Case Study 1: Psych Patient in ED

Aaron Smith, age 20, is a psychiatric patient with bipolar disorder. At the request of his father, he is brought by police to the Emergency Department. This is his third visit to the ED for psychiatric treatment this year.

Personal History and Recent Events

Personal History and Recent Events

Last month, Aaron was expelled from his college dorm due to aggressive behavior and substance abuse. He has moved back into his parents' home. Today, in an outburst, he put his fist through a wall and then turned his rage toward his father. His parents suspect he has stopped taking his medication for bipolar disorder.

Aaron's Demeanor upon Arrival

Aaron displays classic signs of potential to become violent. These include:

  • disheveled appearance
  • clenched fists

Cues from Hospital Records

A quick look at Aaron's hospital records reveals a history of violent behavior:

  • Aaron is being treated for bipolar disorder with prescribed medications.
  • He has had two other recent ED visits before this one: once for disruptive, violent behavior, and once for a drug overdose.
  • He rated "high" for dangerousness on assessment from a previous visit.

Triage Reveals Suicidal Thoughts

The triage nurse questions Aaron to help determine the extent of present danger. After several prompts to get beyond surface answers, the nurse learns that besides his violent outburst at home, Aaron had planned to kill himself by crashing his car, which increases his risk of danger to others.

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Recommended on NP Psych Navigator

Disease Primer

Major depressive disorder (MDD) is one of the most recognized mental disorders in the United States. Learn more about the prevalence, pathophysiology, diagnosis, and management of MDD here.

Clinical Article

State-Dependent Differences in Emotion Regulation Between Unmedicated Bipolar Disorder and Major Depressive Disorder

Rive et al use functional MRI to look at some of the differences between patients with bipolar depression and major depressive disorder.

Unrecognized Bipolar Disorder in Patients With Depression Managed in Primary Care: A Systematic Review and Meta-Analysis

Daveney et al explore the characteristics of patients with mixed symptoms, as compared to those without mixed symptoms, in both bipolar disorder and major depressive disorder.

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Faculty Case Studies

The purpose of this project was to develop a repository of NextGen NCLEX case studies that can be accessed by all faculty members in Maryland.

Detailed information about how faculty members can use these case students is in this PowerPoint document .

The case studies are in a Word document and can be modified by faculty members as they determine. 

NOTE: The answers to the questions found in the NextGen NCLEX Test Bank  are only available in these faculty case studies. When students take the Test Bank questions, they will not get feedback on correct answers. Students and faculty should review test results and correct answers together.

The case studies are contained in 4 categories: Family (13 case studies), Fundamentals and Mental Health (14 case studies) and Medical Surgical (20 case studies). In addition the folder labeled minireviews contains PowerPoint sessions with combinations of case studies and standalone items. 

Family  ▾

  • Attention Deficit Hyperactivity Disorder - Pediatric
  • Ectopic Pregnancy
  • Febrile Seizures
  • Gestational Diabetes
  • Intimate Partner Violence
  • Neonatal Jaundice
  • Neonatal Respiratory Distress Syndrome
  • Pediatric Hypoglycemia
  • Pediatric Anaphylaxis
  • Pediatric Diarrhea and Dehydration
  • Pediatric Intussusception
  • Pediatric Sickle Cell
  • Postpartum Hemmorhage
  • Poststreptococcal Glomerulonephritis Pediatric
  • Preeclampsia

Fundamentals and Mental Health  ▾

  • Abdominal Surgery Postoperative Care
  • Anorexia with Dehydration
  • Catheter Related Urinary Tract Infection
  • Deep Vein Thrombosis
  • Dehydration Alzheimers
  • Electroconvulsive Therapy
  • Home Safety I
  • Home Safety II
  • Neuroleptic Maligant Syndrome
  • Opioid Overdose
  • Post Operative Atelectasis
  • Post-traumatic Stress
  • Pressure Injury
  • Substance Use Withdrawal and Pain Control
  • Suicide Prevention
  • Tardive Dyskinesia
  • Transfusion Reaction
  • Urinary Tract infection

