Mental Health Case Study Analysis for Nursing Students

This mental health case study analysis is about a consumer suffering from bipolar affective disorder. It includes key issues, questions for understanding the consumer's experience, mental illness description, appropriate NMBA registered nurse standards for practice, safety concerns, and reflection on the parting comment made by the night duty RN.

Assessment 3 – Case Study 2021
Inquiry Based Learning template
STEP 1 - CONNECT
Analyse each of the
case study
documents
What are some of the key issues or
information that you consider are important
in the Case Study?
1. Bipolar disorder
2. Sings of Mania
3. Disturbed sleep pattern and initial stage
of insomnia
4. Experimenting with Marijuana
Describe why you believe these are the key issues in the Case Study:
The key issues which underpins in the case of Adam, can be described
as complicated which lead him to do death taking activities. Due to
increased work pressure, Adam had prevalence of Bipolar disorders
includes depressive episodes that can involves major symptoms similar
to Adam's case, such as low energy, low motivation as well as loss of
interest in daily activities, although, these moods are associated with
mood episodes which can last up to days to month and it has also
associated with other complexities in which one most of concerning is
suicidal tendencies. Adam face difficulty in dealing with the situation that
can control the feelings and change in minds. Well, it also includes signs
of maniac, such as high energy, loss of touch with reality and reduced
sleep. Another, key issues which contributes are presence of symptoms
of mania. It is complicated type of mental illness which includes abnormal
upbeat, it can also increase activity and energy. It has been observed
that sleep pattern of a person can impact multiple aspects, as it is refer
as resting mode of mind, if it gets disturbed by a cause, it can negatively
influence mental health of an individual. In addition to this, in the case of
Adam, experimenting with marijuana which can be effective and allow to
get negative health impaction Adam health. This can also lead to create
high negative impact or some negative response on Adams health.
Moreover, there is need to take care about using Marijuana along with

negative health impact of using marijuana and further experiment with it.
STEP 2 -
QUESTION
Consider the
person’s needs
What are your questions for this case study
that help you understand the consumers
experience?
1. Which types of counselling or
Psychotherapies are required for improving
Adam’s health?
2. Which type of social support Adam
needed?
3. How motivation and emotional support
can help Adam to live effectively?
4. How learning of self-management and
promotion of self-esteem can affect Adam’s
life?
5. How enhancements in appetite of Adam
can help in getting better health?
Why are these questions relevant to your learning about this Case
Study?
It has been observed through several similar cases that counselling
involves psychotherapies in which an individual is allowed to discuss
multiple aspects with their psychiatrist, in regards with their own feelings,
thoughts and behaviours which can cause mental health problems. Talk
or speech therapies are determined to help in observing cause root of
problems. In some cases, individuals may not able to speak due to
mental health disorder, in this case, there are other interventions such as
using communication tools, nonverbal communication by signs and
gestures etc. are performed that can help to ease bipolar episode. There
is high requirement of social support in the cases of mental health illness,
as it has been seen that individuals usually to get social withdrawal,
which affects their social acceptance. In the case of Adam, he should go
opt social gathering and should spend quality of time with his friends, so
that he will able to express thoughts which he is not able to share with
other. Along with social support, Adam also requires emotional support
and motivation that can help him cope with mental illness quickly.
According to the studies, it has been observed that emotional support
and motivation to an individual can help a person to manage inner
feelings and thoughts. Individual should achieve learning and
understanding self-management.

STEP 3 -
INVESTIGATE
Research and
describe the
consumer’s mental
illness in the Case
Study
What mental health problems is the
consumer experiencing?
1. Bipolar Affective Disorder
Description of mental health problem:
Bipolar disorder is generally well known as manic depression, it is mental
health condition that is able to cause extreme mood swings, including
emotional highs. Adam is suffering from the bipolar disorder which create
high impact on his mental health and emptions which is possess by him.
Emotional highs are divided into two parts which are Mania and Hypo-
mania and also lows (depression) (Duffy and et. al. 2017). The frequency
of these may vary as these can occur rarely, whereas, in some cases, it
can prevail multiple times a year. Studies considered that Bipolar
Affective Disorder is a lifelong condition that can affect a person in
several aspects. Here, Adam is getting highly affected by this bipolar
disorder which is creating high negative health impact mental health
which leads to change in mood and performing different activates. As it is
associated concerning mental health problems which can lead an
individual to mortality. Additionally, The National Institute of Mental Health
Trusted Source portray the fundamental indications of bipolar problem as
exchanging scenes of high and low temperament (Mistry and et. al.
2018). Changes in energy levels, rest designs, capacity to centre, and
different components can significantly affect an individual's conduct,

