mental health power point project

Kristie Cavitt-Morris

My patient is a 50 year old female; she has a history of bipolar with paranoia and suicidal ideation. Past medical history was not obtainable; this was her first admission at this facility. The physicians have requested her medical records from her previous admissions.

Patient was admitted by emergency detention order. She was banging on the front door of her Daughter’s house screaming “Don’t kill me” and “Don’t burn me.” Patient was admitted though the emergency room on 6/8/2011.

The physician has ordered her to take:

Depakote 1500mg PO daily

Nicoderm patch 14mg daily

Risperdal 2mg BID Ambien 10mg Q HS The patient has refused

to take any medications since being admitted to the facility.

Mental Status: alert and orientated x 2

Marital Status: divorced

Family Support: Boyfriend comes for daily visits, she also has other family members that visit her.

Socioeconomic Data: on Medicaid support, low income

Pt gets up in the morning and dresses herself. Her clothing is appropriate. The pt will not eat her food until it is tasted by another pt to make sure it is not poisoned. Pt will participate in group activates. She is corporative with staff most of the time.

Pt is only engaged in group activity for 5-6 min, before loosing interest. She talks on the phone and her conversations are realistic. Pt is easily agitated and does not like to be touched she feels threatened when she is touched expect by her boyfriend. She is mostly concerned that she has been left by her daughter and is upset she will not come to visit her.

Bipolar I Paranoia Suicidal ideation

Risk for self and other –directed violence related to faulty judgment, as evidence by loud profane, hostile, combative, aggressive, demanding behaviors.

Reference : Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 289). St. Louis, Missouri:Saunders Elsevier.

Patient will not have to be sedated due to aggressive behaviors during my shift.

Reference: Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 301). St. Louis, Missouri:Saunders Elsevier.

1. Encourage pt to take medications as ordered

Medications will reduce anxiety and aggressive behavior

Reference: Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 301). St. Louis, Missouri:Saunders Elsevier

2. Place pt is quiet room when signs of agitation start to show.

Environmental stimuli are reduced.

Reference: Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 301). St. Louis, Missouri:Saunders Elsevier.

3. Encourage short rest periods throughout the day.

Patient might be unaware of feelings of fatigue and over stimulation.

Reference: Reference: Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 302). St. Louis, Missouri:Saunders Elsevier

Goal met, patient was not sedated do to aggressive behavior during my shift.

Risk for suicide related to feeling, overwhelmed and depressed secondary to recent lack of social support, as evidenced by suicide attempt.


Patient will immediately seek help when feeling self-destructive during the next 48 hours.


1. Assess suicide status

Ongoing periodic check of suicidal status. Higher rate of suicide for those who have attempted suicide.


2. Give frequent opportunities for discussion of feelings through verbal invitation and stated concern

Aggressive , hostile communications are cover for painful feelings. When a pt can express them in words, there is less need to act on them out.


3. Remain neutral in face of anger.

Diminishes power struggles and discourages continuing acting-out behaviors.


Goal met, pt talked to nurse about suicidal feelings when she became anger and felt self-destructive within the first 48 hours.

Patient will starting her medications as ordered within 48 hours. (06/08/2011).


1. Educate the patient on the importance of bipolar medications.

Will prevent paranoia and anxiety.


2. Provide resources for medication assistance programs.

Patient is considered low income, she is on disability .


3.. Educate the family on bipolar disorder

Knowing about bipolar disease can reduce fear and anxiety in the family. Support groups are recommended for good coping measures and continuing education.


Not implemented for long term goal.

Reference: Varcarolis, E. & Halter, M. (2010), Mental Health and Mental Illness. Foundations of Psychiatric Mental Health Nursing, A Clinical Approach 6th Edition (pp. 300,301,302,560,561, 562). St. Louis, Missouri:Saunders Elsevier

mental health power point project

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