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Assessment Questions Question 1 

Read the following case study and answer the questions below.

Michael is a 46-year-old man who is being treated in an adult inpatient unit. He was brought into hospital by Police after he was found in Queen St Mall – he was shouting the “bikies are out to get me” and appeared to be distressed and afraid, running aimlessly and often looking behind. He was not wearing shoes, and his only clothing was a towel wrapped around his lower body. He appeared to be very disheveled, his hair was matted and dirty, as were his hands and feet. There were multiple cuts to his hands, some of them deep. When the Police approached Michael, he was challenging to engage, not re-directable, speaking out of turn, intrusive and looking all around him with a startled expression. He also appeared to be paranoid about hospital staff being “undercover bikies”. He told Police he did not want to go to hospital as he feared the nurses would poison his medication and be able to “read his thoughts”. He very reluctantly agreed to attend hospital for assessment.

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Background information: Michael has a diagnosis of Paranoid Schizophrenia, which was diagnosed when he was 19. Michael finished year 12 although found it very challenging to maintain concentration and often lacked motivation to engage with study, his family, and his peers. He started using cannabis as a way to “sleep and relax” and has been using this ever since that time. Michael moved out of his parent’s home when he was 20 and has been living in shared accommodation since. Michael is currently homeless as he was evicted from his shared unit as he did not pay his rent. Michael has in the past worked as a labourer in construction, however ceased this after becoming unwell. He has been unemployed for the past two years and receives DSP (Disability Support Pension).  Nursing Assignment Help

Michael has had multiple admissions for the care of his illness (the last one was 1.5 years ago). He has been prescribed multiple anti-psychotic medication, with limited effect. The last medication he took was Olanzapine (oral). He self-ceased this medication about three months ago, states “it made me fat and did not do anything for me, anyway”

Michael’s parents try to remain in contact (they also live in Brisbane). However, this is hard as he does not have a phone. Michael has a younger brother and they see each other when Michael goes home for a few days at Christmas. Michael’s grandfather also had schizophrenia and completed suicide aged 50.

Michael had a long-term partner however she died of an overdose five years ago. They had no children.

You meet Michael for the first time on the day following his admission. You introduce yourself to him and take him to a quiet place to have a conversation. He appears confused and tells you he does not know why he is in hospital, saying: “there is nothing wrong with me, it is all the bikies’ and the nurses, you are all out to get me”. He is not aggressive towards you however he is not happy to be in hospital. He tells you he has not slept well for a few days as he is “worried about the bikies’ finding him”. He also appears very thin. His cuts have been cleaned and bandaged.

Question 1a. Define and describe what it means to be Paranoid.

Question 1 b. Identify and justify two immediate priorities for Michael’s Nursing care. (Priorities should be- non-pharmacological).

Question 1c. Discuss two Nursing interventions to address each of the above priorities, drawing on peer-reviewed evidence.

Question 1d. Linking to the MSE component of “insight”, identify the legal considerations for Michael’s admission? Nursing Assignment Help


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