work, connections, and different parts of life. The vast majority
experience mind-set changes eventually, yet those identified with bipolar
turmoil are more exceptional than customary temperament changes, and
different side effects can happen. Certain individuals experience
psychosis, which can incorporate daydreams, mental trips, and suspicion
(Vanderplow and et. al. 2021).
Between scenes, the individual's state of mind might be steady for quite a
long time or a long time, particularly in case they are following a
treatment plan. Treatment empowers many individuals with bipolar
confusion to work, study, and carry on with a full and useful life. In any
case, when treatment helps an individual get better, they might quit taking
their drug. Then, at that point, the side effects can return (Duffy and et. al.
2017).
Clinical Manifestations & Symptoms
The clinical manifestations of Bipolar Affective Disorder may vary person
to person. The mood of an individual may found to be have mood swings,
elevated mood, anger, apathy, anxieties, euphoria, hopelessness, loss of
interest in own hobbies and daily activities, lack of pleasure in doing
activities, risk associated with behaviours, crying, excess desires for sex,
impulsive nature, restless and also self-harm (Chiang and et. al. 2017).
There are some cognitive symptoms that involve unwanted thoughts, in
extreme cases delusion, an individual may also feel lack of concentration,
racing thoughts, slow at performing activities, fake beliefs of superiority
(O'Connor and et. al. 2020). There are some psychological signs of this
disorder that can include as agitated depression and in some cases, an
individual can also represent paranoia. In addition to this, studies include

common signs which are fatigue and frenzied language.
Common treatment options for this disorder:
The treatments of Bipolar Affective Disorder begin with initial step which
is evaluation. For Adam, the process of evaluation an individual can
undergo psychiatric assessment, in which a counsellor can ask in regards
with individual’s choices, feelings and pattern of behaviours in which a
psychiatrist compares signs and symptoms with criteria of bipolar and
related with disorders in the DSM-5 (Diagnostic and Statistical Manual of
Mental Disorders), which has been introduced by Australian Psychiatric
Association ((O'Connor and et. al. 2020). In which treatment is guided by
the aid of psychiatrist who are skilled in diagnosing and treating mental
health illnesses. It has been considered that it is lifelong condition and
treatment includes medication such as mood stabilisers, day treatment
programs, substance use treatment and in extreme situations, individuals
are suggested to get hospitalised in order to receive quality of case and
services from service providers. Other treatments that can be also prove
to be good in use which are electro convulsive treatment or ECT,
electrical flows are gone through the mind, deliberately setting off a short
seizure. ECT appears to cause changes in cerebrum science that can
switch indications of specific psychological maladjustments. (Duffy and
et. al. 2017). ECT might be a possibility for bipolar treatment in the event
that you don't improve with drugs, can't take antidepressants for
wellbeing reasons like pregnancy or are at high danger of self-
destruction. Transcriptional attractive incitement or TMS is being
examined as a possibility for the individuals who haven't reacted to

antidepressants.
STEP 4 -
CONSTRUCT
Using a recovery
and person-centred
approach, explore
the issues raised in
this case study and
how you can support
this person during
your early shift
Identify the appropriate NMBA Registered
Nurse Standards for Practice
that would be applicable for you as an RN in
supporting the person in this Case Study
1. Standard 2: Engages in therapeutic
and professional relationships with
each individual.
2. Standard 3: maintain the
capabilities for effective nurse
practice.
3. Standard 5: Develop plan for nurse
practice
4. Standard 6: Provide safe, relevant
and responsive quality nursing
practice
In the case of Adam, as per the standard 2, nurse practitioners should
establish therapeutic and professional relationships with an individual, so
that it can help to provide support to an individual. It can help an
individual to cope with the complications which he deals on daily basis.
As this involves mutual dignity, culture, values, rights, beliefs, trust and
respect, which can establish relation that can help Adam to express his
thoughts, feelings and experiences in a better way. This can provide
information about current condition of an individual and nurses can able
to proceed on next considered interventions of a person. It is also
embedded with a commitment to use of delegation, supervision,
coordination, consultation as well as referrals in the professional’s
reactions that can help to attain improved health outcomes for service
seeker (Al-Maraira and et. al., 2019). Moreover, the standard 3, is
determined to provide considers and responds in a systematic manner to
the health as well as well-being of self, in relation to capabilities of
practice. This standard can facilitate an individual to determine self-
management interventions in order to recover. It can also provide
information in regards with individual to foster their control over their
health. It also helps to identify and can able to promote the essential and
integral role of nursing practice and also the profession that can help
them to influence an individual's better health outcomes for individual.
Though this standard, it can help during shift, it will conduct awareness
and knowledge in regards with mental distress. In addition to this, the
Standard 5 of NMBA described that it is responsibility of nurse
practitioners. By the aid clinical assessment data, multiple tools and

therapies such as behavioural change therapies, the plan can be
developed (Abdul-Muhsin and et. al., 2020). Through the case study. It
has been discovered that Adam would not achieved acute care plan in
order to administer his mental illness. Last;y, the standard 6 is interlinked
with effective care and quality of services should be provided to an
individual. The safe environment should be given to Adam which can help
him to cope with the illness. Also, the considered approach in the case of
Adam, are person centre-red care and holistic approach. The person
centred approach involves person centre quality of care and services that
can be helpful to accomplish desired goals of Adam.
Identify the safety concerns for the person in this Case Study and how
you will support the person during your shift
While getting healthcare services, it is essential to ensure about patient
safety and other related health concern that can allow to get better and
effective safety within healthcare premises. In this case, safety concern
which should be considered are providing optimistic environment to an
individual. There should be open conversation as the patient is suffering
from bipolar affective disease in which suicidal thoughts are common, so
there should absence of any sharp equipment’s near to an individual and
also, Adam required frequent check-ups in regards with his mental
conditions. He needs one companion to whom he can share and express
his needs. So while shift, one should build positive relation by the use of
effective communication skills. An individual might have mood episode or
any emergency treatment. There should be availability of resources that
can fulfil needs of a patient. The medicines should be kept away from the
reach of Adam, as he earlier tried to kill himself by the use of his own
medication, which makes this step as a concerning step. There is need

