HSNS 205 Case Study Mary.

Case Study:

Mary is 45 years old. She was admitted to a

secure mental health unit as an involuntary client 2 days ago, following her presentation to the A&E department with her husband of 25 years, Ian. Ian mentioned to the A&E mental health nurse that he was getting very worried about Mary and her reputation. Ian says that overthe last month Mary has become increasing ‘high’. ‘She just never stops. She is hardly sleeping at all, and she is not eating much.

She has been spending heaps of money, which we don’t have, on things we don’t want. It doesn’t make any sense’.

Ian goes on to report that Mary is drinking a lot of alcohol and that usually she hardly ever drinks. She has been talking about sex to a lot of different people. Ian notes that this is unusual behaviour for her, however he has seen it a couple oftimes before in their life together. He doesn’t know what has triggered this episode. Mary was reluctant to stay in hospital, however the mental health nurse identified a number
of mental health risks and when seeking her voluntary admission failed, the mental health act was applied and the client was admitted to the
mental health unit.

The mental health team have been monitoring and observing Mary’s mental health over the past 48 hours. They have

noted that Mary is not sleeping and that her mood is extremely elevated. Her attention to personal grooming and her body language has
sexually promiscuous overtones. Her speech is loud and the content doesn’t always make sense.

Today she has taken part in some craft

activities in the unit and chosen to paint herjeans with some words and phrases. She has also done a collage and presented it as a gift to
the mental health staff: Mary would like to leave the unit and considers that there is nothing wrong with her. She states that ‘all that

she needs is to be able to show her love to others’. Today she has chosen to wear very brightly coloured and patterned clothing and bright
red lipstick which she has applied thickly, and some of which has smudged. She has chosen to fasten only two buttons on her shirt. She is ir
a hurry have her interview with her mental health workers, because she believes she should go home. She has not yet commenced any
medications, however, the mental health team will review her today and recommend that she commences Olanzapine (Zyprexa) 15mg per day
that she remain in hospital until this acute manic episode is reduced and her safety can be assured.
1- Describe the mental health problem ofthe client in the case study and discuss the prevalence ofthis mental health problem in Australia.

2- What is meant by:
consumer-oriented mental health care? How can this be implemented? Outline the benefits of involving consumers in their own care. Support
your response with evidence from the literature. (Chapter 15 of your Edward et al. (2011) prescribed text will assist you to respond to this
question).

3- Identify medicationls that islare commonly taken for this mental health problem and discuss the nursing management of side

effects related to this medication and how these side effects should be monitored and minimized. (Your prescribed textbook Usher et al
(2009) will assist you to respond to this question).

4- Identify risk factors for the physical health of your case study client. Discuss

the promotion of physical and mental health goals for your client. (Your Edward et al.(2011) prescribed text and your other unit readings
will assist you to respond to this question).

5- Discuss the assessment strategies that are likely to be used for this client and

prioritize them in relation to risk status. (Chapter2 in your Edward et al. (2011 ) prescribed text and MH-OAT will assist you to respond

to this question.

5- Identify the health and well-being problems and relevant nursing interventions for the client in your

case study. Present the problems in order of priority. Demonstrate your clinical reasoning by selecting nursing interventions that can be supported with evidence from the literature.

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