Case Study 9
Below is an anecdotal scenario that seeks to prepare students for a typical inpatient work day. It is structured into three phases and begins with arrival at work.
You’ve just arrived at your shift on a mental health unit and are reviewing your client case load.
- How do you prioritize the client case load?
- Provide the rationale for the prioritization.
- What information is missing before you can move forward?
Next, you hone in on one patient, a 61-year-old, Caucasian female, with bipolar disorder who is mildly agitated. You review the night shift vital stats, as well as medications including her lithium levels.
- What are you most worried about?
- What should your immediate action be?
- How do the client assessment results impact care?
Despite your interventions, the patient’s agitation is escalating. You would describe her as aggressive.
- How do you intervene in a non-confrontational way?
- What psychosocial interventions should you consider?
- When do you use medications, and what PRN medication do you choose and why?
- Which intramuscular site do you choose, what size syringe do you use and how do you prevent a needle stick injury?
- What assessment do you do after you’ve administered PRN?