Medical Surgical  ▾

  • Acute Asthma
  • Acute Respiratory Distress
  • Breast Cancer
  • Chest Pain (MI)
  • Compartment Syndrome
  • Deep Vein Thrombosis II
  • End Stage Renal Disease and Dialysis
  • Gastroesphageal Reflux
  • Heart Failure
  • HIV with Opportunistic Infection
  • Ketoacidosis
  • Liver Failure
  • Prostate Cancer
  • Spine Surgery
  • Tension Pneumothorax
  • Thyroid Storm
  • Tuberculosis

Community Based  ▾

Mini Review  ▾

  • Comprehensive Review
  • Fundamentals
  • Maternal Newborn Review
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Mental Health and Psychiatric Nursing

sample case study psychiatric nursing

The field of mental health often seems a little unfamiliar or mysterious, making it hard to imagine what the experience will be like or what nurses do in this area. This is an overview of the history of mental illness, advances in treatment, current issues in mental health, and the role of the psychiatric nurse .

Table of Contents

Mental health, mental illness, diagnostic and statistical manual of mental disorders, ancient times, period of enlightenment and creation of mental institutions, sigmund freud and treatment of mental disorders, development of psychopharmacology, mental illness in the 21st century, psychiatric nursing practice, mental health and mental illness.

Mental health and mental illness are difficult to define precisely. The culture of any society strongly influences its beliefs and values, and this in turn affects how that society defines health and illness.

No single universal definition of mental health exists. Generally, a person’s behavior can provide clues to his or her mental health.

  • In most cases, mental health is a state of emotional, psychological, and social wellness evidenced by satisfying interpersonal relationships , effective behavior and coping, positive self-concept, and emotional stability.
  • Factors influencing a person’s mental health can be categorized as individual, interpersonal, and social/cultural.
  • Individual , or personal, factors include a person’s biologic make up, autonomy and independence, self-esteem , capacity for growth, vitality, ability to find meaning in life, emotional resilience or hardiness, sense of belonging, reality orientation, and coping or stress management abilities.
  • Interpersonal , or relationship, factors include effective communication , ability to help others, intimacy, and a balance of separateness and connectedness.
  • Social/cultural , or environmental, factors include a sense of community, access to adequate resources, intolerance of violence, support of diversity among people, mastery of the environment, and a positive, yet realistic, view of one’s world.

The American Psychiatric Association (APA, 2000) defines a mental disorder as “a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and is associated with present distress or with a significantly increased risk of suffering death , pain , disability, or an important loss of freedom.

  • General criteria to diagnose mental disorders include dissatisfaction with one’s characteristics, abilities, and accomplishments; ineffective or unsatisfying relationships; dissatisfaction with one’s place in the world; ineffective coping with life events; and lack of personal growth.
  • Factors contributing to mental illness also can be viewed within individual, interpersonal, and social/cultural categories.
  • Individual factors include biologic make up, intolerable or unrealistic worries or fears, inability to distinguish reality from fantasy, intolerance of life’s uncertainties, a sense of disharmony in life, and a loss of meaning in one’s life.
  • Interpersonal factors include ineffective communication , excessive dependency on or withdrawal from relationships, no sense of belonging, inadequate social support, and loss of emotional control.
  • Social/cultural factors include lack of resources, violence, homelessness, poverty, an unwarranted negative view of the world, and discrimination.

The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR)  is a taxonomy published by the APA.

