Reference no: EM133746877
Essentials of Mental Health Nursing
Assessment - Case Study
James Carpenter is a 40-year-old Caucasian single father residing in a suburban area. He works as a graphic designer and is the primary caregiver for his 8-year-old daughter, Emily, following his divorce two years ago. James was diagnosed with Bipolar Affective Disorder (Bipolar I Disorder) at the age of 25, characterised by episodes of manic highs and depressive lows. His mental health journey has been marked by periods of stability with the support of mood-stabilising medication and therapy.
Recently, James was also diagnosed with Type 2 Diabetes Mellitus, a condition he manages through diet, exercise, and medication. Juggling his mental health and diabetes care alongside his responsibilities as a single parent presents ongoing challenges. James is known in his community for his creative talents and involvement in local art projects, which serve as a therapeutic outlet for him.
Upon interview
James reports to the nurse,
That he has not been sleeping because he is working on this design which he intends to sell to a large company in Sydney. He tells you that he has already started applying for a patent for this design. Upon questioning he tells you that he is a genius.
He denies hearing voices but says that sometimes he has ‘powers' to interpret people's thoughts.
He is yet to pay a fine for doing burnouts on the road and driving at excessive speed because he thinks that if he crushes, he will not die and that he is a very good driver.
He speaks rapidly and excessively, jumping from one topic to another without letting others speak.
However, James feels overwhelmingly sad, hopeless, or empty, which persists for most of the day.
He loses interest in activities he used to enjoy, such as painting or spending time with his daughter, Emily.
James has a medical history of Type 2 Diabetes Mellitus. There is a family history of Hypertension and Type 2 Diabetes Mellitus.
His medications include:
For Bipolar Affective Disorder:
Lithium Carbonate 900 mg daily (Mood stabiliser)
Quetiapine 200 mg nightly (Atypical antipsychotic)
For Diabetes:
Metformin 1000 mg twice daily (Oral hypoglycaemic agent)
Insulin glargine 20 units at bedtime (Long-acting insulin)
You are the registered nurse responsible for James Carpenter during an afternoon shift in an acute mental health ward. Your initial task for the shift is to admit a new patient to the unit. James Carpenter is a new admission to the ward, arriving via the emergency department (ED).
As you prepare to admit James to the unit, you review his recent vital signs recorded in the ED:
Temperature: 38.2°C
Heart Rate: 110 bpm
Respiratory Rate: 16 breaths per minute
Blood Pressure: 130/80 mmHg
Oxygen Saturation (SpO2): 98% on Room Air
Blood Glucose Level (BGL): 17.5 mmol/L
James appears cooperative but slightly anxious about the admission process, expressing concerns about maintaining stability in his health conditions while being away from his daughter, Emily. Ensuring a supportive and therapeutic environment for James will be crucial during his stay in the mental health ward.
Your task is to:
Therapeutically engage with James and develop a plan of care using the template provided.