SOLVED235

A 29-year-old patient with PMH of schizoaffective disorder, bipolar type, and polysubstance abuse presented to the emergency department with suicidal and homicidal ideations with plans and intent. The patient was often evasive when speaking about plans surrounding suicide; however, he could verbalize some of the concerns surrounding homicidal ideation toward his father and Landmark staff. The patient has had no sleep in over 2 days and disclosed developing command auditory hallucinations. The patient has not been compliant with medication historically and reports that he does not feel well on them. The patient does exhibit high-risk factors with prominent mental health and substance abuse history with noncompliance with medications. The patient was irritable, demanding, and impatient, asking staff to change TV channels several times at the beginning of the shift. He refused scheduled medications and stated that he was there because he was sleepwalking, stating he was hearing voices. He stated that he does not want to go back to Landmark and will kill someone there if he does. He denies an acute somatic complaint and states that he has not been taking any psychiatric medication. He stated that he was at Landmark for alcohol. Analyze thee mental Status Exam: Affect, Thought Process, Thought Content, Orientation, Memory (immediate recall, short-term, long-term), Intellectual Functioning, Judgment, Sensorium/Cognition, Insight, Impulse Control, Motivation for Treatment
SCIENCE
HEALTH SCIENCE
NURSING

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