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General appearance
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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).
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Behaviour
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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.
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Speech
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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.
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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.
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Thought process
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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.
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Thought content
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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).
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Perception
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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
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Cognition
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Harry showed cognitive impairment. His mental state was not right. He showed signs of memory loss.
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Judgment
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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.
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Insight
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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.
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SYMPTOM |
Intervention |
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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.
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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).
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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.
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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. |
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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.
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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.
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To solve the whole matter, Harry is needed to take care of the clinicians in this case. Through the interview, it can be understood that the patient has a various problem due to the anxiety and depression. To sort out the entire problem, the clinicians need to take the extra attention to Harry. It is seen in the interview process that Harry loses his memory, and his thinking is about the outside of this universe. While he is talking with the interviewer, his speech seems to have incongruousness. Though there is not any proof of self-killing in the interview, he gave his future plan of killing his brother.
The risk screening tools which should be used in this nursing report are as below.
The risk screening tool plays a pivotal role in the assessment of the overall risk that is possessed by Harry. The risk screening tool comprises of the different parameter those areas below.
Advanced health directive: Here the main condition of Harry will be assessed, if he has grown any suicidal tendency in the recent time. The stressful events will be noted in this tool. According to the case study, Harry is hallucinating and thinking his brother as his own enemy.
The violence of aggressive factors: These factors should be assessed properly because it plays a very important factor. In the case of Harry, he is showing a sign of violence and he has a thought of murdering his own brother. This is one of the huge risks which are assessed by communicating with the patient. The entire background of Harry is also assessed to analyze any factors which will explain these events of violence (Miller, 2011).
Vulnerability assessment: This is one of the essential assessments done to find out any events of trauma that occurred in the in the Past. Harry hallucinating tendency might be any reason of traumatically events from the past.
Absconding factors are assessed- It is noted that if the patient has any absconding events or not.
Parental Status and responsibility- During the assessment the status of the parents are also considered because it has a huge effect on the victims. In the case of Harry, it is important to know the family background to do the final holistic assessment in a proper way. The holistic risk assessment should be performed in Harry for the mitigation of the possible risk that will develop from the symptoms like a hallucination, rage, and depression shown by Harry.
References:
Engdahl, S. (2010). Mental health. Farmington Hills, MI: Greenhaven Press/Gale Cengage Learning.
Hunnicutt, S. (2010). Universal health care. Detroit: Greenhaven Press.
Miller, D. (2011). Health care. Detroit, Mich.: Lucent Books.
Quigley, A. (2007). Mental health.Detroit: Greenhaven Press.
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