Case Study Mr. Stevens

Mr. Gillespie is a 21 year old male who presented to the ED after an intentional overdose on 20 600mg of Gabapentin. Per documentation from ED staff Mr. Gillespie reported he became angry at his grandmother tonight and tried to "prove a point." Mr. Gillespe reported to staff threatened to overdose on his on pills, however dumped them in the toilet. He expressed after making threats to overdose on his prescribed Celexa did not phase his grandmother, he proceeded to take her Gabapentin. Per documentation Mr. Gillespe has been living with grandmother for 2 weeks and before that was living with his mother in Cary. At the time of the assessment Mr. Gillespie was calm and cooperative. He denies current suicidal ideation, homicidal ideation, and symptoms of psychosis. He appears guarded during the assessment. He reports tonight his grandmother and he got into an argument over him getting a job. He reports his grandmother informed him he has to be out by Friday. Mr. Gillespe denies history of self harm. He

is a nurse practicing in Missouri that has, already, previously been placed on probation for testing positive for heroin. She has recently had a relapse in her recovery and is fighting to get her license back so she can practice nursing. The state board has already given her one chance and she was practicing in Missouri. She has been sober for nearly 3 years and has taken suboxone the entire time of her sobriety to help with withdrawal. E.M. hates that she has a dependency on the suboxone and wanted very badly to wean herself off of it. She spoke with her physician about this matter and her physician strongly suggested that she not be taken completely off her prescription of suboxone. Her physician lowered her dose and she began taking a lower dose. After time passed, E.M. felt like she had things under control and she completely stopped taking her prescription. E.M. went under some stress at her job and ended up leaving the facility she was working at. She knew that one of her old co-workers had access to heroin and after running into him at a local store, she started abusing again. Beginning at the time of her first time being placed on probation E.M. has been required to provide urine samples at randomly selected intervals. During her time of remission, when she was abusing, she failed to call and leave urine samples. At this time, E.M. explained that she was focusing on bettering herself and working on her sobriety. I feel that E.M. was very sincere and was accountable for her actions. She truthfully took responsibility for her wrongful actions. E.M. stated that she now realizes that her heroin addiction is a lifelong addiction that will always be knocking at her door and she cannot stop taking suboxone. The board questioned her and wanted to make sure she did not have plans of going against her physician’s orders again. E.M. was in tears almost the entire time she was explaining her actions to the members of the board and I feel like they were true

S: "I got dizzy and lightheaded." Subject stated he was on hi way home to Kansas City when he took a surge energy drink. Pt attend after that he got lighthead and dizzy so he pulled over. Pt stated at that time he started having anxiety problems and hyperventilating and his hands began to cramp. Pt stated he called his mom who called 911. Pt stated he felt better after he claimed down and got his breathing under control. Pt states he rarly drinks caffeine and avoids coffe or any type of energy drink. Pt states his mom gave it to him for the long drive home. Pt denies any current s/s and states "I feel fine now." Pt states, "I will be fine and don't need to

Mr. Saunders is a 60 year old male who presented to the ED via LEO under petition by his niece, Rachelle, for allegedly putting a gun into his mouth, him putting a gun in another individuals mouth called "legs", and increasing alcohol consumption. At the time of the assessment Mr. Saunders is calm and cooperative. He denies suicidal ideation, homicidal ideation, and symptoms of psychosis. Mr. Saunders reports he has been depressed for several months and has been binge drinking alcohol. He reports relational issues with his wife has been the primary stressor contributing to his distress. He express feelings of hopelessness, worthlessness, irritability, and isolation. He does admit to informing a friend, William, he see no reason to leave if he can not be with his wife. Patient does not appear to be exhibiting signs of agitation,

The following case study is of a 37-year old Hispanic male weighing 145 lbs and 70 inches tall found unconscious by his girlfriend. According to her he was unconscious for about 15 hours and she was concerned because he would not wake or respond and was breathing shallow and slow. She then called 9-1-1. The patient entered the ER by emergency vehicle and on my initial assessment Pt had an altered mental status, was very unresponsive showing symptoms of a possible drug overdose. The girlfriend told the physician the Pt had taken 75 mg of methadone and an unknown amount of Xanex and other amounts of Benzodiazepines. On assessment, the doctor noticed his altered mental status and unconscious status. He had a gag

Ms. Webster is a 28 year old female who presented to the ED via LEO under IVC by her mother for suicidal ideation and alcohol dependence. Ms. Webster denies allegations to nursing staff. Per documentation she appears intoxicated. Per documentation Ms. Webster states, "Going through withdrawals". Before assessment this clinician spoke with nursing staff about Ms. Webster, they reports she has been asking for Ativan since she has been placed in her room. They reports she informed them that she had not consumed any alcohol today. At the time of the assessment Ms. Webster is found sitting upright in her room. Ms. Webster reports she had a plan to hang herself. She states, " you know I have to say that to get into detox." Ms. Webster reports alcohol abuse as primary stressor contributing to her distress. She denies depressive symptoms. Ms. Webster states,

Mrs. Payne is a 48 year old female who presented to the ED via EMS following her visiting to Liberty, NC from Greensboro and going into the police department and reporting she was having suicidal thoughts to wreck her car. During Mrs. Payne being triage she informed ED staff of compliant as a plan to over dose on Oxycodone at home. She reports not being able to get to prescribed Geodon and Valium for the past 2 weeks.

