Patient Introduction Location: Inpatient orthopedic unit Time:…

Patient Introduction Location: Inpatient orthopedic unit Time:… Patient IntroductionLocation: Inpatient orthopedic unitTime: 14:00Report given by charge nurse:Situation: Sharon Cole is a 31-year-old female who was admitted last night for surgical repair of a right ankle fracture. She went to surgery this morning at 08:00 and came back from the postoperative unit at 11:30. Background: Mrs. Cole sustained the injury when she fell from the stage in a bar. According to the paramedics who responded to the 911 call at the bar, she was ranting about the government and talking about how she was the only one who could help rectify Washington’s problems. She jumped up on the stage and grabbed the microphone from the band leader, and in the struggle that ensued, she fell off of the stage and fractured her ankle.Her husband was contacted by the emergency department, and he was here prior to her surgery. He and her sister had been searching for her for hours before the accident. He reported that she was diagnosed with bipolar disorder 6 years ago and that she had not been sleeping or eating much for the past 2 weeks. The family was worried that she was at risk of another manic episode, but she became irritable when they questioned her behavior or her compliance with her medication. Her husband reports that she is normally adherent to her medication regimen, which is lithium 600 mg twice a day. The last time she stopped her medications was 2 years ago, and she had a manic episode after that. A psychiatric consult was initiated, and her medications and diagnosis were confirmed by her regular psychiatrist. Lithium will be restarted this afternoon.Assessment: She has been very loud and verbal since she came from the postoperative unit. She is somewhat oriented; she knows that she’s in the hospital, but doesn’t really remember the details of the fall. She knows her name and recognized her husband, but her recollection of the events of last night is inconsistent as she relays the story to different staff members. She does not know what day it is. She is having grandiose thoughts, her speech is pressured, and she is talking constantly, exhibiting a flight of ideas, with thoughts ranging from issues in Washington to suggestions about running the hospital better. She has used the call light several times, saying that she needs to get out of here, and keeps asking whether she can use the unit phone to call Washington. So far, she has responded to redirection with irritability. She has a fentanyl patient-controlled analgesia (PCA) pump for pain control. Her vital signs are stable: temperature, 37.2°C (99°F); heart rate, 88 beats/min; respiratory rate, 16 breaths/min; blood pressure, 134/70 mmHg. She denies pain, but she says she never feels pain. She has threatened to take her intravenous (IV) line out to get rid of the pain medicine, which she says makes her feel like she’s “not herself.” So far, we’ve been able to talk her into keeping it. She takes small sips of water when it is directly given to her. There is a sitter present for the patient’s safety.Recommendation: There is an order for lorazepam, 2 mg, as needed for agitation. We have not given it yet, but you may need to do that. Please also complete an assessment. The provider wants to be called about assessments and her status. He expects she can be discharged later today, but she may need to be moved to the inpatient psychiatric unit.ManiaBoyd, M.A., and Luebbert, R. (2022). Psychiatric Nursing: Contemporary Practice, 7th Edition.Mania, Chapter 26, p. 436Bipolar DisorderBoyd, M.A., and Luebbert, R. (2022). Psychiatric Nursing: Contemporary Practice, 7th Edition.Bipolar Disorders, Chapter 26, pp. 436-457 Diseases and ConditionsExpert Clinical Content from Lippincott AdvisorBipolar disorderDrugsExpert Clinical Content from Lippincott AdvisorLithium carbonateLorazepamRisperidoneNursing Care Plan for Medical DiagnosesExpert Clinical Content from Lippincott AdvisorBipolar disorderSigns and SymptomsExpert Clinical Content from Lippincott AdvisorAgitation ProceduresExpert Clinical Content from Lippincott ProceduresDifficult behavior managementManic episode patient care Please answer these questionsOpening QuestionsHow did the simulated experience of Sharon Cole’s case make you feel?Talk about what went well in the scenario.Reflecting on Sharon Cole’s case, were there any actions you would do differently? If so, what were these actions and why?Scenario Analysis Questions*PCC        What issues have you identified that could be barriers to a successful treatment for Sharon Cole? How would you address the manic state?PCC/I      Identify a support group that would be beneficial to Sharon Cole’s husband.PCC/S     What action should be initiated due to Sandra Cole’s medication regimen?Concluding QuestionsHow would you apply the skills and knowledge gained in the Sandra Cole case to an actual patient situation in different acute care units (emergency room, intensive care unit, obstetrics unit, etc.)?_______________________________*The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at: http://qsen.org/                                       Health Science Science NursingNUR 4525Share QuestionEmailCopy link Comments (0)

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