Encourage a consumer to discuss about the voices that she has heard and her general health concerns.
Encourage a consumer to discuss about the voices that she has heard and her general health concerns
Intergrated Nursing Concept ASSESSMENT 1 conclusionMental Health PresentationCase study of Mrs S 47 years oldMrs S is suffering with auditory hallucination; she hears her mothers voice and other voices to harm herself. The consumer is non-compliant with her medication because the voices tell her not to take the medication. Due to this she was admitted several times to Hornsby Acute Mental Health Unit. Mrs S had a referral to Assertive Outreach Residential Support (AORS) for follow up regarding her recovery since 2009. Mrs S is unemployed; she is on a disability pension. She lives with her partner who has dialysis 3 times a week. However he is independent with daily activities. Mrs S has a daughter who also suffers from auditory hallucination her daughter is currently studying.Medical HistorySchizophrenia with negative symptom such as depressive mood auditory hallucination since 1989Type 2 DiabetesObesityHypercholesterolaemiaHypertensionHigh risk of falls- last admission from mechanical fall in 21/4/2015Diagnostic testBlood test every fortnight for monitoring WCC due to clozapine prescription. Her recent blood test is on 26/5/2015. It shows that her WCC count is elevated and Neutrophils is also out of normal range.Currently once every fortnightly Electroconvulsive Therapy (ECT).Mrs S stated that it relieves her psychotic symptom. This type of therapy is a form of medical treatment for schizophrenia severe depression bipolar disorder and other psychotic illnesses. Clinical evidence showed that ECT is effective in relieving depressive and psychotic symptoms. The common side effect is memory impairment. This procedure needs to have consent and it has to be under supervision of a psychiatrist an anaesthetist (Sane Australia 2014).Mental Health AssessmentAppearance lack of personal hygiene messy hair and strong odour from the cloth.Behaviour- pleasant maintain eye contact during conversation.Orientation- alert and oriented to place and time.Moods withdrawal lack of motivation.Affect Flatten affect dull tone of voice.Speech normal speech.Perception appropriate emotional response continuing of auditory hallucination.Risk assessmentMrs S is rated as a high risk due to periodic thought of suicide. Also depressive symptom appears to be increasing because she neglects her personal hygiene and her physical illness. For example her blood sugar level monitoring and healthy eating. The consumer has social vulnerabilities relating to financial difficulty and recently finding a new rental property. These issues potentially impact her mental illness symptom.Nursing InterventionGoal: Improving the psychotic and depressive symptoms.StrategiesSupervise self administration of medication by visiting and telephoning a consumer.Ensure consumer follow up with GP and Psychiatrist appointments.Encourage a consumer to discuss about the voices that she has heard and her general health concerns.Promoting distraction technique to reduce the hearing voices symptom such as listening to the music going out with friend and family.Referral to Recovery Pathway Unit for assisting in moving to a new house.Goal: Reducing the risk of fall and improving mobility.StrategiesEducating of side effect of antipsychotic medication such as drowsiness and suitable time to take the medication.Monitoring any changes in mobility after anti psychotic dose adjustment.Referral to physiotherapy for mobility assessment and encourage a consumer to participate in fall prevention program.
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