NURSING 432- FA Hannah Jackson Bipolar Disorder | Interview the Patient | Review Answers and Rationale.

Erika Hightower Hannah Jackson Bipolar Disorder . Can you tell me what has been happening lately? Rationale Relevancy Your Answer This open-ended question will enable the client to express her perception of the events leading to admission and also enable the nurse to assess her judgment and insight. Relevant Relevant Client: Things have been great. I wish people would mind their own business. They are just jealous of my success. 2. Do you ever get the sensation of heart palpitations? Rationale Relevancy Your Answer Physical symptoms such as heart palpitations occur with anxiety, not bipolar disorder. Irrelevant Irrelevant Client: I feel great. I have lots of energy. Everything is going great. 3. How long have you been feeling like you have lots of energy? Rationale Relevancy Your Answer This identifies a timeline for when the symptoms first became apparent. Relevant Relevant Client: I always feel great. I have all these ideas—I am writing a book. 4. Your family expressed concerns; they say you aren’t eating or sleeping well. Rationale Relevancy Your Answer This assesses the client’s perception of her behaviors. Relevant Relevant Client: I am so angry at them. It is none of their business what I do. A person is allowed to eat and sleep when they want. I am an adult. I can use my credit card when I want. I am sick of them being the fun police. I don’t want to talk about this anymore; it makes me want to punch something.The client leaves the room, terminating the interview. Determine if Hannah’s mood is characteristic of hypomania, acute mania, or delirious mania. Rationale Relevancy Your Answer Because of frequent mood swings, it is important to understand how the client is feeling at this moment. Relevant Relevant Assessment Data/Patient Results: Hannah is euphoric and elated. She is singing and telling the staff that she is “high on life.” 2. Assess Hannah’s ability to think logically. Rationale Relevancy Your Answer Cognition and perception become fragmented and often psychotic in acute mania. Rapid thinking proceeds to racing and disjointed thoughts. Relevant Relevant Assessment Data/Patient Results: Hannah is talking rapidly, telling the nurse, “I am so happy to be here today. What do you think is on television? I think I need to go to the shopping mall this week. Can we turn on the radio? Am I getting any visitors today? I think it might snow.” 3. Determine how long ago Hannah last slept. Rationale Relevancy Your Answer Clients experiencing mania often go for days without sleep and still do not feel tired. It is important to know how long it has been since the client rested, as a sleep-deprived individual is at higher risk for injury. Relevant Relevant Assessment Data/Patient Results: Hannah has not slept in 72 hours. 4. Assess Hannah’s feelings of sadness and dejection. Rationale Relevancy Your Answer Feelings of sadness and dejection are associated with depression. At this time, the client is exhibiting signs of a manic high. Irrelevant Irrelevant Assessment Data/Patient Results: There is no evidence that Hannah is feeling sad or depressed. 5. Assess for degree of distractibility. Rationale Relevancy Your Answer Distractibility is seen in all phases of the manic episode. This is evident in the client’s attention being too easily drawn to unimportant or irrelevant external stimuli. Relevant Relevant Assessment Data/Patient Results: Hannah is easily distracted by anyone walking by the room or any unanticipated noises.