Week 6 addiction case study 2
CASE STUDY 2
HISTORY OF PRESENT ILLNESS:
A 38-year-old male presents to the psychiatric emergency department for
psychiatric evaluation. The client was sent directly from his internist’s
office. That morning, the client and his wife presented to the internist’s
office without an appointment, with a chief complaint of “being
overwhelmingly depressed.” The client had developed a plan to commit
suicide, which included taking a bottle of Tylenol and drinking “as much
vodka as it takes.” The internist performed a thorough evaluation, drew labs,
and called 911 to have the client brought to the Emergency Department.
When the PMHNP encounters the client, he is visibly upset and clinging to
his wife. The couple explains that they separated a month ago because the
client “just couldn’t be a husband anymore.” Over the past 6 weeks, he has
become isolated, and has complained of decreased energy, concentration,
appetite, and sleep. He lost his job as a house painter 6 months earlier. The
client no longer enjoys taking care of the couple’s 2 children, ages 4 and 6---
a drastic change from the role he has previously enjoyed as a father.
The PMHNP asks the client when he first began feeling down. He states
clearly, “When my mother died, one and a half years ago.” He says that he
has been feeling guilty over the circumstances of her death and wishing he
had been closer to her in the years preceding her death. The wife notes with
concern: “That was just about the time you started drinking so heavily, as
well.” As you question further, you determine that the client has been
drinking daily since his mother’s death. He estimates that he drinks 6 beers a
day. He admits that drinking is a problem, and he tried to stop drinking two
weeks before this visit. The client says: “My wife kicked me out of the
house, I missed my kids, I didn’t have a job…I knew something was
wrong.” He notes that in the days after he stopped drinking, he experienced
some shakiness and felt “like there were bugs under my skin.” He added
that having a beer made these symptoms subside. Last night he became very
upset after calling his wife to check on the children and finding they were
not at home. He sat in his hotel room and thought, “I can’t go on living like
this.” He called his wife at 6 a.m. the next day and said he thought he might
kill himself. She immediately brought him to the internist’s office.
PAST PSYCHIATRIC HISTORY:
This study source was downloaded by 100000884024057 from CourseHero.com on 11-30-2024 02:33:12 GMT -06:00
https://www.coursehero.com/file/163294278/NR546-wk-7-case-study-July-22docx/
CASE STUDY 2
HISTORY OF PRESENT ILLNESS:
A 38-year-old male presents to the psychiatric emergency department for
psychiatric evaluation. The client was sent directly from his internist’s
office. That morning, the client and his wife presented to the internist’s
office without an appointment, with a chief complaint of “being
overwhelmingly depressed.” The client had developed a plan to commit
suicide, which included taking a bottle of Tylenol and drinking “as much
vodka as it takes.” The internist performed a thorough evaluation, drew labs,
and called 911 to have the client brought to the Emergency Department.
When the PMHNP encounters the client, he is visibly upset and clinging to
his wife. The couple explains that they separated a month ago because the
client “just couldn’t be a husband anymore.” Over the past 6 weeks, he has
become isolated, and has complained of decreased energy, concentration,
appetite, and sleep. He lost his job as a house painter 6 months earlier. The
client no longer enjoys taking care of the couple’s 2 children, ages 4 and 6---
a drastic change from the role he has previously enjoyed as a father.
The PMHNP asks the client when he first began feeling down. He states
clearly, “When my mother died, one and a half years ago.” He says that he
has been feeling guilty over the circumstances of her death and wishing he
had been closer to her in the years preceding her death. The wife notes with
concern: “That was just about the time you started drinking so heavily, as
well.” As you question further, you determine that the client has been
drinking daily since his mother’s death. He estimates that he drinks 6 beers a
day. He admits that drinking is a problem, and he tried to stop drinking two
weeks before this visit. The client says: “My wife kicked me out of the
house, I missed my kids, I didn’t have a job…I knew something was
wrong.” He notes that in the days after he stopped drinking, he experienced
some shakiness and felt “like there were bugs under my skin.” He added
that having a beer made these symptoms subside. Last night he became very
upset after calling his wife to check on the children and finding they were
not at home. He sat in his hotel room and thought, “I can’t go on living like
this.” He called his wife at 6 a.m. the next day and said he thought he might
kill himself. She immediately brought him to the internist’s office.
PAST PSYCHIATRIC HISTORY:
This study source was downloaded by 100000884024057 from CourseHero.com on 11-30-2024 02:33:12 GMT -06:00
https://www.coursehero.com/file/163294278/NR546-wk-7-case-study-July-22docx/
