HLT54115 – Assignment – Written Task PDF

Preview

Summary

Implement & Monitor Care for A Person with Mental Health Conditions...

Description

HLT54115 – Assignment – Written Task Implement & Monitor Care for A Person with Mental Health Conditions Part A Define and /or describe the following terminology.



Psychotic disorder

Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that someone is plotting against you or that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that is not there. (Medlineplus.gov, 2018)



Paranoid Schizophrenia

Paranoid schizophrenia is the most common form of schizophrenia, a type of brain disorder. Paranoid schizophrenia is characterized by predominantly positive symptoms of schizophrenia, including delusions and hallucinations. Someone with paranoid schizophrenia will experience a preoccupation with delusions. Delusions refer to something you believe that is not true. There are many types of delusions, although the following are more common with those who experience paranoid schizophrenia:      

Ill health: Belief of having a terrible disease or condition Jealousy: Belief that a spouse or partner is being unfaithful Passivity: Belief of being controlled or manipulated by an outside influence Persecution: Belief of being interfered with or the center of a conspiracy Reference: Belief of being talked about by others, including the press Thought control: Belief that ideas are being put into your mind by others

A hallucination is a false sensory perception and can affect any of the five senses. Examples of auditory (sound) and visual (sight) hallucinations in paranoid schizophrenia may include things like:      

Hearing voices coming from an outside source, such as a speaker or other object Hearing voices commanding or conversing inside your mind Hearing abrupt sounds or music when there is nothing present Hearing sounds such as humming, whistling or laughing when no one is around Seeing faces and bodies Seeing images of a situation or event (Verywell Mind, 2018)



Two types of delusions

There are different types of delusional disorder based on the main theme of the delusions experienced. The types of delusional disorder include: 



 

 



Erotomanic: Someone with this type of delusional disorder believes that another person, often someone important or famous, is in love with him or her. The person might attempt to contact the object of the delusion, and stalking behavior is not uncommon. Grandiose: A person with this type of delusional disorder has an over-inflated sense of worth, power, knowledge, or identity. The person might believe he or she has a great talent or has made an important discovery. Jealous: A person with this type of delusional disorder believes that his or her spouse or sexual partner is unfaithful. Persecutory: People with this type of delusional disorder believe that they (or someone close to them) are being mistreated, or that someone is spying on them or planning to harm them. It is not uncommon for people with this type of delusional disorder to make repeated complaints to legal authorities. Somatic: A person with this type of delusional disorder believes that he or she has a physical defect or medical problem. Mixed: People with this type of delusional disorder have two or more of the types of delusions listed above. (WebMD, 2018)

Auditory Hallucinations

Auditory hallucinations are false perceptions of sound. They have been described as the experience of internal words or noises that have no real origin in the outside world and are perceived to be separate from the person’s mental processes. (Psychiatrictimes.com, 2018)



Involuntary admission (Using the current NSW Mental Health Act)

A person can also be admitted involuntarily, or against their will, to a mental health unit. The Mental Health Act sets out strict criteria that must be met in order for someone to be admitted to hospital against their will. Firstly, the person must be mentally ill or mentally disordered, as defined by the Act, and secondly there must be no other care of a less restrictive kind (such as a voluntary admission or support at home from family or a community mental health team) that is appropriate or reasonably available. An assessable person may be detained in a declared mental health facility in the following circumstances:      

On the certificate of a medical practitioner or accredited person. This is called a Schedule 1 admission s 19; After being brought to the facility by an authorized ambulance officer s 20; After being apprehended by the police s 22; After an order for an examination and an examination or observation by a medical practitioner or accredited person s 23; On a court order of a Magistrate or bail officer (under s 33 of the Mental Health (Criminal Procedure) Act 1990 s 24; After a transfer from another health facility s 25;



On a written request made to the authorized medical officer by a primary carer, relative or friend of the person s 26. This may occur where remoteness or urgency makes it impracticable to have the person seen by a medical practitioner. (Legalaid.nsw.gov.au, 2018)



Anxiety

Anxiety is a general term for several disorders that cause nervousness, fear, apprehension, and worrying. Anxiety is the body’s physical response to fear. The symptoms might include:     

racing heart rapid breathing sweaty palms butterflies in your stomach ‘burst’ of energy.

