Case Study: Medication Management for a Consumer
Answer:
Rationale of Lithium Carbonate 500mg
Ellen Hawkbridge had been diagnosed with bipolar disorder when she was 23-year-old, and that is the reason she was reacting funny in RSL club. Although the doctor had commenced the Sertraline 100mg medication, her medical review shown that she was under lithium carbonate 500mg prescription. The importance of this medication was to treat the case of bipolar disorder observe her behaviors (Yildiz, Ruiz, & Nemeroff, 2015). Some of the symptoms of bipolar that had been observed on Ellen was her aggressiveness, hostility, poor judgment and hyperactivity among others. The intake of Lithium Carbonate medication may reduce the frequency of experiencing symptoms of the manic episodes, although it takes around 1-3 three weeks before it takes effect on the body (Malhi, 2009).
The us
e of this medication for bipolar disorder treatment requires lab tests to check the levels of lithium in the blood. Therefore, the level of medication provided is determined by the lab tests and in normal cases, a high amount of lithium carbonate is used during the commencement of medication. In the case of Ellen, use of 500mg shows that her level of lithium in the blood are perfectly managed, although she is not stabilized (Malhi, 2016). Through her comment about the effect of lithium on her body shows that she has been under bipolar medication for a while.
Side Effects of Lithium Carbonate
Many medications can cause side effects depending on the body’s response that may be affected by the usage or constituents of the drug. The side effects might be either temporary, mild or severe depending on the observed unexpected/unwanted response. Therefore, there is a need for nursing interventions to harmonize these side effects because they might lead to extended medical effects. Some of the major side effects of lithium carbonate include abdominal pain, diarrhea, and increased frequency of urination, nausea, increased thirst and tiredness among others (Miklowitz, 2011). There are various nursing interventions that can be used to neutralize the effect of these side effect to the body of the victim.
Abdominal Pain
The abdominal pain might be either in the small intestine or the colon. Pain resulting from the small intestines can be observed by feeling of nausea, vomiting, mild distension, or leading to dehydration. On the other side, the colon can lead vomiting latent fecal, experiencing mild abdominal discomfort or severe distension. The abdominal pain can be resolved by embracing several nursing interventions that might be certain or hypothesis for relieving the discomfort. Firstly, the patient can be kept in a comfortable position to let the pain reduce. Also, some other recommended methods of relieving pain can be used such use of medications when severe cases are observed. These interventions can either be undertaken by a nurse, a medical practitioner or any other person who understands the situation (National Institute of Mental Health, 2016).
Diarrhea
Diarrhea is caused by the increased frequency, fluid and/or volume of the stool. This might be one of the side effects of using lithium carbonate as the treatment of bipolar. A patient having diarrhea might also experience hyperactive bowel sounds, pain, stomach cramping, and dehydration among others. Some of the nursing interventions that can be used include auscultating the abdomen to check the presence or characteristics of bowel sounds, restricting intake of solid food that might lead to intestinal workload and embracing change in diet. Also, emphasizing washing of hands to raise the level of hygiene and encouraging oral intake of fluids to avoid dehydration are other nursing interventions that can be used (Leonard & Jovinelly, 2012).
Increased Frequency of Urination
Increased frequency of urination can be managed by encouraging the patient to drink a lot of fluids mostly water and avoid drinking during the afternoons. This intervention will help in flushing out bacteria from the urinary tract and supporting renal blood flow. Secondly, the victim should be encouraged to urinate whenever it is suddenly felt to avoid or lower the chances of bacterial infection resulted from the urine (National Institute of Mental Health, 2016).
Evidence that Ellen was Not Taking Medication in the Case Study
The importance of taking lithium carbonate is to control the symptoms of bipolar disorder. In Ellen’s case study, the behaviors observed in the club of harassing patrons and refusing to leave as requested by the security was a clear indication that she has skipped her medication. If she was in taking the drug perfectly, she could not be hyperactive in the club. Also, Ellen has been spending a large percentage of her money purchase cigarettes and Brady among other products observed in the television channels. In her budgeting, there is no indication of purchasing her drugs or visiting the doctor, which clearly indicates that she is not worried about her condition.
Ellen has also been over-reactive to her son that has kept him away for several weeks without communicating because he finds it hard to talk over the phone. Since it has been observed to be hard for Ellen to take the drugs by herself, there is a need for other approaches to help her take medication effectively. Firstly, her husband can be directed to ensure that the drugs are taken appropriately to help her manage the bipolar condition (Blackwell, 2015). Also, the health center can offer home-based nursing support that can be ensuring that Ellen honors the doctor’s medical prescriptions.
Recovery Principles
These principles are aimed at ensuring that the mental medications are provided in a way that help in effective recovery of the patients.
Rights and Attitudes
This principle is focused on listening and acting on the communication from the patients and guardians. Therefore, any decision undertaken is good for all the stakeholders, and it embraces the fact that all individuals are important. The principle of attitudes and rights protects the citizenship, human rights, and individual’s legal boundaries. Also, the principle of rights and attitudes helps in maintaining recreational, social, vocational and occupational activities that are meaningful to the patient (Health.gov, 2016).
Respect and Dignity
The health practitioners dealing with mental patients need, to be honest, respectful and cautious. This means that as they assist them in the recovery process, they should not involve them in disrespectful activities or situations. Therefore, this principle helps the doctors and nurses to respect the beliefs, values, and culture of the patients (Health.gov, 2016). Finally, stigma and discrimination are challenged by this recovery principle whenever they exist.
References
Blackwell, W. (2015). Engaging Families in the Treatment of Bipolar Disorder. Bipolar Disorders, 17, 13-13. https://dx.doi.org/10.1111/bdi.12306_2
Health.gov, (2016). Department of Health | National framework for recovery-oriented mental health services. Health.gov.au. Retrieved 25 August 2016, from https://www.health.gov.au/internet/main/publishing.nsf/Content/mental-pubs-n-recovfra
Leonard, B. & Jovinelly, J. (2012). Bipolar disorder. New York: Rosen Pub.
Malhi, G. (2009). The impact of lithium on bipolar disorder. Bipolar Disorders, 11, 1-3. https://dx.doi.org/10.1111/j.1399-5618.2009.00705.x
Malhi, G. (2016). Bipolar disorders: key clinical considerations. The Lancet, 387(10027), 1492-1494. https://dx.doi.org/10.1016/s0140-6736(15)01045-4
Miklowitz, D. (2011). The bipolar disorder survival guide. New York: Guilford Press.
National Institute of Mental Health, (2016). NIMH » Bipolar Disorder. Nimh.nih.gov. Retrieved 25 August 2016, from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml
Yildiz, A., Ruiz, P., & Nemeroff, C. (2015). The bipolar book. Oxford: Oxford University Press.
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