  • The DSM-IV-TR describes all mental disorders, outlining specific diagnostic criteria for each based on clinical experience and research.
  • The DSM-IV-TR has three purposes:
  • To provide a standardized nomenclature and language for all mental health professionals.
  • To present defining characteristics or symptoms that differentiate specific diagnoses.
  • To assist in identifying the underlying causes of disorders.
  • The multiaxial classification system that involves assessment on several axes, or domains of information, allows the practitioner to identify all the factors that relate to a person’s condition.
  • Axis I is for identifying all major psychiatric disorders except mental retardation and personality disorders .
  • Axis II is for reporting mental retardation and personality disorders as well as prominent maladaptive personality features and defense mechanisms .
  • Axis III is for reporting current medical conditions that are potentially relevant to understanding or managing the person’s mental disorder as well as medical conditions that might contribute to understanding the person.
  • Axis IV for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of mental disorders.
  • Axis V presents a Global Assessment of Functioning, which rates the person’s overall psychological functioning on a scale of 0 to 100; this represents the clinician’s assessment of the person’s current level of functioning.

Historical Perspectives of the Treatment of Mental Illness

  • People of ancient times believed that any sickness indicated displeasure of the gods and in fact was punishment for sins and wrongdoing.
  • Those with mental disorders were viewed as either divine or demonic, depending on their behavior.
  • Later, Aristotle attempted to relate mental disorders to physical disorders and developed his theory that the amounts of blood , water, and yellow and black bile in the body controlled the emotions.
  • These four substances, or humors, corresponded with happiness, calmness, anger, and sadness; imbalances of the four humors were believed to cause mental disorders, so treatment was aimed at restoring balance through bloodletting, starving, and purging.
  • In early Christian times, all diseases were again blamed on demons, and the mentally ill were viewed as possessed; priests perform exorcism to to rid evil spirits.
  • During the Renaissance, people with mental illness were distinguished from criminals in England; those considered harmless were allowed to wander the countryside and or live in rural communities, but the more “dangerous lunatics” were thrown in prison, chained, and starved.
  • In 1547, the Hospital of St. Mary of Bethlehem was officially declared a hospital for the insane, the first of its kind; by 1775, visitors at the institution were charged a fee for the privilege of viewing and ridiculing the intimates, who were seen as animals, less than human.
  • In the 1790s, a period of enlightenment concerning persons with mental illness began.
  • Phillipe Pinel in France and William Tukes in England formulated the concept of asylum as a safe refuge or haven offering protection at institutions where people had been whipped, beaten, or starved just because they were mentally ill (Gollaher, 1995).
  • In the United States, Dorothea Dix (1802-1887) began a crusade to reform the treatment of mental illness after a visit to Tukes’ institution in England; she was instrumental in opening 32 state hospitals that offered asylum to the suffering.
  • The period of scientific study and treatment of mental disorders began with Sigmund Freud (1856-1939) and others, such as Emil Kraeplin (1856-1926) and Eugene Bleuler (1857-1939).
  • With these men, the study of psychiatry and the diagnosis and treatment of mental illness started in earnest.
  • Freud challenged society to view human beings objectively; he studied the mind, its disorders, and their treatment as no one had before.
  • Kraeplin began classifying mental disorders according to their symptoms, and Bleuler coined the term schizophrenia .
  • A great leap in the treatment of mental illness began in about 1950 with the development of psychotropic drugs, or drugs used to treat mental illness.
  • Chlorpromazine ( Thorazine ) an antipsychotic drug, and lithium, an antimanic agent, were the first drugs to be developed.
  • Over the following 10 years, monoamine oxidase inhibitor antidepressants , haloperidol ( Haldol ), an antipsychotic; tricyclic antidepressants ; and antianxiety agents, called benzodiazepines , were introduced.

The National Institute of Mental Health (NIMH) estimates that more than 26% of Americans aged 18 years and older have a diagnosable mental disorder- approximately 57.7 million persons each year (2006).