Anxiety disorders can be classified into six main types. These include:       

Generalized anxiety disorder (GAD) Panic disorder Phobia Social anxiety disorder Obsessive-compulsive disorder (OCD) Post-traumatic stress disorder (PTSD) Separation anxiety disorder (Medical News Today, 2018)



Mania

Mania: An abnormally elevated mood state characterized by such symptoms as inappropriate elation, increased irritability, severe insomnia, grandiose notions, increased speed and/or volume of speech, disconnected and racing thoughts, increased sexual desire, markedly increased energy and activity level, poor judgment, and inappropriate social behavior. A mild form in mania that does not require hospitalization is termed hypomania. Mania that also features symptoms of depression ("agitated depression") is called mixed mania. (MedicineNet, 2018)



Suicidal ideation

Suicidal thoughts, or suicidal ideation, means thinking about or planning suicide. Thoughts can range from a detailed plan to a fleeting consideration. It does not include the final act of suicide. Suicidal thoughts are common, and many people experience them when they are undergoing stress or experiencing depression.

A person who is experiencing or could experience suicidal thoughts may show the following signs or symptoms:  feeling or appearing to feel trapped or hopeless  feeling intolerable emotional pain  having or appearing to have an abnormal preoccupation with violence, dying, or death  having mood swings, either happy or sad  talking about revenge, guilt, or shame  being agitated, or in a heightened state of anxiety  experiencing changes in personality, routine, or sleeping patterns  consuming drugs or more alcohol than usual, or starting drinking when they had not previously done so  engaging in risky behavior, such as driving carelessly or taking drugs  getting their affairs in order and giving things away  getting hold of a gun, medications, or substances that could end a life  experiencing depression, panic attacks, impaired concentration  increased isolation  talking about being a burden to others  psychomotor agitation, such as pacing around a room, wringing one's hands, and removing items of clothing and putting them back on  saying goodbye to others as if it were the last time  seeming to be unable to experience pleasurable emotions from normally pleasurable life events such as eating, exercise, social interaction, or sex  severe remorse and self-criticism  talking about suicide or dying, expressing regret about being alive or ever having been born (Timothy J. Legg, 2018)



Challenging behavior

A person with challenging behavior is not a ‘problem’ to be fixed and is not doing something ‘wrong’. But behavior is a sign that something isn’t working. It shows that there is some unfulfilled need or a problem with communication. It is the impact of these behaviors that makes them challenging. Challenging behavior can be:  

Self-injurious: Head-banging, scratching, pulling, eye poking, picking, grinding teeth, eating things that aren't food. Aggressive: Biting and scratching, hitting, pinching, grabbing, hair pulling, throwing objects, verbal abuse, screaming, spitting.

 

Stereotyped: Repetitive movements, rocking, repetitive speech and repetitive manipulation of objects. Non-person directed: Damage to property, hyperactivity, stealing, inappropriate sexualized behavior, destruction of clothing, incontinence, lack of awareness of danger, withdrawal. (Scope.org.uk, 2018)

Part B 1. List 10 observations regarding mental state that would be relevant in assessing this person's current condition.

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

Anxious contributing to sleeplessness Distracted Insomnia – Lack of sleep Depression and Happiness Manipulative Aggression – very verbal / irritability Not patient Stability Unusual features (e.g. tremors, or slowed, repetitive, or involuntary movements) Level of arousal (e.g. calm, agitated) Rapport and social engagement

2. Prepare a written care plan to meet James's current needs, addressing Five (5) needs/deficits. Problem Insomnia

Goal

Nursing Intervention

Evaluation

Improve sleeping pattern Sleep more hours

-Administer prescribed medication -Environmental support to sleep -Refuse to give caffeine stimulant -Schedule to sleep -Refuse to watch TV and lights off - Encourage the patient to verbalize his own anxiety and coping patterns. -Help the patient develop 3 coping mechanisms to help with the his anxiety attacks.

