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CASE STUDY

BIPOLAR DEPRESSION/MANIA

 

Lucas Callahan is a 25-year-old Caucasian who was brought into the ED by the local police. The police report that they received a call from a local grocery store clerk informing them that Lucas was demonstrating erratic behavior which was witnessed by the police upon their arrival. They report that Lucas has been cooperative and non-violent.  

Lucas appears disheveled, unkept, and  ungroomed. He is wearing unlaundered shorts and a shirt even though it is a cool fall evening. When asked what brings him to the ED, he replies, “the crazy cops brought me. No one believes me that there are government agents chasing me because I was able to obtain all their secrets. I do not know why the cops would bring me here. I guess they are afraid of being chased too”. Lucas’s speech is rapid, but you are able to articulate everything he is saying. He is continuously swinging his legs and clapping his hands between comments. He maintains eye contact when he is speaking to you, however, seems distracted in between questions and comments, continuously looking around the room making it difficult for you to assess his concentration. He goes on to say that he is “mega great now” when asked about his mood. He denies experiencing any perceptual disturbances. He is able to tell you his name, the date, the time, and his current location. 

Lucas reports he is not taking any prescribed medication currently and informs you that he was prescribed an antidepressant about three years ago when he was experiencing “the big sad” but immediately stopped taking them stating they “dull the mind and have too many side effects”. He was unable to elaborate. He has not followed up with his psychiatrist or family doctor since this time. Looking through Lucas’ medical history, you note that Lucas was brought to the ED three years ago and was admitted to the inpatient psychiatric unit for 40 days for treatment of depression and suicidal ideation.

All laboratory investigations come back normal aside from Lithium level with results of 0.2 mEq/L and he denies any suicidal or homicidal thoughts stating, “life is too much fun”. 

Question:

1) According to the Case Study of Bipolar Depression/ Mania, What data is important and RELEVANT and has clinical significance for the nurse?

2) What are the nursing assessments and interventions required with regards to the LITHIUM levels?

3) What education programs and topics can the patient engage with? And why?

4) Which interdisciplinary team would you include in planning patient’s (Lucas) unit programming? And why?

5) What is the nursing priority or plan of care needed for the patient (Lucas)?

SCIENCE
HEALTH SCIENCE
NURSING
NURSING 2600

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