John Smith Case Study - Health Assignment Help

Assignment Task :

Abstract:

In this case study, I will discuss my role within the multidisciplinary team as a Registered Nurse in the provision of care for John Smith, a 19 year old male admitted to the acute mental health facility due a deterioration in his mental state, characterised by various psychotic symptoms. I will explore how this young man’s particular circumstances and areas of concern influenced my nursing practice and how it impacted his response to specific interventions and treatment, with reference to current literature and evidence based practise. 

Case Scenario:

John Smith (pseudonym) is a 19-year-old male with a background of Autism Spectrum Disorder (ASD), admitted to the acute adult inpatient unit after being assessed by the Acute Service Team (ACS) following a referral made by his mother. After a home visit was conducted by the ACS earlier in the day, John was scheduled under the NSW Mental Health Act 2007 due to concerns about his deteriorating mental state and aggressive, erratic behaviour. During the initial assessment in the admission unit, John presented as highly anxious, with paranoid thinking, repetitive and fixated ideas and thought disordered. His thought content varied from paranoia regarding his Facebook account being hacked, fixated delusions that he was under surveillance/being monitored and persecutory beliefs that his neighbours at his Department of Housing (DOH) unit were dangerous. 

John has an established diagnosis of ASD, and last year received a diagnosis of Schizophrenia by a private psychiatrist, in context of an independent court assessment regarding an incident where he physically assaulted his father due to paranoia that he was monitoring him. Following this incident, the Police took out an AVO on him on behalf of the father, which mandated he was unable to return home at that time. This lead to John’s first admission to a mental health facility. He was discharged from the unit on a Section 32 and placed into a DOH unit with NDIS supports. During his first admission he was commenced on 10mg of oral aripiprazole for aggression management with good effect. However, following discharge he breached the conditions of his Section 32 by failing to attend medical appointments or adhere to his medication.

In the days preceding his recent admission, John’s mother had contacted the ACS team concerns for John’s welfare and safety. The documented assessment from the ACS revealed that  during the interview John was fixated on the belief that he had been treated unjustly in his previous admission, loosely referring this to not feeling safe at his DOH. Collateral from John’s mother stated that over the last few months his sleep cycle had progressively reversed and that he often wandered the streets alone during the night and would sleep in the daytime, regularly showing up at her house in the early hours of the morning. She disclosed that on several occasions she would have to lock herself in the bedroom in fear of John’s aggressive behaviour. She also reported concerns that he was often dishevelled, malodorous and had recently lost a significant amount of weight. 

Discussion

Upon admission to a mental health facility, a thorough risk assessment must be conducted, as well ongoing risk evaluation and monitoring throughout the course of the patient’s stay. The importance of risk identification and management tools are to promote patient safety and support appropriate patient-centred care planning (Folley & Trollor, 2015). Upon John’s admission, a thorough risk assessment and mental state examination were conducted and the following risks were identified: Risk of Aggression, Self Neglect, Absconding and Misadventure. Through collecting and processing the information known about John, including his background history, current clinical presentation and risks, the following were identified as the main areas of concern to be addressed on his admision: 

• Symptom Management 

• Ongoing Risk Assessment/Management

• Medication Compliance 

• Discharge Planning  

For this assessment you will have to prepare a written case study concerning a client that you have personally cared for in your role as a member of the multidisciplinary team. 
 

DIRECTIONS:

• Write a paper of no more than 2000 words

• Ensure that you include examples of your direct involvement with the client you have selected

• Conduct a thorough literature review that relates to your case study (e.g. literature that supports the clinical choices made in the management of the client) 
 

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