Bipolar/Depression Case Study RNUR 2050 Luis Chaves is a 22-year-old who migrated to Miami at the age of 2 years with his parents. He is unemployed and lives with his sister. He is actively involved with an intercity gang and depressed. T oday he intentionally overdosed with paroxetine, zolpidem, oxycodone and alcohol. He goes to his sister’s apartment to say goodbye
after taking the drugs and alcohol and confesses to overdosing. His sister immediately calls 911 as be became unconscious. On the way to the emergency room Luis was treated with naloxone, which produces a rapid improvement in his level of consciousness. He becomes agitated and starts yelling that he “doesn’t want to live anymore.” This is the report from the emergency squad:
We responded to the residence at 2204. Upon arrival we found a 22-year-old male unconscious. Sister reports that the client stated overdosing with paroxetine, zolpidem, oxycodone, ibuprofen and alcohol. Patent airway and breathing spontaneously at 8 resp. a minute, pulse 60 bpm, blood pressure 90/58 mmHg. Naloxone administered during transport and client’s level of consciousness increased. Began yelling “I don’t want to live anymore.” Respirations 20 breaths per minute, pulse 90 bpm, blood pressure 148/988. Handoff report given to emergency room nurse.
Answer the following questions related to the above information:
1.You have received report from the emergency squad, what are your top three priority concerns? 1. Safety- pt tried to commit suicide and doesn’t want to live anymore, so suicide precautions.
2. Blood pressure- elevated 3. Respiratory because of relapse of decreased respirations after Narcan wears off.
2. As the nurse triaging Luis what is your priority focused assessment? 1.Cultural preferences
2.Respiratory status
3.Suicide risk
4.Substance abuse history 3. Luis responded to naloxone on the way to the emergency department. Which of the following substances would not react to naloxone? ( Select all that apply ) This study source was downloaded by 100000858369494 from CourseHero.com on 02-21-2024 11:30:23 GMT -06:00
https://www.coursehero.com/file/78214162/Bipolar-and-depression-case-studydocx/amurimi 1.Paroxetine (Paxil)
2.Zolpidem (Ambien )
3.Oxycodone
4.Ibuprofen
5.Alcohol Luis is stabilized in the emergency department. He reports feeling “desperate” over
being estranged from his 4-year-old son and the negative consequences of his current life decisions. He goes on to discuss conflicts that he has with his mother, his inability to find a job, the recent deaths of several close friends murdered in gang violence, and feelings of helplessness, hopelessness, and depression and self-
loathing. He shares that his biological father is an alcoholic and has a drug abuse problem. He denies that he has problems with alcohol because he “just doesn’t like the taste” and only drinks one or two times a month. He also states that he doesn’t take drugs because he doesn’t “like the way they make me feel”. Luis states that he has a family history of depression, schizophrenia and bipolar disorder. At age 14 he tried to commit suicide for the first time and has made three attempts since then
and has been hospitalized for this. He says, “I wish I hadn’t gone to my sister and told her what I did; then this would be over.” He denies feeling suicidal currently. 5.What is the best predictor of a suicide attempt? 1.A family history of suicide attempts
2.Previous suicide attempts 3.Stating suicidal intent
4.Having a friend who had a suicide completion 6 You continue your assessment. What questions should you ask? ( Select all that apply)
1.“What medications are you currently prescribed besides oxycodone?”
2.“T ell me more about any illicit drugs you have taken in the past.”
3.“How do you feel about your attempt being unsuccessful?” 4.“What is your relationship with your sister?”
5.“Tell me more about your family history of mental illness.”This study source was downloaded by 100000858369494 from CourseHero.com on 02-21-2024 11:30:23 GMT -06:00
https://www.coursehero.com/file/78214162/Bipolar-and-depression-case-studydocx/amurimi
after taking the drugs and alcohol and confesses to overdosing. His sister immediately calls 911 as be became unconscious. On the way to the emergency room Luis was treated with naloxone, which produces a rapid improvement in his level of consciousness. He becomes agitated and starts yelling that he “doesn’t want to live anymore.” This is the report from the emergency squad:
We responded to the residence at 2204. Upon arrival we found a 22-year-old male unconscious. Sister reports that the client stated overdosing with paroxetine, zolpidem, oxycodone, ibuprofen and alcohol. Patent airway and breathing spontaneously at 8 resp. a minute, pulse 60 bpm, blood pressure 90/58 mmHg. Naloxone administered during transport and client’s level of consciousness increased. Began yelling “I don’t want to live anymore.” Respirations 20 breaths per minute, pulse 90 bpm, blood pressure 148/988. Handoff report given to emergency room nurse.
Answer the following questions related to the above information:
1.You have received report from the emergency squad, what are your top three priority concerns? 1. Safety- pt tried to commit suicide and doesn’t want to live anymore, so suicide precautions.
2. Blood pressure- elevated 3. Respiratory because of relapse of decreased respirations after Narcan wears off.
2. As the nurse triaging Luis what is your priority focused assessment? 1.Cultural preferences
2.Respiratory status
3.Suicide risk
4.Substance abuse history 3. Luis responded to naloxone on the way to the emergency department. Which of the following substances would not react to naloxone? ( Select all that apply ) This study source was downloaded by 100000858369494 from CourseHero.com on 02-21-2024 11:30:23 GMT -06:00
https://www.coursehero.com/file/78214162/Bipolar-and-depression-case-studydocx/amurimi 1.Paroxetine (Paxil)
2.Zolpidem (Ambien )
3.Oxycodone
4.Ibuprofen
5.Alcohol Luis is stabilized in the emergency department. He reports feeling “desperate” over
being estranged from his 4-year-old son and the negative consequences of his current life decisions. He goes on to discuss conflicts that he has with his mother, his inability to find a job, the recent deaths of several close friends murdered in gang violence, and feelings of helplessness, hopelessness, and depression and self-
loathing. He shares that his biological father is an alcoholic and has a drug abuse problem. He denies that he has problems with alcohol because he “just doesn’t like the taste” and only drinks one or two times a month. He also states that he doesn’t take drugs because he doesn’t “like the way they make me feel”. Luis states that he has a family history of depression, schizophrenia and bipolar disorder. At age 14 he tried to commit suicide for the first time and has made three attempts since then
and has been hospitalized for this. He says, “I wish I hadn’t gone to my sister and told her what I did; then this would be over.” He denies feeling suicidal currently. 5.What is the best predictor of a suicide attempt? 1.A family history of suicide attempts
2.Previous suicide attempts 3.Stating suicidal intent
4.Having a friend who had a suicide completion 6 You continue your assessment. What questions should you ask? ( Select all that apply)
1.“What medications are you currently prescribed besides oxycodone?”
2.“T ell me more about any illicit drugs you have taken in the past.”
3.“How do you feel about your attempt being unsuccessful?” 4.“What is your relationship with your sister?”
5.“Tell me more about your family history of mental illness.”This study source was downloaded by 100000858369494 from CourseHero.com on 02-21-2024 11:30:23 GMT -06:00
https://www.coursehero.com/file/78214162/Bipolar-and-depression-case-studydocx/amurimi