Sleep pattern improved, as to sleeping longer hours

Anxiety

To minimize anxiety attacks

Aggression

Minimize aggressive behavior

-Listen to the frustration. Find out what may be causing the agitation and try to understand. -Modify the environment. Decrease noise and distractions or

The patient verbalizes his own anxiety and coping patterns. -The patient effectively uses the coping mechanisms to help with the anxiety attacks The patient calmed down after converting his frustration and anger in to positive thoughts and behaviors.

relocate. -Provide reassurance.

Falls risk

Minimize the risk of falls

-See to it that the beds are at the lowest possible position.

Patient did not have a fall and conceded low risk as charted on Fall Risk assessment tool.

-Keeping the beds closer to the floor reduces the risk of falls and serious injury. Placing the mattress on the floor significantly reduces fall risk. Document

Becoming Lost

Reduce memory lost

in Falls risk assessment tool. -Educate the patient about the location there are in. -Accompany on walks -Provide safe and secure walking area. Encourage patient to remember 10 objects in the ward and to go find them.

Patient walked to a destination and back without getting lost. Patient found 8/10 objects in the ward, to suggest improvement in memory capacity.

3. Describe the action of three (3) mediations that might be prescribes for a client with schizophrenia, highlighting their actions, usual dosages and side effects.

REFERENCE Medlineplus.gov. (2018). Psychotic Disorders: MedlinePlus. [online] Available at: https://medlineplus.gov/psychoticdisorders.html [Viewed 14 May 2018]. Verywell Mind. (2018). Paranoid Schizophrenia Includes Delusions and Hallucinations. [online] Available at: https://www.verywellmind.com/what-is-paranoid-schizophrenia-4155331 [Viewed14 May 2018]. WebMD. (2018). Delusional Disorder. [online] Available at: https://www.webmd.com/schizophrenia/guide/delusional-disorder#1 [Viewed 14 May 2018]. Psychiatrictimes.com. (2018). Auditory Hallucinations in Psychiatric Illness | Psychiatric Times. [online] Available at: http://www.psychiatrictimes.com/cme/auditory-hallucinations-psychiatric-illness [Viewed 14 May 2018]. Legalaid.nsw.gov.au. (2018). 2.10. Involuntary admission - Legal Aid NSW. [online] Available at: https://www.legalaid.nsw.gov.au/for-lawyers/policyonline/practice,-procedures-and-directions/2.-thepractice-and-procedure-manual-for-mental-health-advocacy-civil-and-forensic-work/2.10.-involuntaryadmission#2.10.2%20In%20what%20circumstances%20may%20an%20assessable%20person%20be %20detained? [Viewed 14 May 2018]. Medical News Today. (2018). Anxiety: Causes, symptoms, and treatments. [online] Available at: https://www.medicalnewstoday.com/info/anxiety [Viewed 14 May 2018].

MedicineNet. (2018). Definition of Mania. [online] Available at: https://www.medicinenet.com/script/main/art.asp?articlekey=4271 [Viewed 14 May 2018]. Timothy J. Legg, C. (2018). Suicidal ideation: Symptoms, causes, prevention, and resources. [online] Medical News Today. Available at: https://www.medicalnewstoday.com/kc/suicidal-thoughts-ideation193026 [Viewed 14 May 2018]. Scope.org.uk. (2018). What is challenging behaviour? | Disability charity Scope UK. [online] Available at: https://www.scope.org.uk/support/parents/challenging-behaviour/overview [Viewed 14 May 2018]....