MH2 - Stress Vulnerability Model - Medical Science Assignment Help

Assignment Task

Writing problems (is it a nursing issue right now (can be addressed immediately) or sub-acute issue at the moment). Identify what can be dealt with straightaway: Have 3-4 problem statements then the care plan. E.g. Perceptual disturbances: auditory illusion like hearing planes and paranoid delusion that has made him belief that his parents are going to kill him. Insomnia – sleep disturbances. Potentially girlfriend is a delusion.

Because of his current perception and delusions, he is unpredictability and paranoia make him a risk for aggression and a potential of harm to others.

Harm to self. Even if the answer is “No” we cannot put no risk for suicide. Always consider suicide as high risk. Remove all hanging devices including clothing and belt.

Potential for non-compliance or non-adherence to taking the medication.

Potential risk for absconding. He was brought in involuntarily by police and he states he does not understand why he is there. Shows lack of insight. Be aware of appearance if need to call security to bring 

Things you will do and the rationale why?

Absconding - Door policy, close to nurse station, LOC, Therapeutic relationship – primary nurse (constancy of care). Due to lack of insight but also due to psychotic paranoia.

Medication Non-compliance - reason for non-compliance, explanation-education, rapport – therapeutic relationship. Different anti-psychotic medication, dose adjustment – administer medication (5 rights). If the patient refuses, educate patient if still refuse, give options, ask for reason and notify doctor and document and handover. Know how quickly it is going to work and what side effects to look for after administration (drive out? Long term side effect in fine motor skill like writing). Frequency of medication gives idea for the efficacy of the medication. IMI – when refused might need to have 4 people to assist in administration as it is in the best interest of the patient.

Harm to self - Use the term assess. When reassessing for intent to harm self…at least twice in an 8-hr shift. Close observation – use the procedure/policy of facility. A plan of care. What she should look for, what to do and how to document. Do MSE, include risk.

Harm to others (aggression) - Medication not immediate restraint option. Using methods to deescalate the situation/reaction. A conversation to change the situation before using medication or secluding and restraining.

Delusional Ideas – Therapeutic relations, increase his ability to understand the reality by giving reality statements (e.g., Parents are not here, they won’t visit, they are not preparing food). Introduce yourself and remind who you are what you are doing and why you are doing what you are doing by reminding him why he is in the hospital.
Paranoia (Perceptual disturbances)- Reality orientate. Removing trigger e.g., TV. Changing channel, removing. Ask him and check for facial expression e.g., did you talk to your GF today. Therapeutic relationship. Observation, question, and medication. Assessment

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