Reference no: EM133844598

Question

Develop three nursing diagnoses and 3 nursing interventions

Bipolar, SUD

YR is a 40 year old gay male immigrant from Bosnia who is chronically homeless. He was seen in medical clinic and referred to you for an evaluation. He has been diagnosed with HIV, Hep C, type 2 diabetes and HTN. His BMI is 30, he is currently taking HCTZ 25 mg qd, Combivir 150/300 1 tab a day and Epivir 150 mg bid and his viral load currently is zero. His last HgbA1C is 9. His BP is 120/80, pulse 70, temp 98. CBC shows elevated MCH and MCV, Hct 25, Hgb 10. Comp panel reveals 3 times normal LFT's, other levels WNL and Thyroid profile WNL. He is depressed, drinking at least a quart of vodka a day, with his longest sobriety 1 year about 6 years ago. He has been in detox once but no seizures in his past. During that sobriety time, he noted that he had periods of up to 4 days with little sleep, irritability and expansiveness and racing thoughts. When he is drinking he doesn't have these symptoms. He also tells you that he has problems with initial and middle insomnia, getting about 4-5 hours of sleep a night. He has had chronic back pain and drinks to help his pain. He denies trauma hx and anxiety symptoms. He has made 3 suicide attempts in the past, hanging himself twice and trying to OD once on alcohol and Tylenol. He has never had a psychiatric hospitalization or treatment. Today, he is depressed, 3/10 (10 best), with wishing he was dead. He has no AV hallucinations/delusions now or history of this. His last drink was this morning, he does not smell of alcohol currently.