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Sarah is a 38- year old woman brought to ER by police after a neighbor in her apartment building called due to Sarah attempting to open neighbor’s door and walking in the hallway with her underwear.  Sarah usually is at work during the day but neighbor told police that she has not left the apartment in several days.  Sarah does have a long history of Bipolar Disorder but has been stable for over 12 years on Lithium and Wellbutrin.  

Upon collecting history from Sarah, the ER nurse notes that she appears confused and disorganized at times and her speech is slurred.  Sarah states she has been taking her medications religiously and see her prescriber every 8 weeks for follow up.  Sarah admits to having been fighting a “bug” in the past weekand was taking Advil Cold and Sinus.  She is complaining of feeling sick to her stomach, nauseated, some diarrhea, feeling dizzy and fatigued which she equates to the “bug” she has.  The nurse also notes that Sarah has bilateral fine hand tremors. The nurse obtains his vital signs:  oral temperature = 97.8 F, Pulse = 100, Respiratory Rate = 20, Pulse Oximetry of 94%, and Blood Pressure = 138/88.  On exam hyperreflexia and nystagmus is noted.  

 

1. What is the most likely diagnosis?  What caused this condition? What are the signs and symptoms that support the likely diagnosis?  

 

2. What is the anticipated standard treatment for this condition?

 

3. Give at least three priority nursing diagnoses for this patient (Including RT and AEB)

 

4. What teaching should be included when a patient is prescribed Lithium?

 

 

 

 

SCIENCE
HEALTH SCIENCE
NURSING
PSYCH 2250