You are a new graduate nurse and part of a small multidisciplinary team in a large 24-hour medical clinic. A young woman has just presented. She is dishevelled, appears nervous, constantly moving about the waiting room looking closely at different objects. She responds warily to any interaction with other patients. She has asked reception several times if a doctor can see her now. The duty doctor asks you to sit in and assist him with the interview.
1. Describe the key communication skills you will use in order to engage with her in the interview. (400 words)
The young woman gives her name as Sarah. In response to asking why she has attended, she gives a clearly articulated story about a school teacher using radiation to control her thoughts. She describes difficulty getting onto the train to attend school as she feels other passengers can find out what she is thinking. When you ask her how she feels about her situation she says it is very confusing and frightening. In response to the doctor asking if he can help, she says she wants him to “make it all stop”.
2. There are a number of clinical signs and symptoms in the scenario so far. Identify three significant signs or symptoms and support your clinical opinion with evidence from the scenario. (400 words)
Following a basic physical and presenting history the doctor acknowledged the confusion and distress, explaining she is experiencing psychotic symptoms. He seeks Sarah’s permission to ring her mother. He also makes an appointment for the next day to see her again. Before leaving she is provided with a script for 5mg olanzapine nocte.
3. Discuss the education you will need to provide to Sarah about her medication. (400 words)
Sarah briefly acknowledges the education you provided to her. However, you notice that her responses are monosyllabic with a flat tone, and she did not ask any questions.
4. Her response may suggest that she did not fully grasp the information you were providing. Discuss your clinical plan to address compliance issues that might arise for Sarah. (400 words)
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