Question

Richard is a 25 y.o. male patient who is being admitted to the inpatient mental health unit. He has a diagnosis of Bipolar 1 disorder. He has no history of physical or medical illnesses. During the admission assessment, Richard indicates that when he was 21 y.o., he was treated for bipolar 1 as an outpatient in the hospital clinic. He indicates was prescribed Carbamazepine but stopped taking it about 1 year ago. He told the nurse he has recently moved to the city as a mechanic, lives with a close relative temporarily. He does not have any friends in the city. About 3 weeks ago he had a surge of energy, was working 14-hour days and was up at night for days. During the interaction Richard often talked about his past depression and suicidality. Over the past month he has lost 15 lbs., has difficulty eating and has no appetite. He does not have the”…energy to get out of bed..” and has missed 4 days of work in the past week. He acknowledges having thoughts of ending his life by “driving off the road”. However, he says he is uncertain and afraid that if he takes his own life he will go to hell. You are the nurse assigned to provide care to Richard.

What is Richard’s priority of care? (from a nursing perspective)

Answer 1

Bipolar disorder, formerly called manic depression, is a mental health condition that causes extreme mood swings that include emotional highs (mania or hypomania) and lows (depression).

When you become depressed, you may feel sad or hopeless and lose interest or pleasure in most activities. When your mood shifts to mania or hypomania (less extreme than mania), you may feel euphoric, full of energy or unusually irritable. These mood swings can affect sleep, energy, activity, judgment, behavior and the ability to think clearly.