Presenting Problem: Pt is 16 y/o female who is currently at Tuckers Pavilion Acute facility. 8/7/16 Kelly refused to take her medication, and was generally noncompliant to staff directions. She communicated AWOL intent; she also broke a lightbulb to make a number of superficial cuts to her arm, but refused to turn in the glass an dstated that she had flushed it down the toilet. She refused first aid and refused to cooperate with staff directions. She also communicated that she was going to do worse things to herself, Intercept contacted crisis stabilization which transitioned the child to Tuckers Psychiatric at 6am. 8/12/16, Pt was upset to find out she was not getting discharged from Tuckers. Require hydroxyzine 50mg at 1530 medication

Dr. Gentry requested an assessment for Kaitlin Bradley, an 19 year old female who presented to Randolph Hospital ER reporting suicidal ideation, with a plan, and symptoms of psychosis, and homicidal ideation. She stated " I plan to do some stupid shit". Ms. Bradley reports she has had suicidal ideation daily since the age of 10, She reports that in the past two weeks her suicidal ideation has gotten worse. She reports yesterday she was suicidal and reports if she was going to kill herself she would overdose no whatever pills she can get her hands on. Ms. Bradley reported cocaine and marijuana use, which was confirmed in her drug screening. She reports she came to the hospital so she would not harm herself. Ms. Bradley has a history of suicide

Your affiant requested David J. Yashinsky Jr. to submit to a series of psychophysical divided attention tests; none of which he was able to successfully complete. Your affiant informed Yashinsky of my findings and requested him to submit to a chemical test of blood. He refused to submit to the blood test stating he just waned to go home like last

REPORTER: The reporter/ Social Services Director (Vernestine) called with concerns for the victim, Tanya. Tanya has had an aneurism, and she has paralysis. The reporter said the victim’s cognition is off, and she cannot perform her daily ADL’s, but she can talk. The reporter said Tanya has two small children, but her mother (Phyllis) may be keeping the children. The alleged perpetrator is Bryan Blakemore (Husband). On Yesterday (03/29/2016), the victim was discharged AMA (on medical advice). The reporter said when the victim is discharged AMA, they are not given any medications. The victim left with out any medications, but Bryan was given a list of all the victim’s medication. Bryan said he was going to see a doctor in Jackson, MS to have

CPI arrived at the family residence located at 149 S Calhoun Avenue, Eatonville, FL 32751. CPI completed a joint visit with Taina L. Ramos FIS Counselor. Taina completed a BHC screen with Mr. Clayborne. Mr. Clayborne admitted to have a history of alcohol misuse and impulsive and aggressive behavior while under the influence. He began drinking while in his 20’s and drinks 1 to 2 times weekly. Mr. Clayborne drink preference is beer, but sometimes drinks vodka. He usually drinks when is stressed out. He has been to Alcoholics Anonymous meetings in Springfield, MA. The last meetings he attended was about 2 years ago. While in prison was seen by a psychiatric five times a day for 3 months, but is it not diagnosed with a mental health condition.

I made contact with Powell, Jermaine L. DOB 02/02/77, who related he had a verbal argument with his wife (Powell, Denise DOB 02/24/81 over the discipline of their child (Powell, Nathan L. DOB 09/18/12). Jermaine related that Denise has bi-polar disorder and takes medication. Jermaine further related she has mood swings causing them to fight. Jermaine related he and Denise were separated and recently reconciled one (1) month ago. While I having a conversation with Jermaine I observed signs of impairment, he had an odor of an alcoholic beverage emanating from his breath and person.

D-Met with the patient upon request. Upon meeting with the patient, the patient appeared upset and addressed her frustration in this writer's office. According to the patient, she's upset with her PCP forcing the patient to admit herself to the psych. ward to get on medication. Failure to do so, her PCP will complete the medication protection for her electricity. The patient owes over $3000 and with the protection, her light company cannot turn off her lights. Please note, the patient was pacing back and forth and getting emotional. This writer consolet he patient and validated her feelings. According to the patient, she reports that CMHA informed her that she in order to get into their clinic, an evaluation is needed whereas the evaluation can be completed at a hospital; however, the patient is worried about being admitted. Please note, the patient denies any suicidal or homocidal ideation when questioned.

a 44 year old Divorced African Male came into Henry Ford Hospital ED as a walk-in and told the HFHS staff that he was having mental health issues he does still struggle with depression and anxiety. The consumer stated that he initially went into the hospital after his brother was shot twice in the head. At that time the client reports that he was placed on Risperdal, while at Kingswood in January, and he became a zombie at that time. He stated that he has been in and of the hospital multiple times since then, and each time, he has been placed on Risperdal and he doesn't feel that his meds were ever adjusted correctly.