Mental Health Nursing Healthcare Professional

Questions: 1.Identify and describe the following four (4) key components of the mental state, as they relate to Ellens presentation:- Mood- Thought Content- Thought form- Insight 2. Identify and describe two (2) areas of risk for Ellen in relation to her current presentation. 3. Discuss four (4) nursing care priorities for Ellen and provide a nursing intervention and a rational for each intervention identified. 4. Identify one (1) recovery principle (as per the National Framework for Recovery-Oriented Mental Health Services). Answers: 1 Mood: Mood of the person can be identified by asking him few questions about things related to him or general topic. Also, mood can be identified by observation by healthcare professional or psychologist. In mental health status mood is considered as continual internal feeling of the person. As person expresses mood verbally, mood is the subjective report of the persons emotional condition. Mood of the patient should be evaluated over a longer duration of tome like few weeks and mood should not be evaluated at particular event or incidence. Mood can be either low, unresponsive and depressed and on the other side it can be high and aggressive. Ellens mood is aggressive, elevated, labile or reactive, irritable (Nakash et al., 2015). Thought Content: Though content of a person is based on the thinking of a particular thing in a continuous manner and not trying to come out of this thinking process. Most importantly such person never shares this though process and their viewpoints with others. This though content is most of the time on the negative side like irritated and miserable. Person is constantly anxious and fearful about particular things. Such persons have strong belief that other people are going to hurt them. Person has hallucinations and illusions which reflects fake perceptions and misunderstood perceptions respectively. From inquiry and observations, it is evident that thought content of Ellen are lavish, teasing and fundamental sexual intimation (Finney et al., 2016; Nordgaard et al., 2013). Thought Process: There are different expressions of thought process like linear, goal-directed, loose associations, confused, incidental, racing, lateral, and vague. Thought process of person can be identified by asking questions to the person and making inference from his speech. However, thought process cannot be observed by health care professional of psychologist. Thought process of Ellen is fluctuating and it is running from one thought to another. Ellen is confused about timings, however she is well oriented towards place and person. Also, Ellen is low in concentration (Nordgaard et al., 2013). Insight: Persons insight of the mental condition can be assessed by identification of his or her mental illness, his or her agreement or disagreement to the treatment or management provided and recognition of diseased condition such delusions and hallucinations. After getting idea of the insight of mentally ill person, plan for management or treatment of persons condition is uncomplicated. In case of Ellen, it is difficult to get insight of her condition. In her inquiry to get insight of her condition, Ellen mentioned that she doesnt have any mental health issue and she should stop medications. However, it has been observed that she has serious mental illness (Finney et al., 2016). 2. From the case study it is evident that Ellen may have two risks such as violence and social isolation. Ellens behavior towards other people is unpredictable and it is disturbing or harming other people. In this condition people can keep themselves distant from her. Due to this social isolation, Ellen may have less mobility, depressed condition and less participation in intellectual activities. All this can lead to the chronic disease condition in Ellen. Socially isolated Ellen would not get proper support from family members and other people in her ill health. In such scenario, outside caretaker can abuse her both mentally and physically. Overall, her holistic care and wellbeing can be disturbed (Metzl, MacLeish, 2015; WHO, 2012). It is obvious that, Ellen exhibited harshness with other customers in the club and showed her violent behavior. Ellen has florid psychotic thoughts and may become more violent in comparison to other people. Habit of psychoactive substances use is one of the most prominent reasons for the violent behavior of the people and Ellen is also taking such type of substances. She has habit of cigarettes and brandy and when she was caught by the police also she was under the influence these psychoactive substances (Metzl, MacLeish, 2015; WHO, 2012). 3. Nursing care priority 1 - Aggressive behaviors Nursing intervention - Nurse should administer Ellen with medication which induces sedation in her. Nurse should use haloperidol or risperidone for treating acute aggression in Ellen. Nurse should use Buspirone for managing chronic anxiety. Rational - These medications are helpful in calming down Ellen and as result she would not become aggressive and it would not affect others (Grahame, 2012). Nursing care priority 2 - Activities of daily living Nursing intervention - Nurse should enquire with Ellen about her activities of daily living. After getting information from Ellen, nurse should make list of activities for which Ellen requires nurse assistance. Nurse should help Ellen in routine activities like cooking, clothing, toilet use, medication administration. Nurse should force Ellen to sleep for adequate period of time. Rational - It is evident from the case that, Ellen is disoriented to time and she is not performing her daily activities on their respective time. Hence, nurse should help Ellen to carry out her daily activities on time (Walker, 2015). Nursing care priority 3 - Denial to consume medicine Nursing intervention - Nurse should counsel Ellen for medication consumption. Nurse should educate Ellen about the importance of medication. Nurse should push Ellen to consume medicine regularly. Nurse should advice Ellen that medicines are for the benefit of her and these medicines would aid in getting away from her current situation. These medications are not meant to spoil her. Rational - Form the case study, it is evident that Ellen is refusing to take medicines and she made strong belief that these medications are spoiling her. In such scenario, nurse should counsel her for consumption of medicine (Walker, 2015). Nursing care priority 4 - Funding and use of resources Nursing intervention - Nurse should advice Ellen for spending money on unnecessary things and stops her from doing this thing. Nurse should incorporate social worker in this activity. Rational - There are fewer funds available with Ellen for her treatment. In future, she may not have fund for her treatment (Grahame, 2012). 4. Attitudes and Rights: Ellen should always listen and take advice from her husband and son, her doctor and social health worker in her treatment, management and her recovery process. She should think about happiness and well being of the herself, her husband, son and society members. Ellen should be kind to others and she should try to avoid aggressive and violent behavior towards others. She should respect others rights and she should not always think of herself only. Ellen should participate in every social activities in her society and she should make sure that she should influence others with her positive and creative attitude in cultural and professional activities. With this altered attitude, she would be well accepted by her husband, son and community members. With this her ill condition would be handled in a better way and she would have better care and management. With these changes Ellen would be more positive and confident and her future would be in high spirits (www.health.gov.au). References: Finney, G.R., Minagar, A., Heilman, K.M. (2016). Assessment of Mental Status. Neurologic Clinics, 34(1), 1-16. Grahame, S. (2012). Psychological Interventions In Mental Health Nursing. Open University press Metzl, J.M. MacLeish, K.T. (2015). Mental Illness, Mass Shootings, and the Politics of American Firearms. American Journal of Public Health, 105(2), 240249. Nakash, O., Nagar, M., Kanat-Maymon, Y. (2015). Clinical use of the DSM categorical diagnostic system during the mental health intake session. Journal of Clinical Psychiatry, 76(7), e862-9. Nordgaard, J., Sass, L.A., Parnas, J. (2013). The psychiatric interview: validity, structure, and subjectivity. European Archives of Psychiatry and Clinical Neurosciences, 263(4), 353-64. Recovery Principles. Retrieved from https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-i-nongov-toc~mental-pubs-i-nongov-pri on 26.09.2016. Risks To Mental Health. Retrieved from. https://www.who.int/mental health/mhgap/risks to mental health EN 27 08 12.pdf on 26.09.2016. Walker, S. (2014). Psychosocial Interventions in Mental Health Nursing. SAGE Publications.