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Consuelo is a 30-year old married female born and raised in a small village in Venezuela.  Her parents are poor.  Her husband is a medical doctor providing medical care on a mission trip in her village.  She has been in the United States for 4 years and speaks a little English but needs Spanish for clear understanding.  They have a 2-year old son.  Consuelo has been diagnosed with Bipolar and takes lithium carbonate.  Recently she stopped taking her lithium and has been staying up all night and eating very little.  She is dressing and behaving in a sexually provocative manner and going on spending sprees buying things she does not need and cannot afford.  Her husband decides she is out of control and calls Consuelo’s psychiatrist who suggests admission to the psychiatric unit of the hospital. 

On Admission: 

The patient is dressed in a short and tight-fitting dress.  Her speech is clear but sprinkled with profanity as she moves rapidly from topic to topic.  At the nurses’ request, Consuelo sit’s down, then jumps up and moves about the room.
Consuelo’s husband says that Maria has stopped taking her lithium and has not been sleeping or eating enough.  He describes her extravagant purchases.  He states that she has put the family in serious debt and states she is unfit to care for their child.  With her husband translating for her, Consuelo objects to being admitted to the hospital but then agrees to admission.  Her husband expresses concern about her sexually provocative behavior and states he fears that she will get sexually involved with other clients.

As the day progresses

Her first meal, Consuelo is in the dining room with the other clients.  Instead of eating, Consuelo carries napkins to, and talks to, all the other clients and ignores the food.  Staff members have told Consuelo several times to sit down and eat, and she has not complied.  The nurse asks the dietitian to prepare a sandwich and a banana for Consuelo.  After the clients are finished with lunch, the nurse suggests Consuelo go to her room to wash her face and hands.
The psychiatrist ordered pregnancy tests comes back negative.  Psychotherapist ordered Lithium carbonate (Eskalith), olanzapine (Zyprexa), and birth control pills.  At medication time, the nurse gives Consuelo her medications and then examines Consuelo’s mouth.  The nurses do some teaching about the medication, who becomes upset when she learns she has prescribed birth control and says she will not take it as it is not allowed in her religion.
The nurse notices that Consuelo is irritable and verbally hostile at times as well as inappropriate during her first days on the unit. During one encounter with Consuelo, the nurse senses great hostile energy coming from Consuelo who says, “You think you are so smart! You don’t know nothing!”  Sometimes Consuelo is demanding or threatening.  She demands that the nurse send someone to the store to pick up items for her and takes her credit care to pay for them. She continues to dress and talk in a sexually provocative manner.  She has been intrusive with another client in the day room and the client is threatening to harm Consuelo.  The nurse observed that the clients are loud and their behavior is escalating
What criteria is used to diagnose Bipolar?
Which of Consuelo’s behaviors are consistent with a Manic Episode?

 

(2pts)

Question 1 – Consuelo is a 30-year old married female born and raised in a small village in Venezuela.  Her parents are poor.  Her husband is a medical doctor providing medical care on a mission trip in her village.  She has been in the United States for 4 years and speaks a little English but needs Spanish for clear understanding.  They have a 2-year old son.  Consuelo has been diagnosed with Bipolar and takes lithium carbonate.  Recently she stopped taking her lithium and has been staying up all night and eating very little.  She is dressing and behaving in a sexually provocative manner and going on spending sprees buying things she does not need and cannot afford.  Her husband decides she is out of control and calls Consuelo’s psychiatrist who suggests admission to the psychiatric unit of the hospital.  On Admission:  The patient is dressed in a short and tight-fitting dress.  Her speech is clear but sprinkled with profanity as she moves rapidly from topic to topic.  At the nurses’ request, Consuelo sit’s down, then jumps up and moves about the room. Consuelo’s husband says that Maria has stopped taking her lithium and has not been sleeping or eating enough.  He describes her extravagant purchases.  He states that she has put the family in serious debt and states she is unfit to care for their child.  With her husband translating for her, Consuelo objects to being admitted to the hospital but then agrees to admission.  Her husband expresses concern about her sexually provocative behavior and states he fears that she will get sexually involved with other clients.  As the day progresses Her first meal, Consuelo is in the dining room with the other clients.  Instead of eating, Consuelo carries napkins to, and talks to, all the other clients and ignores the food.  Staff members have told Consuelo several times to sit down and eat, and she has not complied.  The nurse asks the dietitian to prepare a sandwich and a banana for Consuelo.  After the clients are finished with lunch, the nurse suggests Consuelo go to her room to wash her face and hands.   The psychiatrist ordered pregnancy tests comes back negative.  Psychotherapist ordered Lithium carbonate (Eskalith), olanzapine (Zyprexa), and birth control pills.  At medication time, the nurse gives Consuelo her medications and then examines Consuelo’s mouth.  The nurses do some teaching about the medication, who becomes upset when she learns she has prescribed birth control and says she will not take it as it is not allowed in her religion. The nurse notices that Consuelo is irritable and verbally hostile at times as well as inappropriate during her first days on the unit. During one encounter with Consuelo, the nurse senses great hostile energy coming from Consuelo who says, “You think you are so smart! You don’t know nothing!”  Sometimes Consuelo is demanding or threatening.  She demands that the nurse send someone to the store to pick up items for her and takes her credit care to pay for them. She continues to dress and talk in a sexually provocative manner.  She has been intrusive with another client in the day room and the client is threatening to harm Consuelo.  The nurse observed that the clients are loud and their behavior is escalating What criteria is used to diagnose Bipolar? 

Which of Consuelo’s behaviors are consistent with a Manic Episode?  

Verdana

 

10pt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SCIENCE
HEALTH SCIENCE
NURSING

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