Mental Health Case Studies With Complete
Solutions Latest Update 2024
A 22-year-old patient presents to the emergency room after a motor vehicle
accident. The patient had airbag deployment and was wearing his seatbelt. The
patient was hit on the passenger side by a vehicle going about 40 miles per hour.
Extraction time was 5 minutes and the patient was ambulatory on the scene. No
loss of consciousness was reported and the patient denies hitting their head. The
patient is complaining of chest pain.
Question: Which tests should be checked on this patient?
An EKG shows sinus tachycardia and the patients cardiac markers come back
negative. The patient states, "I know what is happening to my body and I am
having a heart attack! They hit me so hard that my heart stopped working! That is
the only explanation for this pain in my chest! My grandfather died of a heart
attack, so check again. Isn't there another test we can do to make sure?" Despite
reasoning with the patient and informing him - correct answers Question: Which
tests should be checked on this patient?
Answer: EKG and cardiac markers such as troponins.
Question: What is the best approach for this patient?
Answer: This patient will not listen to science per-se so building a trusting
relationship is key to help this patient listen to you. VALIDATE their concerns and
, feelings!!!! For example, "Being hit by another car is very jarring to the body, I
have you on the cardiac monitor, so if anything shows up we will be able to
intervene. Your heart is pumping at a fast rate so we will keep monitoring you."
Never tell the patient that they are being ridiculous/overly worrisome or that they
are making it up. Comfort them by letting them know you are concerned and will
be monitoring them.
Question: What medication could help this patient calm down?
Answer: Potentially a benzodiazepine such as Ativan or Xanax. This patient likely
has a lot of adrenaline on board due to the intensity of being hit by another car,
making their heart rate high. (Don't forget to always have the antidote for benzo's
on hand just in case: Romazicon!)
Question: What is this patient likely suffering from?
Answer: Somatoform disorder
The patient is a 45-year-old male who is a frequent flyer in the emergency room
for abdominal pain. The patient always has a high ETOH level and demands to be
given 3 macaroni and cheese dishes, 2 chicken sandwiches and 2 whole milk
cartons. The patient reports he drank 2 pints of liquor and a 6-pack of beer.
Vital signs are as follows:
Heart rate: 103
Respirations: 20
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