NURSING 432 FA Hannah Jackson Bipolar Disorder | Interview the Patient | Review - Answers and Rationale. Coppin State University..
Can you tell me what
... [Show More] has been happening lately?
Rationale Relevancy
Your
Answer
This open-ended question will enable the client to express
her perception of the events leading to admission and also
enable the nurse to assess her judgment and insight. Relevant Relevant
Client: Things have been great. I wish people would mind their own business. They are
just jealous of my success.
2.
Do you ever get the sensation of heart palpitations?
Rationale Relevancy Your Answer
Physical symptoms such as heart palpitations occur
with anxiety, not bipolar disorder. Irrelevant Irrelevant
Client: I feel great. I have lots of energy. Everything is going great.
3.
How long have you been feeling like you have lots of energy?
Rationale Relevancy Your Answer
This identifies a timeline for when the symptoms
first became apparent. Relevant Relevant
Client: I always feel great. I have all these ideas—I am writing a book.
4.
Your family expressed concerns; they say you aren’t eating or sleeping well.
Rationale Relevancy Your Answer
This assesses the client’s perception of her
behaviors. Relevant Relevant
Client: I am so angry at them. It is none of their business what I do. A person is allowed to
eat and sleep when they want. I am an adult. I can use my credit card when I want. I am
sick of them being the fun police. I don’t want to talk about this anymore; it makes me
want to punch something.The client leaves the room, terminating the interview.
Determine if Hannah’s mood is characteristic of hypomania, acute mania, or delirious mania.
Rationale Relevancy
Your
Answer
Because of frequent mood swings, it is important to
understand how the client is feeling at this moment. Relevant Relevant
Assessment Data/Patient Results: Hannah is euphoric and elated. She
is singing and telling the staff that she is “high on life.”
2.
Assess Hannah’s ability to think logically.
Rationale Relevancy
Your
Answer
Cognition and perception become fragmented and
often psychotic in acute mania. Rapid thinking
proceeds to racing and disjointed thoughts. Relevant Relevant
Assessment Data/Patient Results: Hannah is talking rapidly, telling the
nurse, “I am so happy to be here today. What do you think is on television?
I think I need to go to the shopping mall this week. Can we turn on the
radio? Am I getting any visitors today? I think it might snow.”
3.
Determine how long ago Hannah last slept.
Rationale Relevancy
Your
Answer
Clients experiencing mania often go for days without sleep
and still do not feel tired. It is important to know how long it
has been since the client rested, as a sleep-deprived
individual is at higher risk for injury. Relevant Relevant
Assessment Data/Patient Results: Hannah has not slept in 72 hours.
4.
Assess Hannah’s feelings of sadness and dejection.
Rationale Relevancy
Your
Answer
Feelings of sadness and dejection are associated with
depression. At this time, the client is exhibiting signs of
a manic high. Irrelevant Irrelevant
Assessment Data/Patient Results: There is no evidence that Hannah is
feeling sad or depressed.
5.
Assess for degree of distractibility.
Rationale Relevancy
Your
Answer
Distractibility is seen in all phases of the manic episode.
This is evident in the client’s attention being too easily
drawn to unimportant or irrelevant external stimuli. Relevant Relevant
Assessment Data/Patient Results: Hannah is easily distracted by
anyone walking by the room or any unanticipated noises.
6.
Assess for breast tenderness, headaches, bloating, and weight gain.
Rationale Relevancy
Your
Answer
Physical symptoms such as these are associated with
premenstrual dysphoric disorder, not bipolar disorder. Irrelevant Irrelevant [Show Less]