Management of Bipolar Personality Disorder (BPD) Assignment
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Added on 2020-04-01
Management of Bipolar Personality Disorder (BPD) Assignment
Added on 2020-04-01
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Running Head: MANAGEMENT OF BIPOLAR PERSONALITY DISORDER (BPD)Management of Bipolar Personality Disorder (BPD)Name:Institution and Affiliations:Instructor:Date:
MANAGEMENT OF BIPOLAR PERSONALITY DISORDER (BPD)PART 1 Holistic assessment and planning1.1 IntroductionColleen is a 24 years old woman and mother of three from Mackay with a history of earlysexual assault, street life and trauma related to separation from her family 4 years of age. She hasbeen diagnosed with borderline personality disorder which she is under care for. She suffers from chronic low self-esteem and a feeling of being unsafe. Her most dangerous symptoms include self-mutilation and suicidal ideations. This presentation includes an assessment of the patient’s mental status and a clinical formulation both of which inform decision making on specific patient nursing plans. The nursing care plan targets the reduction of self-harm, assuranceof safety and encouraging development of self-esteem. These plans are in line with culturally safe care principles of social justice, accountability, transparency and negotiated partnership. Theplan also incorporates the recovery philosophy principles which guide care provision. A clinic handover description is also provided to ensure that other nurses other the one assigned to care for the patients can assist her with necessary care when the earlier is not present.1.2 The Mental Status ExaminationA comprehensive assessment according to Talley & Littlefield (2009) is important in mental health care as it informs decision making on the nursing plan and the principles of recovery and cultural safety care to be used. No.SectionSub SectionObtained Information1General appearance/ behavior/attitudeAge & groomingPatient looked appropriate to her age, well dressed & kempt, attractiveFacial expression, manners & attitudeSad, irritable, cooperative and over-confidentPosture and psychomotor activitySlow posture and mannerisms but increased in some cases.2Client speechRateBegins with pressured speech and the rate increases later.
MANAGEMENT OF BIPOLAR PERSONALITY DISORDER (BPD)VolumeSpeaks slowly, but gets loud at times.3EmotionsMoodDisturbed mood; she doesn’t like herself, only likes some people like a favorite nurse. She gets angry and very hurt often. She cannot control her anger and has a feeling of hopelessness. AffectPresented with intense sadness, remorse, loneliness and guilt. LabilityIntensely emotional with full range & variety showing elation, fear, irritability, distrust, excitement, and anger. Had labile and/or unstable emotions.Range: Content/Situation AppropriatenessHer affect is incompatible with her ideas, thought content and with the situation description.4Process of Thought Form of thoughtMinimal loose associations and/or preoccupationsContent of thoughtSuicidal ideation (“No one wants me/I just want to end it”). Hallucinations (She hears a male voice telling her she is “rotten” and “no good.” Feelings of unreality/depersonalization, with illusions.5Mental Capacity & SensoriumOrientationShe is oriented to place, person and to timeIndividual’s MemoryPresented with adequate remote and recent memory. Concentration & AttentionPresented with minimal distraction to attention and concentration. General intellectual assessmentAbove average abstract reasoning General Intelligence involving general awareness, simple calculations and abstract reasoning was average.6Insight & judgmentHealth and illnessShe has knowledge and accepts that she has some mental problem. She admits that she causes trouble to others and that is why she “wants to end it.”Need for treatmentExpressed cooperation and non-reluctance to treatment. Plans and goalsHer plan is to reconnect with her family and her major goal is to not only have her children but also to after her own family by herself.1.3 Clinical Formulation TableFactorDetail1.Presenting factorBorderline disorderRisks continued self-mutilation and suicideRisk of severe impairment in her functioning (inability to provide for her own basic needs in the long-term).Risks impairment in her well-being (depression, anxiety)Risks continued impairments in her relationships with her boyfriends and also impairments at work.2.Precipitating factorBiological: Borderline disorder
MANAGEMENT OF BIPOLAR PERSONALITY DISORDER (BPD)Social: a. Financial stress (Does casual jobs) (b). Relational conflicts (broke up with all her boyfriends) (c). Traumatized after being separated from her family at 4 years and sexually abused by her foster father (d). Poor living conditions in low rent rooms3.PredisposingSeparation from her family at age 4Early life as street-girlSexual assault by foster fatherEarly struggles for education and survivalRelationship breakups with different men4.PerpetuatingLack of coping skills as emotions get highly intensePoor self-care: engages in self-mutilation and suicidal ideationLabile emotionsLoneliness and feelings of being unwanted.Chronic cognitive distortions including self-blameDeficit in natural resources few friends, no family, poor housing unstable financial position. Stress5.ProtectiveSeveral friendsLow rent room houseHas a jobHas access to a counselor in MackayCooperative under care assessmentsIntelligentLiterate and numerateCan access information on upcoming Link-Up conferences that can help findher parentsNo burden of caring for children1.4 Plans for Nursing CareConsidering Maslow’s hierarchy of needs Colleen has two major needs. The first one includes safety needs where the theory stipulates that individuals require feeling protected from any elements, having order, freedom, free of fear and stable (Taormina & Gao 2013, p.155). The patient thus requires assistance to prevent her from self-mutilation practice; where she has been seen in the toilets with a nail scissors slashing at her own wrists. The nursing care plan will include treating the wrist wounds and actively involving the client to identify better alternative behavior than self-mutilation (Reeves-Dudley 2017, p.85). Colleen should be assisted to anticipate specific situations which might raise tension and rage. She also needs to be involved in
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