Bipolar Depression/Mania
SKINNY Reasoning
Brenden Manahan, 35 years old
Primary Concept
Mood and Affect
Interrelated Concepts (In order of emphasis)
Psychosis
Clinical Judgment
Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
, SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Brenden Manahan is a 35-year-old male, who has been admitted to the crisis intervention unit for exacerbation of his
bipolar disorder. He was admitted on a 501 (involuntary inpatient admission, patient has been deemed either dangerous to
self or others) and brought to the hospital by police because his mother feared for his safety. In the past few weeks he
stopped taking his medication because he feared that his mother was poisoning him.
Brenden has not slept in the past four days due to racing thoughts. He believes that he is the head of the CIA and told
his mother that he needed her car to go to CIA headquarters in McLean, Virginia, and fire everyone. When the police
arrived they noted that Brenden was speaking at a very rapid rate and pace and was becoming increasingly agitated. He
began yelling that the police where there to poison him and prevent him from returning to his job.
He has been admitted to the locked mental health unit for evaluation of his mental capacity and stabilization. Brenden
will participate in the following education groups: medication education, and bipolar illness education. The goal is to
resume lithium carbonate and divalproex sodium.
Personal/Social History:
This study resource
Brenden was diagnosed at 19 with bipolar I, and subsequently has been admitted six times due to non-adherence to the
medication regimen. Brenden is divorced and has a 3-year-old son who lives with his mother. He was recently in court to
have his visitations reduced to one supervised visit a week. He lives with his mother, who is supportive.
was
What data from the histories is important and RELEVANT and has clinical significance for the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Current VS: WILDA Pain Assessment (5th VS):
T: 99.1 F/37.3 C (oral) Words: Patient denies
P: 110 (regular) Intensity:
R: 28 (regular) Location:
BP: 142/84 Duration:
O2 sat: 99% room air Aggravate:
Alleviate:
Patient Care Begins:
What VS data are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
SKINNY Reasoning
Brenden Manahan, 35 years old
Primary Concept
Mood and Affect
Interrelated Concepts (In order of emphasis)
Psychosis
Clinical Judgment
Patient Education
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
, SKINNY Reasoning
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Brenden Manahan is a 35-year-old male, who has been admitted to the crisis intervention unit for exacerbation of his
bipolar disorder. He was admitted on a 501 (involuntary inpatient admission, patient has been deemed either dangerous to
self or others) and brought to the hospital by police because his mother feared for his safety. In the past few weeks he
stopped taking his medication because he feared that his mother was poisoning him.
Brenden has not slept in the past four days due to racing thoughts. He believes that he is the head of the CIA and told
his mother that he needed her car to go to CIA headquarters in McLean, Virginia, and fire everyone. When the police
arrived they noted that Brenden was speaking at a very rapid rate and pace and was becoming increasingly agitated. He
began yelling that the police where there to poison him and prevent him from returning to his job.
He has been admitted to the locked mental health unit for evaluation of his mental capacity and stabilization. Brenden
will participate in the following education groups: medication education, and bipolar illness education. The goal is to
resume lithium carbonate and divalproex sodium.
Personal/Social History:
This study resource
Brenden was diagnosed at 19 with bipolar I, and subsequently has been admitted six times due to non-adherence to the
medication regimen. Brenden is divorced and has a 3-year-old son who lives with his mother. He was recently in court to
have his visitations reduced to one supervised visit a week. He lives with his mother, who is supportive.
was
What data from the histories is important and RELEVANT and has clinical significance for the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
RELEVANT Data from Social History: Clinical Significance:
Current VS: WILDA Pain Assessment (5th VS):
T: 99.1 F/37.3 C (oral) Words: Patient denies
P: 110 (regular) Intensity:
R: 28 (regular) Location:
BP: 142/84 Duration:
O2 sat: 99% room air Aggravate:
Alleviate:
Patient Care Begins:
What VS data are RELEVANT and must be recognized as clinically significant by the nurse?
RELEVANT VS Data: Clinical Significance:
