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Introduction Bernadette Cook is a 50 – year – old women with a lived experience of bipolar affective disorder (BPAD). She was brought into the hospital by her husband in relation to her changed behavior which he thinks is not safe. Bernadette has stopped taking her BPAD medication thinking that her psychrist has been positioning her food mixing lituum carbonate in her food. According to her perception she is experiencing metabolic syndrome in result by consuming the medication prescribed by her doctor. Also, she thinks that the medication she is taking gives her a bad chest pain and she does not trust anyone apart from her husband. Considering Bernadette case, we will be conducting mental state examination of Bernadeette, which will help us to Part 1: 1 a). Appearance Bernadette cook is a 50- year old white causation female wearing black tiger printed tops and black cardigan. No abnormal appearance, appeared well groomed. Short blond hair and wearing prescribed glasses. Bernadette is approx. 5 foot 6 inch with fairly big body size. No physical disabilities. She has maintained eye contact with the nurse during the interviews. 1 b). Speech Bernadette is agitated and stressed, raised her voice frequently while asking a question. She is feeling very pressured while answering the questions. The tone of the voice is not appropriate, swearing in between the conversation. Repeating the same answers over and over again. 1 c). Mood Bernadette case study Please follow this guideline along with the marking rubric. Part 1a: Please read the guidelines below to answer this question. When you answer this question you must use as evidenced by …. Part 1b Define BPAD with reference. And explain 3 symptoms; with references. Part 1 c) 3 potential risk I am thinking here is · Risk of self-neglect · Risk of reputation · Risk of non-compliance with medication But if you think some others can relate more please feel to add and also use reference for this. 1d) please use the template provided for the care plan. You need to use the format as it mentioned. For example Bernadette is noncompliance to medication as evidenced by her altered mood, her perception about medication, her statement:” medication has ruined my life” As it said in the note below the template, identify 1 issue with 5 good intervention or 5 issues with 1 interventions. use reference to support you answer. Part 2a) I am thinking the potential physical health issues are: Weight gain or obesity Deterioration on mental health Diabetic issues Actual health issues Abnormal heart beat Impact of lithium carbonate Please add some more if you think is applicable since its worth 10 marks. Use references please 2b) nursing intervention I am thinking are educating patient about medication ECG Weekly weight monitor Report to doctor about chest pain Check vital signs Monitor BMI Measuring gut etc provide references 2c) health promotion strategies that I am thinking are regular exercise join community walking healthy eating habit weight loss program input of dietician please use references CRIT3000 Case Study on Bernadette Cook Bernadette Cook is a 50-year-old woman with a lived experience of bipolar affective disorder (BPAD). She lives in the community of choice and has a supportive husband. She loves to read and works as a librarian in her local library. Six months ago, Bernadette attended a health check seminar organised by her library and was advised to go for a full physical health check. She went to the local GP to do it and received her medical report in a mail 2 weeks later. The report showed that Bernadette has high blood pressure, her weight was over her recommended BMI, excess fat around her waist (abdominal circumference), and high triglycerides. Bernadette was emotionally affected by her medical report but decided to keep it from her husband. She started researching online about the reasons for her health issues and found some information about metabolic syndrome related to the medications she is taking for BPAD. Bernadette was angry that her psychiatrist did not tell her about the risk of metabolic syndrome and decided to stop her medications. Bernadette’s mood started to deteriorate four weeks after she stopped her medications. She was experiencing labile mood throughout the week and started to believe that her psychiatrist is trying to kill her with the medication. She even started to think that people are trying to poison her and would only eat the food after husband took the first bite. She was brought into the hospital by her husband as he thinks that she was not able to be kept safe at home. [MENTAL HEALTH SERVICE] Complex Nursing Practice I Brief Risk Assessment Form Instructions Complete the Brief Risk Assessment (BRA) form on page two (2) of this document. The BRA Does Not contribute to the assignment word count. It should be used as a tool to help you decide the risk/s that need to be managed. It should also be placed in the Appendices section of the assignment. Please DO NOT insert the BRA into case study text. Scanned forms will NOT be accepted for grading as they are not compatible with Turnitin. Follow the steps below to complete the check boxes in the BRA. STEP 1: Double click your selected checkbox for the Check Box Form Field Options to appear STEP 3: Click ok to complete checking the box STEP 2: Select checked option from the default value tab BRIEF RISK ASSESSMENT SURNAME: UMRN (N/A) SEX: BRIEF RISK ASSESSMENT FORENAMES: BIRTHDATE (Age in yrs.) PATIENT’S ADDRESS: (this field is N/A) SOURCE OF INFORMATION |_|The consumer |_|Immediate carer (parent, spouse, child) |_|Other informants (family, friends) |_|Previous clinical records |_|Assessing clinician’s knowledge of consumer’s past behaviour/current clinical presentation |_|Police/ambulance/other agencies |_|Other (please specify) ___________________________________ SUICIDALITY Static (historical) factors Yes (1) No (0) Not Known Dynamic (current) risk factor Yes (2) No (0) Not Known Previous attempt(s) on own life |_| |_| |_| Expressing suicidal ideas |_| |_| |_| Previous serious attempt |_| |_| |_| Has plan/intent |_| |_| |_| Family history of suicide |_| |_| |_| Expresses high level of distress |_| |_| |_| Major psychiatric diagnosis |_| |_| |_| Hopelessness/perceived loss of coping or control over life |_| |_| |_| Major physical disability/illness |_| |_| |_| Recent significant life event |_| |_| |_| Separated/Widowed/Divorced |_| |_| |_| Reduced ability to control self |_| |_| |_| Loss of job/retired |_| |_| |_| Current misuse of drugs/alcohol |_| |_| |_| PROTECTIVE FACTORS (describe) : : LEVEL OF SUICIDE RISK (total score): |_| LOW (<7) |_|="" moderate="" (7-14)="" |_|="" high="" (="">14) AGGRESSION/VIOLENCE Static (historical) factors Yes (1) No (0) Not Known Dynamic (current) risk factor Yes (1) No (0) Not Known Recent incidents of violence |_| |_| |_| Expressing intent to harm others |_| |_| |_| Previous use of weapons |_| |_| |_| Access to available means |_| |_| |_| Male |_| |_| |_| Paranoid ideation about others |_| |_| |_| Under 35 years old |_| |_| |_| Violent command hallucinations |_| |_| |_| Criminal history |_| |_| |_| Anger, frustration or agitation |_| |_| |_| Previous dangerous acts |_| |_| |_| Preoccupation with violent ideas |_| |_| |_| Childhood abuse |_| |_| |_| Inappropriate sexual behaviour |_| |_| |_| Role instability |_| |_| |_| Reduced ability to control self |_| |_| |_| History of drug/alcohol misuse |_| |_| |_| Current misuse of drugs/alcohol |_| |_| |_| PROTECTIVE FACTORS (describe) : LEVEL OF VIOLENCE RISK (total score): |_| LOW (<7) |_|="" moderate="" (7-14)="" |_|="" high="" (="">14) OTHER RISKS IDENTIFIED (AND RISK FACTORS) RISK MANAGEMENT ISSUES (please ensure alerts are noted here) (To be completed by assessing clinician) PRINT NAME: DESIGNATION: SIGNATURE: DATE: (Where appropriate, management plan to be acknowledged by requesting medical practitioner) PRINT NAME[footnoteRef:1]: DESIGNATION: [footnoteRef:2] SIGNATURE: DATE: [1: ] [2: ] NURS3000 Complex Nursing Practice 1 Curtin University Assignment 1 Report Marking Guide CRICOS Provider Code © School of Nursing, Midwifery & Paramedicine 1/14 00301J (WA) CRIT3000 Complex Nursing Practice 1: Skills Assessment Marking Rubric What do we need to do? Unit Learning Outcome assessed: Use clinical knowledge and skills to conduct a comprehensive mental health and physical health assessment and plan care for a person with complex health-related issue in a clinical environment. For this assessment you are require to watch the video of a case study provided and address the following sections: Introduction: Write an introduction to the case study and state the focus of your assignment (2 Marks). Part 1: 1a) Using information from the video, describe Bernadette’s mental state by completing the following components of Mental State Examination (MSE) (10 Marks). a) Appearance b) Mood and affect c) Thought content d) Cognition e) Insight and judgement Present your MSE section using the subheadings stated above. Please note that you must validate any specialised terminology you use. For example: The person (use the person’s name) was agitated, as evidenced by appearing to be tense and easily irritated. DO NOT discuss background information in the MSE section. An MSE is a snapshot of occurrences at the time of the interview. The way the person is presented; the information they gave during the interview; the clinician’s interpretation of the MSE constructs at the time of assessment. Remember most of