  • Furthermore, mental illness or serious emotional disturbances impair daily activities for an estimated 10 million adults and 4 million children and adolescents.
  • Mental disorders are the leading cause of disability in the United States and Canada for persons 15 to 44 years of age.
  • Homelessness is a major problem in the United States today; the National Resource and Training Center on Homelessness and Mental Illness (2006) estimates that one-third of adult homeless persons have a serious mental illness and that more than one half also have substance abuse problems.
  • In 1993, the federal government created and funded Access to Community Care and Effective Services and Support (ACCESS) to begin to address the needs of people with mental illness who were homeless either all or part of the time.
  • In 1873, Linda Richards graduated from the New England Hospital for Women and Children in Boston; she went on to improve nursing care in psychiatric hospitals and organized educational programs in state mental hospitals in Illinois.
  • Richards is called the first American psychiatric nurse; she believed that “the mentally sick should be at least as well cared for as the physically sick” (Doona, 1984).
  • The first training of nurses to work with persons with mental illness was in 1882 at McLean Hospital in Belmont, Massachusetts.
  • The care was primarily custodial and focused on nutrition , hygiene , and activity.
  • The role of psychiatric nurses expanded as somatic therapies for the treatment of mental disorders were developed.
  • Treatments such as insulin shock therapy (1935), psychosurgery (1936), and electroconvulsive therapy (1937) required nurses to use their medical- surgical skills more extensively.
  • The first psychiatric nursing textbook, Nursing Mental Diseases by Harriet Bailey was published in 1920; in 1913, John Hopkins was the first school of nursing to include a course in psychiatric nursing in its curriculum.
  • In 1973, the division of psychiatric and mental health practice of the American Nurses Association (ANA) developed standards of care, which it revised in 1982, 1994, and 2000.
  • Standards of care are authoritative statements by professional organizations that describe the responsibilities for which nurses are accountable.
  • The goal of self-awareness is to know oneself so that ones’ values, attitudes, and beliefs are not projected to the client, interfering with nursing care; self-awareness does not mean having to change one’s values and beliefs unless one desires to do so.

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Case Studies

Case 5: denise.

Denise, a 19-year-old woman, has been admitted informally to an acute mental health ward; this is Denise's first admission. Denise was being treated for depression by her GP; prior to her admission Denise attempted to kill herself by cutting her wrists. Subsequently a short admission was arranged with the aim of devising a comprehensive care package.

After speaking about the circumstances leading up to her suicide attempt Denise became increasingly tearful and distressed, and started demanding to see a doctor. After being told that the doctor was on their way and would arrive in about 10 minutes, Denise became angry demanding medication to calm her down; she then proceeded to run towards the ward's doors shouting that she wanted to go home. At that moment the doctor arrived on the ward and Denise also immediately calmed down.

During the assessment process Denise disclosed that being angry if she did not get her way was not unusual for her. She also mentioned that she felt awful after these bouts of anger. She described herself as a "terrible person who was out of control" and she just wanted to die. After assessing Denise the nurse started to formulate a plan of care.

(a) What type of psychological interventions would the nurse consider implementing?

Show Answer

  • Build a collaborative and therapeutic relationship based on a person-centred approach.
  • Normalise an individual's experiences of mental distress.
  • Take a "strengths approach".
  • Maintain safety and effectively manage challenging behaviours.
  • Explore the individual's capacity to change.
  • Modify thought processes – identify, challenge and replace negative thoughts.
  • Focus on the individual controlling and regulating their behaviour – promoting and enhancing healthy ways of coping.
  • Prevent social isolation and promote social functioning.
  • Focus on relapse prevention – early warning signs and self-monitoring of symptoms.
  • Signpost to self-help and relevant support groups.
  • Therapeutically support recovery.

(b) Currently Denise has been admitted informally to the ward. Due to Denise's impulse control difficulties this may change. On this basis what does the nurse professionally need to know when managing Denise's legal status?

  • Understand and apply current legislation in a way that protects Denise.
  • Act in accordance with the law, relevant ethical and regulatory frameworks, and also take into account local protocols/policies.
  • Respect and uphold Denise's rights
  • Know when to actively share personal information with others when the interests of safety and protection override the need for confidentiality.

(c) Denise is subsequently diagnosed with a "borderline personality disorder". What other types of personality disorders are there?

