ignments Questions Patient Introduction Location: Patient room on a locked mental health unit Time: 1900 Report from day shift nurse: Situation: David Carter, a 28-year-old male, was admitted 2 hours ago after he became violent with his mother and threw a table at her when she asked him to take his medications. She then called the police, who brought him to the emergency room on an involuntary emergency detention Background: David Carter was diagnosed with schizophrenia 10 years ago, and he was stable on his medications until he recently stopped taking them. He had a depressive episode 5 years ago that was successfully treated with venlafaxine. His mother reports that recently he has been talking about his food being poisoned. His mother also reports that he has become more isolated, not going out and always sitting at his computer She shares that he has been posting some "weird updates online. She suspects that he has stopped taking his medications, probably because he believes they are responsible for his weight gain. The medications he has been prescribed for the last year include olanzapine 10 mg and venlafaxine XR 75 mg daily. During his admission, he was alternately agitated and withdrawn, but he did answer questions, although at times inappropriately. He appears to have paranoid delusions, evidenced by stating that he believes people are listening to his thoughts. He has auditory hallucinations telling him that he should not eat the hospital food because it is poisoned. His speech has loose associations with some evidence of neologisms, and it is difficult to carry on a conversation with him. The patient's behavior indicates a moderate risk of violence. Preventative measures should be taken. He is malodorous and appears disheveled. He has refused to take a shower Assessment: I have finished most of David Carter's admission, I have taken his vital signs, recorded his history, and obtained the history of his present iness from his mother. He is in his room, and his mother just left. He refused to eat his dinner but did drink a few sips of water from a water bottle he unsealed himself. His vital signs are stable temperature 37 2°C (99°F), heart rate 90 beats/min, respiratory rate 16 breaths/min, blood pressure 134/84 mmHg, and Sp02 96 % He appears tired. I did get him to take his medications with a great deal of coaxing Recommendation: Please complete a mental status examination, orient him to reality, offer food, and find ways to encourage him to eat it. Please also call the charge nurse and provide an update when you have completed your assessment Schizophrenia Diseases and Conditions Videbeck, S. (2023). Psychiatric-Mental Health Nursing, 9th Edition. Schizophrenia, Chapter 16, pp. 254-281 Expert Clinical Content from Lippincott Advisor Schizophrenia, long term care Q Search