for the safety which can allow to share all the needs which may Adam
needs and should be delivered for improving in confident regarding
getting healthcare treatment and care. This can ensure for getting better
safety concern while getting care and treatment.
STEPS 5 and 6
Reflect on the
parting comment
made by the night
duty RN about the
consumer (this is
located in the course
outline)
STEP 5 - EXPRESS
What are the key issues which are present
in this scenario?
1. Feels to have high energy during night
2. Restlessness
3. High dose of Medicines i.e. Lithium
Carbonate XR and Quetiapine
STEP 6 – REFLECT
While delivering healthcare treatment and services, I have observed that
there are many key issues which are highly effective in present that can
lead to create high impact on the patient (Adam). I have found that need
of high energy during night, restlessness and high dose of medication
can create issues for the patient. However, there is need to get proper
care of patient to avoid such type of risk. I have observed through case
study that at night, an individual seems to be have energy. Hugh energy
in a body can inopportune the sleep pattern of an individual. This can
lead Psychomotor unsettling regularly influences individuals with bipolar
turmoil, yet it is additionally connected with different conditions that
influence emotional wellness or neurological capacity. It is an actual
articulation of uneasiness and mental pressure. I felt that this can take
many structures, some that are less significant and others that are more
extreme. It includes tedious, purposeless or inadvertent developments
and practices. These developments and practices are made in light of
sensations of fretfulness brought about by expanded nervousness. As
per the observation, in condition of bipolar disorder I have determined
that an individual may struggles with his or her thoughts and might lose in
the actual reality. High dose of medicine can make an individual more
fragile. The medicines which should be provided to Adam, should be
more specific, and that are able to fulfil the demands of a person. As per
the studies, I concluded that during nights, an individual also get

hallucination that are sometimes harder to mage for an individual. Mental
illness is associated with mental challenges, that can have minimized
through the intervention of awareness in respect of disorders. I have also
ensured about the Adam’s safety and getting better health through
providing better medication which can be effective to provide better
improvement in health. This can help to get ensure about high energy
during night. I have also cared about ensure about Adam’s restlessness
which can be cared through using of medication. As a registered nurse, I
need to get ensure about the medication high doses which can have
adverse health impact on Adam that can lead to create difficulty and also
negative health impact which can further can impact difficulty in getting
better health and can have higher risk of getting further complications.

References:
Abdul-Muhsin, H., Critchlow, W., Navaratnam, A., Gnecco, J., Tay, K., Girardo, M., Andrews, P., Cheney, S. and Humphreys, M., 2020. Feasibility
of holmium laser enucleation of the prostate as a 1-day surgery. World journal of urology, 38(4), pp.1017-1025.
Al-Maraira, O.A. and Hayajneh, F.A., 2019. Use of restraint and seclusion in psychiatric settings: A literature review. Journal of psychosocial
nursing and mental health services, 57(4), pp.32-39.
Burke, D. and Cocoman, A., 2020. Training needs analysis of nurses caring for individuals an intellectual disability and or autism spectrum
disorder in a forensic service. Journal of Intellectual Disabilities and Offending Behaviour.
Chiang, K.J., Tsai, J.C., Liu, D., Lin, C.H., Chiu, H.L. and Chou, K.R., 2017. Efficacy of cognitive-behavioral therapy in patients with bipolar disorder:
A meta-analysis of randomized controlled trials. PloS one, 12(5), p.e0176849.
Duffy, A., Vandeleur, C., Heffer, N. and Preisig, M., 2017. The clinical trajectory of emerging bipolar disorder among the high-risk offspring of
bipolar parents: current understanding and future considerations. International journal of bipolar disorders, 5(1), pp.1-11.

Mistry, S., Harrison, J.R., Smith, D.J., Escott-Price, V. and Zammit, S., 2018. The use of polygenic risk scores to identify phenotypes associated with
genetic risk of bipolar disorder and depression: A systematic review. Journal of affective disorders, 234, pp.148-155.
Parker, J.M. and Hill, M.N., 2017. A review of advanced practice nursing in the united states, canada, australia and hong kong special
administrative region (SAR), china. International Journal of Nursing Sciences, 4(2), pp.196-204.
Vanderplow, A.M., Eagle, A.L., Kermath, B.A., Bjornson, K.J., Robison, A.J. and Cahill, M.E., 2021. Akt-mTOR hypoactivity in bipolar disorder gives
rise to cognitive impairments associated with altered neuronal structure and function. Neuron, 109(9), pp.1479-1496.