  • Cluster A – paranoid, schizoid and schizotypal.
  • Cluster B – antisocial (type: dissocial), borderline (type: emotionally unstable), histrionic, and narcissistic (not included in types).
  • Cluster C – avoidant (type: anxious), dependent, obsessive-compulsive (type: anankastic).
  • paranoid – suspicious and excessively sensitive;
  • schizoid – emotional coldness, little interest in other people;
  • schizotypal – odd beliefs and unusual appearance;
  • borderline – instability of mood, impulsive;
  • histrionic – excessive attention seeking;
  • narcissistic – grandiose and arrogant;
  • antisocial – disregard of self and others;
  • avoidant – feelings of inadequacy;
  • dependent – submissive behaviour;
  • 0bsessive-compulsive – a preoccupation with orderliness.

(d) What specific psychological interventions would the nurse deliver?

  • boundary setting;
  • promoting healthy ways of coping;
  • motivational interviewing and pre-therapy work;
  • delivering specific therapeutic approaches/therapies.

(e) How could the nurse learn from their experiences of working with Denise?

  • identifying and describing the experiences;
  • examining the experiences in depth and teasing out the key issues;
  • critically processing the issues;
  • learning from the experiences by implementing future actions that improve the nurse's practice.

Denise has now been on the ward for over 6 months. Each time discharge has been arranged Denise self-harms or threatens suicide. Denise has now agreed to go to a therapeutic community, a place has been secured and Denise is now engaging in pre-therapy work.

(a) What other treatments besides a therapeutic community are recommended for individuals diagnosed with a borderline personality disorder?

  • cognitive behaviour therapy – group and individual;
  • behavioural approaches;
  • mentalisation-based approaches;
  • dialectic behaviour therapy.

(b) While working with Denise the primary nurse has found the relationship at times to be quite stressful. What are the signs of stress?

  • sleep problems;
  • loss of appetite;
  • difficulty concentrating;
  • constantly feeling anxious;
  • feeling irritable and/or angry;
  • having repeating thoughts;
  • avoiding certain situations and/or people;
  • an increased use of alcohol;
  • muscle tension.

(c) What strategies could the nurse use to manage their stress?

  • engage in physical activity;
  • engage in something that makes them laugh;
  • learn relaxation and/or deep breathing techniques;
  • take control of the situation;
  • seek support and talk;
  • problem solve;
  • eat a healthily diet;
  • drink plenty of water;
  • be mindful.

(d) What process should be utilised as a way to support the primary nurse to improve their practice?

Correct answer: A common method of systematically reflecting on practice is through the clinical supervision, which is a formal activity where a clinical supervisor facilitates the nurse to reflect upon their practice and identify strategies that focus on improving their practice.

Consider Chapters 20, 34 and 37.

Print Answers | « Previous Case

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  • Section One: Introduction
  • Section Two: Learning and Teaching Resources to Support Integration of Mental Health and Addiction in Curricula
  • Section Three: Faculty Teaching Modalities and Reflective Practice
  • Section Four: Student Reflective Practice and Self-Care in Mental Health and Addiction Nursing Education
  • Section Five: Foundational Concepts and Mental Health Skills in Mental Health and Addiction Nursing
  • Section Six: Legislation, Ethics and Advocacy in Mental Health and Addiction Nursing Practice
  • Section Seven: Clinical Placements and Simulations in Mental Health and Addiction Nursing Education
  • Section Eight: Reference and Bibliography
  • Section Nine: Appendices and Case Studies

Section Nine

Case studies, also in this section.

