Discuss the Relationship Between Medication Management and Recovery Principles in Mental Health

$10.00

Mental Health-Nursing Care

 

SKU: Repo920459

Professional Portfolio

Choose and respond to one (1) of the two following case studies and provide a medication management plan for the chosen individual.  Your plan will be based on the four questions listed below.

 

Answer the following questions in your management plan:

Q1. What physical health considerations should be undertaken prior to giving this medication to the consumer?

 

Q2. Provide rationales for the use of this medication in this consumer.

 

Q3. What are the side effects / adverse effects of this medication? Indicate the management strategies that would be used to deal with these effects?

 

Q4. Discuss the relationship between medication management and recovery principles in mental health.

 

CASE STUDY 1:  Sebastian

Sebastian is a 23-year-old man who currently lives at home with his parents. Sebastian has a 5-year history of smoking marijuana with his schoolmates.  He has had multiple admissions to the local acute psychiatric unit. On his current admission, he was responding to a female auditory hallucination telling him that his neighbour was going to kill him. Sebastian has hardly slept for at least 3/52 prior to this admission, and he has been carrying a knife on his person to protect himself.  Sebastian was agitated on admission however; his behaviour became settled quite quickly as he felt safe in the unit.  His treating team including his case manager in the community have made the decision to commence Sebastian onRISPERDAL® CONSTA® (risperidone) 75 mgIMI fortnightly.He was discharged home to the care of his parents.

 

Family History:

Sebastian lives with both of his parents who are very supportive. They both work full time.Sebastian has a younger sister Sally who is 16 and currently completing Year 11.

Medical History:

Sebastian is fit and healthy.

Sebastian has been diagnosed with drug-induced psychosis and is currently being managed on an antipsychotic medication RISPERDAL® CONSTA® (Risperidone)75 mg IMI, fortnightly.

Current Mental State Examination

Appearance & Behaviour:

  • Healthy weight.
  • Height 172cm
  • No distinguishing features (e.g. no scars)
  • Attends to personal hygiene
  • Guarded at times with some questions
  • Easy to establish rapport
  • Poor eye contact when irritable

Cognition:

  • Orientated to time, place and person
  • Short term memory impaired, unable to recall when he last slept

Mood:

  • Anxious mood, particularly when preoccupied with neighbour

Affect:

  • Restricted affect

Speech:

  • Fluent speech
  • Clear and concise in communication
  • Rate and flow of speech normal

Form of thought:

  • Nil formal thought disorder

Content of thought:

  • Paranoid towards neighbour, hence feels unsafe in community
  • Denies any suicidal and homicidal thoughts

Perception:

  • Experiences female auditory hallucination

Insight:

  • Limited insight into his illness.
  • Constantly questions the need to take his medication

Judgement:

  • Poor judgement

 

CASE STUDY 2: Rebecca

Rebecca is a 30-year-oldwoman who is married with twelve-month-old daughter.Rebecca has had two (2) previous admissions to the mental health unit following suicide attempts. This is her third admission. Her husband Paul rang the triage team expressing concern that he thought that Rebecca was relapsing. He reported that she told him she was tired all the time and was unable to get out of bed. Yet he would hear her up at night crying quietly in their kitchen and he thinks she had stopped taking her medications. She was not taking care of their child or the house. Rebecca’s husband reports their relationship is under strain because she isn’t able to talk to him about what is wrong. Both sets of parents are helping with the care of their child.Rebecca has been commenced on Mianserin hydrochloride 120 mg daily by her treating team in the inpatient mental health unit.

Family History

Rebecca is the youngest child of three siblings with two older brothers aged 39 and 36 years; her parents are very supportive and have a good relationship with Rebecca and her husband. Rebecca’s maternal grandmother and her aunt have a diagnosis of major depression. Rebecca and Paul live in the same suburb as her parents. Rebecca’s parents are active members of the carer’s group run by the local Mental Health service.

 

Medical History

Nil physical problems

 

Psychiatric History

Rebecca was first diagnosed with Major Depressive Disorder at the age of 25 and has had two admissions to inpatient care in the past 5 years. Rebecca is currently being managed on Mianserin hydrochloride – 120mg PO daily.

 

Current Mental State Examination

Appearance & Behaviour:

  • Looks stated age of 30
  • Average height and weight
  • Black hair, unkempt
  • Dressed appropriate to weather, slightly dishevelled
  • Has scars on both wrists
  • Reluctant to be involved in conversation with intermittent eye contact

Cognition:

-Orientated to time, place and person. Not able to maintain concentration throughout interview.

Mood:

– Rebecca says she is very sad and tired

Affect:

-Congruent when discussing events leading to admission

Speech:

– Slow with monosyllabic responses

 

Form of thought:

– Logical and sequential

 

Content of thought:

– Believes that her husband and daughter would have a better life if she weren’t around. She states that she is not a good mother.

 

Perception:

– No perceptual disturbances elicited

 

Insight:

– Moderate insight into illness, states she knows she has depression and will take medication but doesn’t believe that it will do any good.

 

Judgement:

– Judgement is poor, however, she is willing to take medication, and try to stay well.

– Is accepting of the need for case management, has agreed to attend counselling with her husband.

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