1................................................................3
Part 2................................................................9
Summary and Conclusion................................11
References.......................................................12
Introduction
Bernadette, a 50 year old woman is a patient of Bipolar Affective Disorder. She is
ought to the hospital by her husband, who is quite supportive. His husband thinks that due to Bernadette’s altered behaviour, she is not safe at home. She had stopped taking her BPAD medications as she was angry with her psychiatrist for he did not tell her about the risk of BPAD. He was encouraging her constantly to take those medications for 30 years. She is thinking that the psychiatrist has been poisoning her
eakfast, by mixing Lithium Ca
onate into it. As per Bernadette’s perception, she is experiencing the metabolic syndrome as a result of taking medications prescribed by her Psychiatrist. She also thinks that the same medications cause chest pain, high BP and fat growing inside her. She does not trust over anybody except her husband. Considering Bernadette’s case study, we will conduct he Mental State Examination (MSE) which will help us identify the detailed information about her appearance, mood, thoughts, cognition and insight.
PART 1
(a). Appearance
In appearance, Bernadette is 50 year old Caucasian lady wearing formal outfit. She has a medium height, with a fairly big body size. She is normal in her looks, having well groomed short blond hair with eye glasses. She has no physical disability. She maintains an eye contact with the nurse during her interview responses. During the interview, she seems agitated, stressed and angry. Recu
ently she raised her voice while talking to nurse and became aggressive. She exhibited the sign of disoriented thoughts; self discovered false perception of medications she has been taking since 30 years. She seemed extremely wo
ied in attitude, not believing on anyone as evidenced by her repeating the same answers again and again.
(b). Mood and effect
Bernadette was feeling emotional about her health. She said “My life is over really” when she was asked about how was she feeling. She seemed i
itating as evidenced by her aggressive tone of voice. She appeared to be anxious as evidenced by her perception of ‘experiencing metabolic syndrome’. She appeared depressed and euthymic, as evidenced by her statement- “Medications have completely ruined my life”. During the interview she seemed agitated, depressed and angry with the psychiatrist whom she trusted for 25 years. And she believes that the Psychiatrist was adding lithium ca
onate into her
eakfast. That’s why she has stopped taking medications. Now according to her own perception and knowledge gained through internet, she affirms that she does not want to take any medications. She raised her voice tone repetitively while answering the questions. She seemed to have pressured speech, distu
ed and disoriented thoughts as evidenced by her not believing on anybody, not eating drinking anything until her husband comes.
(c).Thought content
Her thought process was pressured and disoriented as she was repeating same sentences during the whole conversation. Many times, she became loud in her tone. She seemed confident in her false beliefs and assumptions that she developed while reading the internet as evidenced by her statement- “Lithium Ca
onate that she is consuming is making her fat, increasing her Blood Pressure and has caused metabolic syndrome to her.” Her speech is tangential and loose in association as she is shifting her topic from one topic to another, during the conversation. She showed the symptoms of delusion and paranoia, as evidenced by her statement- “Everyone is trying to poison me”. She demonstrates manic episodes through consistently changing mood from loud and aggressive tone and speech. She is fearful and wo
ied.
(d).Cognition
Bernadette is very well oriented to person, place and time. However, she showed poor concentration and attention as evidenced by her aggression, anxiety, instability of thoughts, wo
y and tendency of switching over from one topic to another during the conversation.
(e).Insight and judgement
Bernadette demonstrated lack of insight and decision making. She believed that the medications prescribed to her have caused metabolic syndrome to her. She has a delusion as evidenced by saying that the psychiatrist is trying to kill her. She trusted nobody except her husband. Bernadette is not ready to accept that the withdrawal from medications might have caused mood change and thought distu
ance. She expressed poor knowledge about the medications she is taking for her health condition. During the interview when she was asked about the medications she is taking, she could not tell much about them. Bernadette mentioned that she is having a chest pain, which she thinks has occu
ed due to medications prescribed to her by the psychiatrist. Bernadette showed poor ability to understand the cause of her illness. She is not ready to listen anyone but only asserts her own incomplete knowledge attained over the internet. She showed delusion which might cause poor health outcomes and may expose her to a serious health risk.
1b) Defining Bipolar Affective Disorders and three symptoms displayed by Bernadette.
Bipolar Affective Disorder refers to a mental illness that causes extreme cyclic alterations in mood characterized by episodes of manic highs and depressive lows (National Institute of Mental Health, 2020). During the manic episodes the person experiences excited and high mood behaviours which encourage him to involve in risk taking. The patients may experience problems in focusing over any task, may feel frustrated, i
itated, racing thoughts and speed in speech. During the depressed or low phase, the patient often feels sad, guilty, self neglecting, and self harming. More than 2% of the population is affected by Bipolar Disorder in the world. It is potentially life long, episodic and disabling disorder that is difficult to diagnose.
The three symptoms displayed by Bernadette are as follows:
I
itability: During the conversation Bernadette seemed to be in manic state, showing the symptoms of i
itability. Her speech was loud, forceful. She was using loud and dominating tone, language and voice.
Rationale: Anger is not a symptom of Bipolar disorder but the patients may gets angry due to shifts in mood they...