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CASE STUDY

Bipolar Depression/Mania

Brenden Manahan is a 35 year old male, who has been admitted to the local mental health hospital for exacerbation of his bipolar disorder. He was admitted on a Jan 20 2021 (involuntary inpatient admission, patient has been deemed either dangerous to self or others) and brought to the hospital by the police because his mother feared for his safety. In the past few weeks he stopped taking his medications because he feared that his mother was poisoning him. 

Brenden has not slept, showered, ate, or changed his clothes and although it is summer, he is wearing multiple layers of clothing and winter boots in the past four days due to racing thoughts. He believes that he is the head of the CSIS and told his mother that he needed her car to go to CSIS headquarters in Ottawa, ON 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 were there to poison him and prevent him from returning to his job. 

He has been admitted to the locked mental health unit for evaluation for 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.

Additional Information:

Brenden was diagnosed at 19 years of age with bipolar I and subsequently has been admitted six times due to non adherence of the medication regime. Brenden is divorced and has a three 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. 

Upon admission to the unit, you take Brenden’s vital signs which are the following:

T: 37.3 C, P 110 regular, R 28 regular, BP 142/84, O2 sat: 99% RA, Pain: denies. Also, through your assessment, you find that there are no medical concerns, no history of ETOH or other street drugs, and he is oriented to person and place but not to time, impaired ability to concentrate, and labile emotions.

QUESTION:

Bipolar Disorder- Brenden

 

1)    Let’s take a look at Brenden’s case. If you were a Nurse working with him in real life, what would be important for you to know?

a. Do you feel prepared to work with Brenden?

2)    Medication and poisoning- how do you work with fixed- false beliefs or delusions?

3)    Brenden came to the unit and had not slept for 4 days- why is this important for nursing considerations? What can we do?

4)    Trauma informed care- relapse of mental health, police involvement, involuntary hospital admission, strain on social supports. What are your thoughts on this? How might this impact a student nursing care?

5)    Bipolar may be considered Chronic and Relapsing within a biological model of mental health- how does being diagnosed at 19 and having multiple hospital admissions impact Brenden’s prognosis?

SCIENCE
HEALTH SCIENCE
NURSING
NURSING 2600

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