8.11 Learning Activity: Case Study
Case Study
Read each case study carefully. Use the information provided in the scenario, along with the course content and any required resources, to answer the questions.
Jennifer Rogers is a 31-year-old woman with bipolar I disorder who was admitted to the hospital last night for surgical repair of a left tibial fracture sustained during a fall associated with a manic episode. She was diagnosed with bipolar disorder in her mid-twenties, shortly after she married and graduated from law school. Her first major manic episode occurred six months after her wedding and required hospitalization. Jennifer recently stopped taking her prescribed medication.
Staff initially experienced difficulty communicating with Jennifer because of her profound hearing loss. Jennifer can read lips and communicates using American Sign Language (ASL). She underwent surgery early this morning, shortly after arriving at the emergency department (ED) by ambulance. Following surgery, she was admitted to the orthopedic unit, where she has been for several hours.
Jennifer is currently experiencing symptoms of mania. She is expressing grandiose ideas and insists that she is urgently needed in Washington, D.C., to solve current political issues.
Jennifer is married and has no children. Her sister lives nearby and is supportive. Jennifer works as an attorney specializing in tax law.
Jennifer’s husband, Joe Rogers, is in the room with her and is currently serving as her interpreter.
Jennifer’s injuries occurred after a fall and an altercation at a bar. Paramedics who responded to the 911 call reported that Jennifer was ranting about the government and stating that her destiny was to be “an angel” who could solve the government’s problems. She climbed onto a table in the bar. During the struggle that followed with security personnel, she fell from the table and sustained a tibial fracture.
Joe contacted the emergency department after discovering that Jennifer was missing from their home the previous evening. He arrived at the hospital before her surgery. Joe and Jennifer’s sister had been searching for her for several hours after learning that she had left work early that day.
Joe reports that Jennifer has not been sleeping or eating adequately for the past two weeks. The last time she stopped taking her medication was two years ago, which also resulted in a manic episode. During that episode, she accumulated more than $12,000 in credit card debt through excessive shopping.
Reflective Questions
- What cues do you recognize as relevant when providing nursing care for Jennifer?
- What is your hypothesis regarding Jennifer’s priority nursing problem or problems?
- What initial steps should be taken to provide client-centered care to Jennifer?
