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Brandon - PATIENTS WITH POSSIBLE Hallucinations/Psychosis/Delusions/Deliri…
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He just started yelling and accusing me of cheating. I have no idea where this came from. He is normally very mild tempered and he has never questioned my faithfulness before.
- Review David's chart before taking action. Maybe there is more to this.
- Confront David. He shouldn't be yelling.
- Walk away. It is not your place to get involved in their marriage.
Sir! Stop your screaming! I can hear you from the nurses station. I have work to do. Leave your wife alone. You will be gone in a few days. Just be quite.
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Well, you lost your temper and your job. I get you didn't want to deal with him, but you missed out on a lot of information. It is important to keep in mind that someone being rude can always be a sign of something more.
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It might be against your morals, or you just don't feel like dealing with it, but you missed out on a lot of information regardless. A family member indicating abnormal behavior in a loved one is always important information that should be explored.
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PATIENT INFORMATION CHART
Patient name: David, Gordon
Age: 77
Prior Diagnosis: Parkinson's Disease
Reason for hospitalization: Broken hip from fall
Living situation: Assisted living facility
Time hospitalized: 12 hours ago
Relationship Status: Married
You notice the patient is diagnosed with PD. And from your extensive learning during second year clinical you learned that PD patients can suffer from delusions. You choose to explore this possibility more
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Yes, ok, will he be alright all alone?
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It is possible that this is a dementia-related episode, but it could also be a form of delirium associated with his PD diagnosis.
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I know it can be scary but it is good for you to be aware of the possibilities. We can't know for sure without an assessment. A risk factor for a person with PD to get delirium is when entering a new environment such as assisted living or a hospital.
Ok, I understand is this temporary?
It absolutely could be. We can learn more about what this is after an assessment if we can go ahead and do that?
Yes, please do whatever you need.
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Hello, David. My name is Br-
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You assess David's attention by talking to him about a variety of his interests. You note his wandering attention and his outbursts
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You discuss goals and interventions found on the "Hallucinations/Psychosis/Delusions/Delirium" document for delusions with his wife and caretakers
You did not notice any hallucinations during your assessment of David. You believe he is experiencing Delusions
You monitor David during his stay at the hospital and continuously evaluate his improvement before he heads back to the assisted living facility where they are prepared to continue your interventions and goals
Great job. You discovered as much information as you could and made long-term interventions and goals for the patient all while keeping a safe environment and remaining professional.
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