  • Alignment between CASN/ CFMHN Entry-to-Practice Mental Health and Addiction Competencies and Sections in the Nurse Educator Mental Health and Addiction Resource
  • Process Recording
  • Criteria for Validation: Process Recording
  • Criteria for Phase of Relationship: Process Recording
  • Journaling Activity
  • Safety and Comfort Plan Template
  • Advocacy Groups for Mental Health in Canada
  • Tips for Engaging Lived Experience
  • Glossary of Terms
  • Case Study 1
  • Case Study 2
  • Case Study 3
  • Case Study 4
  • Case Study 5
  • Case Study 6
  • Case Study 7
  • Case Study 8
  • Case Study 9

The case study is an effective teaching strategy that is used to facilitate learning, improve critical thinking, and enhance decision-making Sprang, (2010). Below are nine case studies that educators may employ when working with students on mental illness and addiction. The case studies provided cover major concepts contained in the RNAO Nurse Educator Mental Health and Addiction Resource.

While not exhaustive, the case studies were developed and informed by the expert panel. It is recommended that educators use the case studies and tweak or add questions as necessary to impart essential information to students. Also, educators are encouraged to modify them to suit the learning objective and mirror the region in which the studies are taking place. Potential modifications include:

  • demographics (age, gender, ethnicity);
  • illness and addiction, dual diagnosis or additional co-morbidities such as cardiovascular disease; and
  • setting (clinical, community).

Suggested “Student questions” explore areas of learning, while “Educator elaborations” recommend ways to modify the case study. Discussion topics are a limited list of suggested themes.

When using these case studies, it is essential that this resource is referenced.

See Engaging Clients Who Use Substances BPG appendices for examples

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Nursing Case Study Examples and Solutions

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NursingStudy.org is your ultimate resource for nursing case study examples and solutions. Whether you’re a nursing student, a seasoned nurse looking to enhance your skills, or a healthcare professional seeking in-depth case studies, our comprehensive collection has got you covered. Explore our extensive category of nursing case study examples and solutions to gain valuable insights, improve your critical thinking abilities, and enhance your overall clinical knowledge.

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Discover a wide range of comprehensive nursing case study examples and solutions that cover various medical specialties and scenarios. These meticulously crafted case studies offer real-life patient scenarios, providing you with a deeper understanding of nursing practices and clinical decision-making processes. Each case study presents a unique set of challenges and opportunities for learning, making them an invaluable resource for nursing education and professional development.

  • Nursing Case Study Analysis [10 Examples & How-To Guides] What is a case study analysis? A case study analysis is a detailed examination of a specific real-world situation or event. It is typically used in business or nursing school to help students learn how to analyze complex problems and make decisions based on limited information.
  • State three nursing diagnoses using taxonomy of North American Nursing Diagnosis Association (NANDA) that are appropriate, formatted correctly, prioritized, and are based on the case study. NUR 403 Week 2 Individual Assignment Case Study comprises: Resources: The case study found on p. 131 in Nursing Theory and the Case Study Grid on the Materials page of the student website Complete the Case Study Grid. List five factors of patient history that demonstrates nursing needs. 
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Pediatric Nursing Case Studies

Nursing Case Study Examples

In this section, delve into the world of pediatric nursing through our engaging and informative case studies. Gain valuable insights into caring for infants, children, and adolescents, as you explore the complexities of pediatric healthcare. Our pediatric nursing case studies highlight common pediatric conditions, ethical dilemmas, and evidence-based interventions, enabling you to enhance your pediatric nursing skills and deliver optimal care to young patients.

  • Case on Pediatrics : Part 1& 2 Solutions
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Mental Health Nursing Case Study Examples 

Mental health nursing plays a crucial role in promoting emotional well-being and providing care for individuals with mental health conditions. Immerse yourself in our mental health nursing case studies, which encompass a wide range of psychiatric disorders, therapeutic approaches, and psychosocial interventions. These case studies offer a holistic view of mental health nursing, equipping you with the knowledge and skills to support individuals on their journey to recovery.

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Geriatric Nursing Case Studies

As the population ages, the demand for geriatric nursing expertise continues to rise. Our geriatric nursing case studies focus on the unique challenges faced by older adults, such as chronic illnesses, cognitive impairments, and end-of-life care. By exploring these case studies, you’ll develop a deeper understanding of geriatric nursing principles, evidence-based gerontological interventions, and strategies for promoting optimal health and well-being in older adults.

