Case Study  II- Bipolar and Anxiety  (Week 4’s Material)

Alice, age 29, had been working in the typing pool of a large corporation for 6 years.   Her immediate supervisor recently retired, and Alice was promoted to supervisor, in charge of 20 people in the department.  Alice was flattered by the promotion but anxious about the additional responsibility of the position.   Shortly after the promotion, she overheard two of her former coworkers saying, “Why in the world did they choose her?  She’s not the best one for the job.   I know I certainly won’t be able to respect her as a boss!”  Hearing these comments added to Alice’s anxiety and self-doubt.

Shortly after Alice began her new duties, her friends and co-workers noticed a change.  She had a great deal of energy and worked long hours on her job.  She began to speak very loudly and rapidly.  Her roommate noticed that Alice slept very little, yet seldom appeared tired.   Every night she would go out to bars and dances.  Sometimes she brought men she had just met home to the apartment, something she had never done before.  She bought lots of clothes and makeup and had her hair restyled in a more youthful look.  She failed to pay her share of the rent and bills but came home with a brand-new convertible.  She lost her temper and screamed at her roommate to “Mind your own business!”  when asked to pay her share.

She became irritable at work, and several of her subordinates reported her behavior to the corporate manager.  When the manager confronted Alice about her behavior, she lost control, shouting, cursing, and striking out at anyone and anything that happened to be within her reach.  The security officers restrained her and took her to the emergency department of the ospital, where she was admitted to the psychiatric unit.  She had no previous history of psychiatric illness.

The psychiatrist assigned a diagnosis of Bipolar I Disorder, and wrote orders for olanzapine (Zyprexa) 10 mg IM STAT, olanzapine 15 mg PO daily, and lithium carbonate 600 mg qid (Townsend, 2015, p. 526)

Address the following questions in your paper related to Alice:

1).  What are the most important considerations which the nurse who is taking care of Alice should be concerned?

2).  Why was Alice given the diagnosis of Bipolar I Disorder versus Bipolar II Disorder?

3).  The doctor should order a lithium level drawn after 4 to 6 days.  For what symptoms should the nurse be on the alert?

4).  Why did the physician order olanzapine in addition to the lithium carbonate? (Support your rationales with literature reviews) (Townsend, 2015, p. 526)

RUBRIC

Therapeutic Communications –   Quality of Content (50 Points)

1). _____/10    APA Cover page, Introduction of topic, conclusion, include level of headings in your paper. 

2). ____/10 pts   What are the most important considerations which the nurse who is taking care of Alice should be concerned?

3).  ____/10 pts   Why was Alice given the diagnosis of Bipolar I Disorder versus Bipolar II Disorder?

4).  ____/10 pts   the doctor should order a lithium level drawn after 4 to 6 days.  For what symptoms should the nurse be on the alert?

5).  ____/10 pts    Why did the physician order olanzapine in addition to the lithium carbonate? (Support your rationales with literature reviews)

Bipolar –    Quality of Content (30 Points)

1). ____/5 pts   What are the most important considerations which the nurse who is taking care of Alice should be concerned?

2).  ____/10 pts   Why was Alice given the diagnosis of Bipolar I Disorder versus Bipolar II Disorder?

3).  ____/10 pts   the doctor should order a lithium level drawn after 4 to 6 days.  For what symptoms should the nurse be on the alert?

4).  ____/5 pts    Why did the physician order olanzapine in addition to the lithium carbonate? (Support your rationales with literature reviews)

Quality of Writing (20 Points)
__/5 Format – Professional Presentation and if Text meets APA/MSN standards
__/5 Organization – Organization of paper demonstrates critical thinking
__/5 Precision – Student uses terminology and writes clearly and concisely
__/5 Mechanics – Student spells, constructs sentences, and punctuates correctly
 

Total:  100  %

Reference

Boyd, M.A. & Luebbert, R. (2020). Essentials of Psychiatric Nursing (2nd ed.). 

Keltner, N.L. & Steele, D. (2019). Psychiatric nursing (8th ed). Mosby. Elsevier

Townsend, M.C.  (2015). Psychiatric mental health nursing: Concepts of care in evidence-based practice. (8th ed.). F.A. Davis Company