NURS 6640 - Week 1 Assignment 1 Journal Entry. Practicum Experience Time Log and Journal Template.

NURS 6640 - Week 1 Assignment 1 Journal Entry. Practicum Experience Time Log and Journal Template. Time Log Week Dates Times Total Hours for This Time Frame Activities/Comments Learning Objective(s) Addressed 1 2/269:30- 10:40 40 Mins Counseling session with 53 y/o male dx w/ Depression. Pt admitted for chest pain and positive drug screen for cocaine, alcohol and marijuana. No hx of tx for depression. During therapy session, pt admitted to thoughts of suicidal idealization and financial hardship causing stress as pt is to be evicted for nonpayment. Counseled pt on outpt tx centers and ongoing outpt therapy. Pt has no desire at this time to quit drinking, to attend therapy, or take medications. Will follow up with pt as he is still actively withdrawing from alcohol. Sitter in room for safety. Incorporated Eeickson's Modeling and Role Modeling Theory that emphasizes unconditional acceptance, nurturance, and facilitation as the nurse helps the patient take steps toward a healthy lifestyle. Providing the patient with resources and information of for outpatient psychotherapy sessions, alcohol support groups and financial assistance gives the patient a sense of affiliated individuation. Continuation of therapy is necessary throughout hospital stay to build on this patient drive to be accepted and dependent on support systems. As of today, the patient continues to have basic needs unmet which leads to distress and progressed illness. Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory. Retrieved from erickson-modeling-androle- modeling-theory 1 2/2610:50- 11:30 40 Mins Follow-up therapy with 72 y/o male dx with paranoid schizophrenia admitted to the hospital for acute renal failure r/t attempted suicide. Pt admits to not taking his antirejection meds from his renal transplant in 2007 in hopes that his kidneys will fail, and he will die. Pt believes aliens have abducted him and his family 20 yrs ago and by dying is the only escape from them. He believes that the aliens are trying to kidnap him for sex trafficking. Pt also reports feeling hopeless and depressed. Therapy with redirection failed as pt is very paranoid of hospital staff at this time. He does not respond to internal stimuli during the interview and is © 2014 Laureate Education, Inc. Page 1 of 25 Practicum Experience Time Log and Journal Template reluctant to talk about the aliens in depth as he is afraid of being sent back to the psychiatric inpatient hospital. Pt is being maintained on Depakote 375 mg a day at HS, Zyprexa 10 mg at HS, and Seroquel 50 mg once daily at HS. Remeron 7.5mg once daily started to help with sleep and Zyprexa increased to 15mg daily. Will follow up tomorrow. 1 2/2611:45- 12:45 60 Mins 58 y/o female dx w/ Bipolar II came in unresponsive from home. Conducted initial assessment and interview with pt. Noted hallucinations, delusions, and very paranoid. Pt was violent towards the nurse last night, grabbing her by the neck and pulling her to the ground. Pt home meds held that are sedating. Pt in 4-point restraints and being certed to inpatient psychiatric hospital. Restarted home dose of Seroquel XR 400mg at HS. Attempted to calm patient and reorient, but patient was very paranoid stating that staff are "poisoning her". 1 2/261:00-2:00 60 Mins 56 y/o Follow up with pt that was admitted for AWA, Depression and needing to be screened for risk of suicide. Pt has depression and reports bursts of anger that he cannot control well. Suicide screen included questions such as "have you ever tried to hurt yourself?", "have you ever thought of a plan?", "has anyone in your family committed suicide?", "do you feel hopeless?", "do you feel like your life isn't worth living?". These questions have ruled the pt out for immediate risk for suicide. Sitter remains in room for one more day to monitor while home medications are restarted, and new medications have time to work. Therapy included utilization of the nursing theory Orlando's Nursing Process Discipline, in which role of the nurse is to identify immediate needs for help (Petiprin, 2016). Started pt on 300mg of Seroquel daily at bedtime to help with mood. Will follow up with patient tomorrow. Orlando's Nursing Process Discipline Theory was used to identify the patient who has cried out for help by attempting suicide at home. As pt is feeling helpless with his current health state, he remains depressed and it’s the nurse’s role to provide direct assistance to the patient’s avoidance of the feeling of helplessness. Petiprin, A. (2016). Psychiatric and mental health nursing. Nursing Theory. Retrieved from erickson-modeling-androle- 1 2/2614:30- 15:30 60 Mins 53 y/o Admitted with Bipolar, Polysubstance Abuse and hx of domestic violence. Initial consult with pt conducted, assessment and interview completed. Pt reports her husband throwing her into a mirror, police being called and him having to leave. She stated that she had much to get done so she "took her friends Adderall, drank alcohol and took her home meds". Pt has no suicidal idealizations, hallucinations or delusions. Offered domestic violence information and resources. Offered emotional support and encouragement. Pt also referred for outpatient psychiatric services for consistent therapy. Pt would not accept any DV information at this time and is in denial about her husband being abusive. Pt © 2014 Laureate Education, Inc.