My Psychiatric Clinical Rotation At Carney Hospital

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

Pt has x5 hx of IP hospitalizations, most recent was April 2015 due to SI. Pt currently receive intensive in home therapy x2 week through integrated helath services. She also receives outpatient psychiatry thorugh Dr. Burk Seigle. Pt is currently prescrived Vyvanse 50 mg daily, Abilify 5mg daily, Clonidine .01mg daily. Pt has not been compliant with Vyvanse or Clonidine due to pt mother does not want medication to be come addicted to medication. Per report from mother she is trying to wean pt off her medication to help stabilize

In the vignette provided Tommy, an 11 yr.-old male Hispanic male is suffering from numerous symptoms such as compulsive behavior, extreme mood swings, difficulty engaging in meaningful conversations and problems with concentration, to name a few. Tommy first started showing signs of disruptive and hyper behavior as early as 18 months. There are numerous factors both environmental and biological that have affected Tommy’s development and care. His mother and maternal grandmother both suffer from bipolar disorder. While pregnant with Tommy his mother had adequate prenatal care however, she may have exposed her son to various harmful substances. Also, prior to becoming pregnant Tommy’s mother had been on numerous medications for substance abuse, severe depression and suicidal ideation.

She leaves her front door unlocked because she lives alone, which places her at risk for harm along with her health conditions. She has been hospitalized four times in the last six months for CHF. Her blood pressure and heart rate are low, respirations high, and no oxygen saturation. She refused the home oxygen delivery. She has had a fourteen pound weight gain since her last admission. There is no edema, has hypoactive bowel sounds, and no bowel movement for three days. She is nauseous, has no appetite, a cloudy head, and has no energy. Her nutritional intake is probably poor. She appears lonely, and may be depressed. She has three new medications, and discharge orders to continue her previous mediations also. There are duplicate prescriptions for two medications with different dosages than she was taking previously. The medication bottles were on the coffee table in disarray. Sallie Mae may not know what medications she is

Her pill bottles were on the table and it appears she has not had proper medication education and reconciliation. Her discharge medications duplicate some of her previous medications with generic vs. brand names. This can be very confusing and dangerous for Sallie Mae. Her discharge instructions stated to “Continue other home meds” without the caveat to discontinue the furosemide and lanoxin; discharge instructions must be clear and concise. Discharge medications must be reviewed against her list of current medications listed at time of admission. A complete review of a patient’s admission medications and reconciliation with her discharge medications along with education and instructions prior to discharge improves patient care and reduces unnecessary readmissions (Hume & Tomsik, 2014). There are services that deliver medications and oxygen to qualified individuals and she should

Ms. Maness is a 45 year old female who presented to the ED with an alleged overdose on 3 pills of Keppra and 3 pills of Librium in a attempt to harm self. Ms. Maness denies suicidal ideations, homicidal ideations, and symptoms of psychosis. Ms. Maness reports a history of Alcohol abuse and recently was 3 days sober, however last night relapsed after conflict with hr boyfriend. Ms. Maness does not appears to be responding to any internal stimuli.

It is a basic principle of law in this country that an adult, mentally competent person has the right to refuse treatment. The court of appeal has emphasised that provided the patient has the necessary mental capacity, which is assessed in relation to the decision to be made, then he or she can refuse to give consent for a good reason, a bad reason or no reason at all (Dimond, 2008). However, in this case it is in the best interest of the patient that the MDT administrated medication covertly. The legal issue identified in this case relates to the issue of consent. Within the case study professionalism had to challenged when it came to the capacity of the patient. The MDT had to resolve the legal issues associated with capacity and consent.

In less than a years time, Kyle Warren had been seen by four different medical doctors, each one with their own diagnosis that included autism, bipolar disorder (also known as manic depression), insomnia, attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Kyle's pill regimen kept multiplying, consuming daily harmful cocktail of mind- altering drugs including Risperdal (anti-psychotic), Prozac (antidepressant), Adderall (psycho-stimulant) and two sleeping medicines. Kyle Warren was only eighteen months old at the time (Wilson 11). Kyles story is not rare, in fact, it has became what I refer to as a “to common” case. For that matter, it was a story much like this one that got me interested in the

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.

The patient has 54 years and completed the electronic screening. The results were negative for suicide ideation (C-SSRS), mild for depression (CUDOS: 30), moderate for anxiety (CUXOS: 33), positive severe for medication non adherence (MMAS-8: 5.25), positive for tobacco and negative for alcohol and illegal drugs (NIDA ASSIST). The patient agrees with the results and he has previous treatment for depression. Moreover, sometimes he doesn’t take the medication due his financial situation. . Furthermore, the recommendation is continue with his mental health treatment, make a referral to our patient navigator to explore pharmaceuticals programs without cost for the patient, and monitoring the medication adherence in two months. Eunice Malave de

There are over a hundred different types of mental disorders but the most common psychotic disorder is schizophrenia. Schizophrenia affects approximately 3.5 million people in the United States. The symptoms include: “hallucinations, delusions, disorganized thinking (speech), grossly disorganized or abnormal motor behavior (including catatonia) and negative symptoms.” ( Barnhill 19) Symptoms of schizophrenia begin to appear around late youth/ early adulthood and must be persistent for a length of at least six months to be concluded as schizophrenia. DSM-IV analyzes the schizoaffective disorder in which patients must show signs of “major depressive

My current therapy practicum at Hartgrove Hospital is primarily focused on Cognitive-Behavioral Therapy but as I have been working with clients over the past 6 months, I have experienced some personal and professional discrepancies between the theory of CBT and how I conceptualize clients and my role as a therapist. The hospital emphasizes the teaching of coping skills, which in line with CBT has the client learning new ways of handling their emotions. While I agree that teaching coping skills, cognitive restructuring, etc. are important for many clients, I have consistently felt like something was missing. I have been exposed to Acceptance and Commitment Therapy (ACT) briefly in the past during my classes and during a didactic at practicum, but I have not done an in-depth examination of how it differs from CBT and what its theoretical and philosophical bases are. I wanted to take this paper as an opportunity to learn more about a therapy that may fit better with how I work with clients and how I view my role as a therapist.

The patient completed the electronic screening by herself. She has 25 years and the results were negative for suicidal ideation (C-SSRS); positive for depression (CAD-MMD, CAT-DI 58.3); positive for anxiety/mild (CAT-ANX: 42.5); negative for mania/hypomania (CAT-M/HM 40.3), she is not taking any medication and is negative for NIDA assist/alcohol (0). Furthermore, the patient denied hallucinations, delusional ideas are not present, and she is oriented (time, place and person). The results were discussed with the patient and Ms. Kubay, NP. The patient should consider an evaluation pharmacotherapy and psychotherapy. The patient does not have mental health history. She prefers start the process with us and then do the transition to other clinic

I received an urgent message from Cynthia Wallace, who was taking calls on the Nursing line. She stated that the patient called and reported that she is experiencing feelings of depression and becoming very suicidal. The patient informed her that she had discontinued he medications around two weeks ago.

The patient is a 56-year-old gentleman who is brought to the emergency room by his family because of increasing combative behavior, agitation and inability on their part to care for him is refusing refusing to eat and threatening to leave the home. He was diagnosed with Alzheimer's disease several years ago at Columbia University hospital by Dr. Britton at that time had such severe behavioral disturbances that he had to be have inpatient hospitalization to stabilize his behavior. At one point he was on Seroquel which has been tapered down and the wife evidently stopped it. He had recently been seen by psychiatrist in Clifton who has him on Risperidol and Xanax but they have not controlled his behavior. According to our psychiatrists who