In a rush of words, a patient tells the community mental health ...

[justinmsk]

In a rush of words, a patient tells the community mental health nurse, Everything's a disaster I cannot concentrate. My disability check did not come. My roommate moved out and I cannot afford the rent. My therapist is moving away.
 
  I don't know what to do and feel like I'm coming apart. Which nursing diagnosis applies? a. Decisional conflict related to challenges to personal values.
  b. Spiritual distress related to ethical implications of treatment regimen.
  c. Anxiety related to changes perceived as threatening to psychological equilibrium.
  d. Self-concept disturbance related to solving multiple problems affecting security needs.

Question 2

A patient with bipolar disorder has rapid cycles. To prepare teaching materials, the nurse anticipates which medication will be prescribed?
 
  a. Clonidine (Catapres)
  b. Phenytoin (Dilantin)
  c. Carbamazepine (Tegretol)
  d. Chlorpromazine (Thorazine)

[LVPMS]

Answer to Question 1

C
Subjective and objective data obtained by the nurse suggest the patient is experiencing anxiety caused by multiple threats to security needs. Data are not present to suggest decisional conflict, ethical conflicts around treatment causing spiritual distress, or self-concept disturbance.

Answer to Question 2

C
Some patients with bipolar disorder, especially those who have only short periods between episodes, have a favorable response to the anticonvulsants carbamazepine and valproate. Phenytoin (Dilantin) is also an anticonvulsant, but it is not used for mood stabilization. Carbamazepine seems to work better in patients with rapid cycling and in severely paranoid, angry, patients with mania.

[justinmsk]

Thanks for the timely response, appreciate it

[nyrave]

Gracias!