Question

Case Study

Clark is in jail for scamming an elderly couple out of their money. As the jail’s evening nurse makes her rounds, she stops to see if Clark has any health problems. He tells her, “You’re too pretty to be a nurse. You should be a model.” He engages the nurse in conversation and then asks, “If you would make a phone call for me, I’d give you $60. It’s just between us. Don’t tell anyone about this.” The nurse schedules Clark for a visit with the psychiatrist who comes daily to the jail. After examining Clark and getting a history, the psychiatrist writes a diagnosis of Antisocial Personality Disorder (APD). He adds Alcohol Abuse and Marijuana Abuse. Clark has a pending driving while intoxicated (DWI) charge, and his drug screen is positive for marijuana. The psychiatrist writes an order for carbamazepine (Tegretol XR), with vital signs taken every shift.

Questions

1. As the nurse, how would you respond to Clark’s comments about your looks and his proposition regarding the phone call?

2. What criteria must the client meet to qualify for a diagnosis of APD? Does this client’s history support this diagnosis?

3. Why did the psychiatrist prescribe carbamazepine? What do you need to teach the client about carbamazepine?

4. Do clients with APD get better or is it impossible to change antisocial personality traits?

5. What nursing interventions would you implement for Clark?

Answer 1

1-As a nurse I would follow my duty guidelines and not allow him or make myself available with phone to Clark. This is against the ethical decision as well as Clark being convicted of different charges, it would be breaking the prison rule to help him make a call.

2-A genuine communications complaint is called a clinical object. The notion of the clinical entity is significant when lecturing provocative circumstances such as auditory processing disorder (APD)—occasionally also named central auditory processing disorder. When relating these principles to APD, the complaint doesn’t hold-up as a genuine scientific entity. Primary, APD does not own an unambiguous description. The extensive diversity of examination gratified consequences in an obviously varied patient collection. Varied meanings of APD, plus the absence of test calibration, makes it indistinct if an APD analysis encounters the third standards—a restraint for the patient. As for the quarter standards, the concept of APD does not enable the course of analysis or involvement.

3-Carbamazepine is used to stop and regulator seizures. This medicine is recognized as an anticonvulsant or anti-epileptic medication. It is likewise used to dismiss convinced kinds of nerve pain. This medicine mechanisms by plummeting the spread of seizure movement in the brain and reinstating the usual equilibrium of nerve activity.

Patient education:

You require to take carbamazepine frequently every day. Do not halt captivating it except your doctor expresses you to halt. Stopping management abruptly can reason glitches and your doctor will want you to decrease your amount progressively if this becomes essential.

4-As with any conduct, the emphasis on spirits and linking antisocial conduct to suitable feeling states is appropriate. Since inpatient agendas tend to be more concentrated and exclusive, they are infrequently required out by the patient themselves. Communal follow-up and provision, moreover by the hospital or specialists, or with the usage of self-help sustenance collections, is imperative to upholding conduct improvements.

5- An unresolved analytic trial is the level of perceptual difficulty, in relations of inducement and task/exam, at which the trouble exist in. While APD is normally called APD, it prepares not map merely onto the purpose of the old-style dominant auditory scheme. The patient would need someone to hear him out which will help management of this anti-social behavior.