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Introduction
Bipolar disorder is a psychiatric mental disease that tends to make the patient have severe mood swings. The mood swings tend to be extreme of each other and can range from manic behavior to severe depression. This gives the characteristic name of the condition as a ‘bipolar’ disorder. In this paper, we have outlined the condition of a selected patient having bipolar disorder. The physical and mental condition as well s the symptoms of the patient are observed and recorded. Moreover, a teaching and nursing plan has been provided which will aid and contribute towards the treatment of the patient.
Initially, this disorder was only apparent in adults; however, in recent years, it has also been observed in children. The main reason is due to the changing family life and environment as well as the change increase in the pollutants which are unknowingly consumed by the young mothers and pregnant women in the region. This results in a chemical imbalance in the brain of the resultant child, making them highly susceptible to disorders akin to bipolar disorder. “Bipolar disorder is a chronic psychiatric disorder with a variable course and significant impact on patient’s social, occupational, and general functioning and wellbeing. Although there are effective pharmaceutical and psychosocial interventions for patients with bipolar disorder, many patients receive poor-quality care” (Revicki et. al.., 2005)
Description of the client/patient
The patient in question is Samantha Houghton (the names are changed for confidential purposes). She is a child of 13 years old who has been living with her family of two brothers and a single mother. The mother of the patient is a widow, so the child does not have a father in his family. The patient himself seemed jovial and almost hysterically happy on the first visit, however, continued observations of the patient have shown large mood swings going into a mode of depression where the client tends to get highly reserved and quiet. The client has been communicating with us in English only. However, oral communication has been limited due to the nature of his condition as well as the limited attention span depicted by the patient. Samantha’s school records provide that she has been fluctuating in her studies, showing exceptional skills on certain occasionally while flunking the assessments on others. The barriers to learning that exist for the client pertaining to the fact that the client has a very limited span of attention. As mentioned above, the client is able to perform well in her papers and tests; however, the mood swings tend to take over and make her performance a fluctuating one over a period of time,. Aside from this, the almost nonexistent groups of friends that are associated with the patient are not too close to the patient. The client herself has been isolating herself lately, making the condition of the disorder more severe by limiting her social interactions.
The cultural background of the person is white, and she has been born and raised in New York. Her grandparents come from England. There exist no history of mental illness in the family. However, the mother was able to provide that she was under high levels of stress and depression during her pregnancy due to her husband’s death.
The mental status of the client is highly volatile in nature right now. This is mostly because of the bipolar disorder that is being faced by the client. She has been able to depict extreme hysterias and manic happiness on occasion when she was able to win a computer game; however, otherwise, she has been under severe depression. Of late, her spells of volatile behavior and more prolonged, and the mood swings have started to come about more often. The main reasons that are aggravating the bipolar disorder for the patient include her family atmosphere and the fact that she is going through puberty at her age. With almost no friends, she is very alone and isolated, which is making the disorder take over her mental state. At this stage, without any treatment, the consequences of bipolar disorder mean that the patient might even suffer from an early death in the form of suicide. In order to monitor her behavior and treatment, she will have to be kept in close contact with the social welfare and the legal systems department for the rest of her life.
Teachin plan
In order to the patient, we will have to support the patient in terms of her development and growth as well as support her through her disorder. For this, first and foremost, the teaching plan has to be made, which will be focused on attaining the short-term goals of stabilizing her condition by increasing her attention span and enabling her to focus on her studies. Specialized tutoring would be provided, which will focus on maintaining the equilibrium of her mental state while providing for the education of the patient. Moreover, in the long term, the goal of the teaching plan would be to encourage the patient to become more communicative and more gregarious in nature. This will increase her confidence level and aid in stabilizing her mood swings. Moreover, the presence of family and friends would help her be more normal like others around her, making her less likely to be suicidal.
The timing in the teaching plan would be such that she will be catered to after her school hours. The duration of the sessions will be kept 1hour long in the begging which will be gradually increased to 3 hours in order to not burden the patient in a sudden manner. The treatment for the patient and her teaching would start alongside her stay in the hospital. This will make it possible for us to closely monitor her and test her in her real-world environment as she gets discharged. Her treatment, however, will continue even after her discharge and can span most of her life.
Intervention
The client will be initially taught her school course alongside basic decorum and behavioral techniques. She will be informed of the environment around her from a broader perspective, and a two-way session of discussion and arguments will be encouraged. Aside from this, she will be provided with medication to control her severe mood swings and erratic behavior, which has been characteristic of late. Aside from this, lifestyle changes would be made for her. This would include fixed waking up and sleeping timings, caffeine-free food, and education pertaining to drugs and alcohol. Aside from this, her day would be managed according to a strict schedule. The family would also be advised to keep crises and arguments at a low level in order to not trigger a disorder. The sibling communication and relationship will be encouraged in this case as this will aid the patient in becoming gregarious and less erratic over time. The alternate method of treatment would be hospitalization and medical treatment in order to make way for immediate control of her symptoms. A longer psychological treatment would follow the medical treatment.
Evaluation
The treatment of the patient will be evaluated according to her progress in the treatment and the way she is able to correspond with those around her. The timings of the mood swings and the communicative behavior will also contribute towards the evaluation of the patient.
References
Bipolar Disorder, Patient Health International – AstraZenec, (2003).
Goodwin, G.M., (2003), Evidence-based guidelines for treating bipolar disorder – recommendations from the British Association for Psychopharmacology, Journal of Psychopharmacology, Vol 17(2) (2003) 149–173. Web.
Kleinman, L.S., Lowin, A., Flood, E., Gandhi, G., Edgell, E., Revicki, D.A., (2003), Costs of Bipolar Disorder, Pharmaco Economics, Vol. 21 Issue 9, pp. 601-622,
Revicki, D.A., Matza, L.S., Flood, E., Lloyd, A., (2005), Bipolar Disorder and Health-Related Quality of Life: Review of Burden of Disease and Clinical Trials, Pharmaco Economics, Vol. 23 Issue 6, pp. 583-594.
Videbeck, S.L., (2005), Psychiatric Mental Health Nursing, Lippincott Williams & Wilkins, ISBN 078176033X
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