Case Study - Mental Health Facility

Reference no: EM132474703

Case Study Assignment -

Assessment Task - Read the case studies below, choose only one of the following case studies to discuss, and answer all 4 of the questions listed below. You do not need an introduction or conclusion and headings are advised. You must use academic writing and reference your work using APA referencing. Your ISBAR may be presented in table format. Please do not use bullet points, instead use well-structured paragraphs.

Case Study 1 - (Remote Clinic)

As the RN you arrive at the remote clinic at Wilcannia for your fortnightly visit, the population here is mainly Indigenous Australians and there is a high percentage of children in this community. It is normally quite a busy day.

The next patient you see is Ashanti, a 3-year-old indigenous girl. Ashanti presents in the arms of her Mother with her Grandmother present. When asked about Ashanti's chief complaint, her mother explains she has 'had the runs for a few days and whatever I give her just goes straight through'. Ashanti is lethargic and unable to walk. On examination you observe Ashanti to have cracked lips, a dry tongue, sunken eyes and looks very unwell. You ask when she last passed urine and you are told 'it has not been for a day or so'.

You take her observations and record the following

RR	SpO₂	BP	HR	AVPU	Temp	Pain	BGL
56	93%	68/32	182	V	37.5	3/10	3.1

Ashanti is fully immunised and has no medical history she weighs 13kg.

On further questioning Ashanti's Mother tells you she has had about 2 cups of juice today you work this out to equate to approximately 400mls. You also ask about her urine output, Ashanti Mother is unsure about this as she just states that it is just her bowels that are working, as far as she knows she has not passed urine.

Questions -

Q1. Discuss your assessments on this patient, identify signs of deterioration and clearly state if the patient requires a clinical review or rapid response as per Between the Flags (BTF). Justify your decision with data from the case and relevant support.

Q2. Document a succinct and accurate ISBAR handover in verbal script format (eg. Hello, my name is...)

Q3. Considering the assessment findings, prioritise and discuss the immediate nursing management of the patient

Q4. Succinctly discuss the ongoing management of this case and integrate the relevant members of the interdisciplinary team

Case Study 2 - (Mental health facility)

Alex is a 23 year who was admitted to the acute ward at the mental health facility, he has been admitted to the locked ward due to his acute psychosis. Alex was recently diagnosed with a drug induced schizophrenia caused by the use of marijuana. Alex has been in the ward for the past two weeks, over the past couple of days it has been discussed amongst staff the large amount of food and water Alex consumes (5 litres plus a day and extra meals), they have put this down to his psychosis.

The following day Alex's behaviour deteriorates, and he has become aggressive and unable to walk in a straight line, the staff are confused and wondering if one of his visitors has given him something. The staff take routine bloods and decide to do a drug screen as well. They have also noted the number of times a day he has been going to the toilet (this has been frequent at least hourly if not more regularly). They conduct a full set of vital observations and document the following;

RR	SpO₂	BP	HR	BGL	AVPU	Temp	Pain
31	96%	132/68	140	30.2mmol/L	A (However Alex is disorientated to time and place)	36.6	0/10

Questions -

Q2. Document a succinct and accurate ISBAR handover in verbal script format (e.g. Hello, my name is...).

Q3. Considering the assessment findings, prioritise and discuss the immediate nursing management of the patient.

Q4. Succinctly discuss the ongoing management of this case and integrate the relevant members of the interdisciplinary team.

Reference no: EM132474703

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