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Bipolar
Depression/Man
ia
UNFOLDING
Reasoning
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Brenden
Manahan,
35 years
old
Primary Concept
Mood and Affect
Interrelated Concepts
(In order of
emphasis)
1. Psychosis
2. Clinical Judgment
3. Patient Education
4. Communication
History of Present Problem:
Bipolar Depression/Mania
Brenden Manahan is a 35-year-old male, who has been admitted to the crisis
intervention unit for exacerbation of his bipolar disorder. He was admitted on a
501 (involuntary inpatient admission, patient has been deemed either
dangerous to self or others) and brought to the hospital by police because his
mother feared for his safety. In the past few weeks he stopped taking his
medication because he feared that his mother was poisoning him.
Brenden has not slept in the past four days due to racing thoughts. He
believes that he is the head of the CIA and told his mother that he needed her
car to go to CIA headquarters
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in McLean, Virginia, and fire everyone. When the police arrived they noted
that Brenden was speaking at a very rapid rate and pace and was becoming
increasingly agitated. He began yelling that the police where there to poison
him and prevent him from returning to his job.
He has been admitted to the locked mental health unit for evaluation of
his mental capacity and stabilization. Brenden will participate in the
following education groups: medication education, and bipolar illness
education. The goal is to resume lithium carbonate and divalproex
sodium.
Personal/Social History:
Brenden was diagnosed at 19 with bipolar I, and subsequently has been
admitted six times due to non-adherence to the medication regimen. Brenden
is divorced and has a 3- year-old son who lives with his mother. He was
recently in court to have his visitations reduced to one supervised visit a
week. He lives with his mother, who is supportive.
What data from the histories is important and RELEVANT and has clinical
significance for the nurse?
RELEVANT Data from Clinical Significance:
Present Problem:
· Exacerbation of BD · Reason why patient is admitted
· Dangerous to · Clinical staff is aware and can
self and others protect themselves and the patient if
patient is dangerous
· Non-adherent to
med regimen · Evidence as to why the
patient is behaving the way they
· Sleep deprived are
· Agitated · Can administer medications
that can help the patient get some
rest
· Can administer medication
that can calm the patient down
RELEVANT Data from Clinical Significance:
Social History:
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