Case Study 2 - Mental Health Facility

Alex is a 23 year who was admitted to the acute ward at the mental health facility, he has been admitted to the locked ward due to his his acute psychosis. Alex was recently diagnosed with a drug induced schizophrenia caused by the use of marijuana. Alex has been in the ward for the past two weeks, over the past couple of days it has been discussed amongst staff the large amount of food and water Alex consumes (5 litres plus a day and extra meals), they have put this down to his psychosis.

The following day Alex's behaviour deteriorates and he has become aggressive and unable to walk in a straight line, the staff are confused and wondering if one of his visitors has given him something. The staff take routine bloods and decide to do a drug screen as well. They have also noted the number of times a day he has been going to the toilet (this has been frequent at least hourly if not more regularly).

They conduct a full set of vital observations and document the following;

RR 4102 BP HR BGL AVPU Temp Pain
31 96% 132/68 140 30.2mmol/t   36.6 0/10
          A    
          (However Alex is
disorientated to time and
place)
   

 

Questions:

  1. Discuss your assessments on this patient, identify signs of deterioration and clearly state if the patient requires a clinical review or rapid response as per Between the Flags (BTF). Justify your decision with data from the case and relevant support.
  2. Document a succinct and accurate ISBAR handover in verbal script format (eg. Hello, my name is...)
  3. Considering the assessment findings. prioritise and discuss the immediate nursing management of the patient
  4. Succinctly discuss the ongoing management of this case and integrate the relevant members of the interdisciplinary team

Expert's Answer

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