NUR2200 Mental Health Care Across The Lifespan

General appearance

Through evaluating the whole interview of Harry, it is clear to know the exact details and detect the parameters of the mental patients like Harry. As far as the interview is concerned, Harry is suffering from the hallucination, anxiety, and the depression. It is more complicated for the clinicians to discuss the problem from different parameters such as the behavior and the appearance, perception, thought process, cognition, insight, speech mood and effect. The MSE (the mental status examination ) is the systematic process of the behavior, appearance

The appearance of Harry provides everything off his mind, when Harry is found in the street as semi-naked. So through the appearance, it is understood that the patient somehow is suffering from the hallucination and depression. Through the interview process, it is clear that when the patient does deliver the answer, he does not maintain the proper eye contact with the interviewer. During the interview process, he looks shy when he delivering the answer (Engdahl, 2010).

Behaviour

Behaviors: While conducting the interview, it is very important to look at the patient’s behaviors. The behavior is often considered as the non-verbal communication. The facial expression of Harry expresses much about his imagined world where he now lives. But on the other hand, it is interesting to find in Harry that he maintains the common rapport with his family member. He also gives the exact reply on the question during the interview.

Speech

The speech given by Harry was not based on reality. The speech was irrelevant and absurd. It did not have any practical relevance. As he stated that he has the superpower to become invisible.

Mood and

Affect

Mood:  During the interview process, Harry’s mood is not rude. He looks calm and quiet. It is seen in most of the cases that the patients of the mental look depressed. But it is the exceptional case for Harry that he happily gives the exact reply on the question of the interviewer. But the reason for his mental problem is somehow his hallucination and depression.

Affect: While conducting the interview, it is seen that he has the appropriateness while giving the answer. But when asking some of the tough questions, he gives the answer in a roundabout way.

Thought process

Process:  During the interview process, he has given the answer which is full of irrelevancy. While giving the answer, he ( Harry) halt his speech. It is seen that he has the memory loss. While conducting the interview, Harry expresses his thought which is full of circumstantial thinking. His irrelevant comments display everything about his mental state.  

Thought content

Based on the patient’s thinking it is understood the exact thought of the patients. But during the interview process, his ideas seem too unreasonable. His thinking of himself is overweight. But there is no thought of self-killing. During the interview process, it is known from him that he has the plan of killing his brother in near future (Quigley, 2007).

Perception

He was not able to perceive the situation. His perception was totally based on a make belief world. He was hallucinating and showing symptoms of hallucination

Cognition

Harry showed cognitive impairment. His mental state was not right. He showed signs of memory loss.

Judgment

This process of the medical status examination refers to the proper guidance whether the patient has the ability to solve the daily problem or not. But in this case, the patient like Harry does not possess this quality. Through this process, the practitioner can have the way to lead the treatment.

Insight

Through this process, it becomes easier to detect the possible problem of the mental health problem. Through this process, it is important to know the possibilities of the hallucinations and the impulses of the suicide of the patient. It also gives the best possible solution to the mental health problem.

SYMPTOM

Intervention

According to the case study, it is clear that Harry is suffering from the clear problem of hallucination. He is hallucinating and showing a schizophrenic tendency. As he is thinking that he is invisible. He shows mainly hypnopompic hallucination which occurs in the general population during waking up. The nursing should be done properly to maintain the patient who is suffering from hallucination.

Proper counselling- The nurse has to develop a relationship with Harry based on trust and empathy. Besides that, it is important to win his trust through proper communication. If it is not done then Harry will not follow or listen to the instruction of the nurse. The nurse has to comprehend and document the time when Harry is showing a hallucinating tendency. Proper counseling and medication should be given by the nurse.

Appropriate routine management and medication: Psychological strategies suggest the use of antipsychotic drugs according to the need of Harry. The medical background of Harry should be assessed before using the antipsychotic drug. Harry daily routine should be properly managed which is one of the essential parameters of intervention. A healthy routine of proper sleep and good dietary intake will help Harry get over this situation. The family members should also be empathetic to the situation (Hunnicutt, 2010).

During the conversation, Harry is not looking directly at the interviewer that shows that Harry is going through depression and his confidence is very low.  From the background information, it is also clear that Harry has stopped talking to his friends recently. It is clear that he is suffering from clinical depression.

The nursing care and intervention for the patients with clinical depression are as below.

Cognitive Behaviour therapy: Concealing will help the patient in fighting the problem. Harry is going through a phase of clinical depression. Regular counselling and empathetic and supportive behaviour by the nurse will help the Harry get over this situation. One of the most important interventions is the cognitive behaviour therapy. The cognitive behaviour of the Harry is analysed and particular management is done on that to reduce the level of depression. Interpersonal therapy which is counselling can also be done by the by the nurse for a cure.

Medication:  Intervention through proper medication will inhibit the depression. Proper serotonin uptake inhibitors like sertraline medicine can be given along with proper diet by the nurse. Antidepressant drugs can be used to treat clinical depression of Harry. Drugs like nefazodone can be used but before this intervention, proper medical background assessment of Harry should be done.

The case study and Interview it is clear that Harry ha severe level of anxiety. Proper nursing care should be done to treat this anxiety.

The nursing care intervention for anxiety is as below.

Stress management techniques: Through proper communication and counseling through empathetic discussion the stress management can be done. Through medication and proper routine, it can be achieved.

Motivation and medication: Through proper motivation is and medication it is possible to decrease the anxiety level in harry. It will also help in increasing the confidence level of Harry.