Reference no: EM133241589
Mohamed, 43 years old, brings himself to your community mental health center for the first time. He says he "feels like killing himself" and recently bought a gun. He states, "My mother talked me into coming here." Mohamed's wife recently left him, taking their two children with her. Since then, he has been depressed and has been using drugs. He says he also "used a little khat (which is similar to amphetamines) yesterday." He denies long-term substance abuse. He says, "I don't know what to do. I feel hopeless. I can't even work. I'm afraid my boss is going to fire me. Nothing like this has ever happened to me before."
Describe your initial nursing actions on meeting Mohamed. Make a list of pertinent factors to consider when his nursing care plan is developed.
How does Mohamed's case differ from a case of chronic, severe depression, lasting about 10 years or more?
How would you rate the severity and lethality of his suicidal ideation? What precautions are likely for him in the mental health unit?
The police bring an unidentified older woman into the crisis center. She is wearing handcuffs and leg shackles. She has reportedly lived in the city park for several years. She has two shopping bags of dirty clothes and other belongings, including cash. Reportedly, she has been extremely agitated, talking to herself and threatening passersby. Today, she entered a church and threw several statues. "Jane Doe" is wearing two dirty dresses, a sweater, jacket, knitted cap, unmatched socks, and dirty tennis shoes. (The temperature today is 92 °F.) Her gray hair is snarled, and she scratches her head often. She is malodorous; her breath is stale. She is thin and missing her front teeth. She appears to have a partially healed wound on her left lower leg. When asked her name, she replies, "God." She is uncommunicative, except to demand cigarettes. When placed in a holding room, she seems fearful and moves into a far corner, striking out when anyone approaches. She refuses to sit on the bed. Ms. Doe refused most of her vital signs, but her weight is 97 lb, her pulse is 120 beats per minute, and respiration rate is 22 breaths per minute. She has a productive cough.
Describe ways to approach Ms. Doe. What immediate nursing actions are likely? List important factors to consider when her nursing care plan is developed. (Consider short- and long-term goals.) What medical and psychiatric diagnoses are likely?
Describe safety measures that might be used in this client's care.
What medications might be prescribed to control the client's behavior and help make her more comfortable?
Identify possible community resources for Ms. Doe on discharge.
Identify physical disorders that must be evaluated and/or ruled out in planning her care.