NURS310 Lecture Notes - Lecture 5: Vecuronium Bromide, Financial Adviser, Bupropion
22 Jun 2018
School
Department
Course
Professor
Depression and suicide risk
Unfolding Case Study
•Introduction
•An unfolding case study involving a suicidal male patient is presented.
•The situation begins with the patient presenting to the emergency department with
suicidal ideation. He is accompanied by his wife.
•The scenario ends with discharge planning.
•This case study is divided into the following segments:
1. Admission – (admission interview, formal status, patient rights, observation level,
suicide risk assessment).
2. Interventions for inpatients (Group Therapy, ECT).
3. Serotonin Syndrome.
4. Discharge planning and follow-up.
* Suicide Risk Assessment is a focal point of this presentation and is woven throughout all
stages.
•Scenario – Segment 1 (Admission)
The patient, Mr. Smith, is brought to Emergency Room, accompanied by his wife of 30 years.
He appears neatly dressed and well groomed. His affect is flat and he appears despondent.
You are working as an RN in emergency and have been assigned to the patient.
•Scenario continued
The triage nurse has assessed the patient and the note you received is:
•60 year old male patient with suicide ideation present.
•Recent significant financial loss following investment in high-risk venture.
•Patient had previously advised many other people to invest in the same venture.
•Delusional belief that he will be legally liable for the losses of others.
•Scenario Continued
•The patient was certified x 1 in ER.
•Certificate states:
•Suicide ideation with plan
•Believes he deserves to be punished
•Despondent and hopeless
•Patient is admitted to an inpatient bed.
•On the Unit
•The patient is seen by a psychiatrist who writes a second certificate.
•Admission orders are written:
• Celexa 20 mg po q morning; ativan 1 mg
po q 4 h prn; zopiclone 7.5 mg q hs prn
•Q 15 minute obs; no passes or privs
•DAT, AAT, routine vitals
•Questions
•What is a “Form 1?”
•How long is a certificate good for?
•How does this change when a second certificate is written?
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•What is a “Form 12?”
•When would this be used?
•What are the patient’s rights under the mental health act?
•Answers
•Form 1 is a Certificate that indicates an individual is
•Suffering from a mental disorder
•Likely to cause harm to self or others or to suffer substantial deterioration
•Unsuitable to be admitted other than as a formal patient.
•Certificates (x 1) are good for 24 hours
•Certificates (x 2) are good for one month
•Answers continued
Patients have the right:
•To be told the reason for admission
•To receive copies of the admission certs
•To be informed when certs expire or are cancelled
•To apply to a review panel
•Patients may fill out FORM 12 to make this application
•Continued
Patients have the right to refuse treatment if mentally competent.
Note: The hospital may control the patient without consent, to prevent serious bodily harm to
the patient or to another person. This includes medication or restraint .
•Formal Patient’s Rights
•YOU HAVE THE RIGHT to contact and receive visits from your lawyer at any time. If you
wish, you may arrange to have a lawyer assist you at the Review Panel hearing and at
the Court of Queen’s Bench.
•YOU HAVE THE RIGHT to receive visitors during regular hospital visiting hours unless
your doctor thinks that a visitor would be harmful to your health.
•YOU HAVE THE RIGHT to confidentiality of all your health information unless the Health
Information Act allows for the release of health information under certain conditions
without your consent.
•YOU HAVE THE RIGHT to confidentiality of any communications written by you or to
you. Hospital staff cannot open, read, withhold or interfere with the delivery of your
letters or notes.
•YOU HAVE THE RIGHT to contact the Alberta Mental Health Patient Advocate Office at
(780) 422-1812
(Alberta Health Advocates, Mental Health).
•Nursing Admission
•You are the nurse assigned to admit this patient. You learn the following things in the
admission interview:
•60 y.o. male; married; lives with wife and 16 y.o. son; Is supported by employment
income from his business as an investment advisor; has had recent significant financial
loss due to poor investment choices. Feels guilty because his clients will also lose
money on investments he has recommended.
•He believes he can be held criminally responsible for giving bad investment advice.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Introduction: an unfolding case study involving a suicidal male patient is presented. The situation begins with the patient presenting to the emergency department with suicidal ideation. This case study is divided into the following segments: admission (admission interview, formal status, patient rights, observation level, suicide risk assessment). 2: serotonin syndrome, discharge planning and follow-up. * suicide risk assessment is a focal point of this presentation and is woven throughout all stages. The patient, mr. smith, is brought to emergency room, accompanied by his wife of 30 years. His affect is flat and he appears despondent. You are working as an rn in emergency and have been assigned to the patient. The triage nurse has assessed the patient and the note you received is: 60 year old male patient with suicide ideation present. Recent significant financial loss following investment in high-risk venture.