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  • Promoting And Protecting Vulnerable Populations – Describe what is meant by vulnerable populations and explain strategies you, as the public health nurse, could use to best facilitate the achievement of healthful outcomes in this population? 

Community Health Nursing Case Studies

Community health nursing plays a vital role in promoting health, preventing diseases, and advocating for underserved populations. Dive into our collection of community health nursing case studies, which explore diverse community settings, public health issues, and population-specific challenges. Through these case studies, you’ll gain insights into the role of community health nurses, interdisciplinary collaboration, health promotion strategies, and disease prevention initiatives.

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Critical Care Nursing Case Study Examples 

Critical care nursing demands swift decision-making, advanced technical skills, and the ability to provide intensive care to acutely ill patients. Our critical care nursing case studies encompass a range of high-acuity scenarios, including trauma, cardiac emergencies, and respiratory distress. These case studies simulate the fast-paced critical care environment, enabling you to sharpen your critical thinking skills, enhance your clinical judgment, and deliver exceptional care to critically ill patients.

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Maternal and Child Health Nursing Case Study Examples

The field of maternal and child health nursing requires specialized knowledge and skills to support the health and well-being of women and children throughout their lifespan. Explore our collection of maternal and child health nursing case studies, which encompass prenatal care, labor and delivery, postpartum care, and pediatric nursing. These case studies provide a comprehensive view of maternal and child health, allowing you to develop expertise in this essential area of nursing practice.

You can also check out Patient Safety in High-Tech Settings PICOT Questions Examples

Surgical Nursing Case Studies

Surgical nursing involves caring for patients before, during, and after surgical procedures. Our surgical nursing case studies cover a wide range of surgical specialties, including orthopedics, cardiovascular, and gastrointestinal surgeries. Delve into these case studies to gain insights into preoperative assessment, perioperative management, and postoperative care. By examining real-life surgical scenarios, you’ll develop a comprehensive understanding of surgical nursing principles and refine your skills in providing exceptional care to surgical patients.

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Obstetric Nursing Case Study

Obstetric nursing focuses on providing care to women during pregnancy, childbirth, and the postpartum period. Our obstetric nursing case studies explore various aspects of prenatal care, labor and delivery, and postpartum recovery. Gain valuable knowledge about common obstetric complications, evidence-based interventions, and strategies for promoting maternal and fetal well-being. These case studies will enhance your obstetric nursing skills and prepare you to deliver compassionate and competent care to expectant mothers.

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Nursing Ethics Case Study

Ethical dilemmas are an inherent part of nursing practice. Our nursing ethics case studies shed light on complex ethical issues that nurses encounter in their daily work. Explore thought-provoking scenarios involving patient autonomy, confidentiality, end-of-life decisions, and resource allocation. By examining these case studies, you’ll develop a deeper understanding of ethical principles, ethical decision-making frameworks, and strategies for navigating ethical challenges in nursing practice.

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Health Promotion Case Study

Community health promotion plays a crucial role in improving the health and well-being of populations. Our community health promotion case studies highlight successful initiatives aimed at preventing diseases, promoting healthy lifestyles, and addressing social determinants of health. Explore strategies for community engagement, health education, and collaborative interventions that make a positive impact on the well-being of individuals and communities.

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  • levels of health promotion
  • Integrate evidence from research and theory into discussions of practice competencies, health promotion and disease prevention strategies, quality improvement, and safety standards.
  • Discuss various theories of health promotion, including Pender’s Health Promotion Model, the Health Belief Model, the Transtheoretical Theory, and the Theory of Reasoned Action.
  • What strategies, besides the use of learning styles, can a nurse educator consider when developing tailored individual care plans, or for educational programs in health promotion?
  • Describe health promotion for Pregnant women
  • Identify a health problem or need for health promotion for a particular stage in the life span of a population from a specific culture in your area. Choose one of the Leading Health Indicators (LHI) priorities from Healthy People 2020: https://www.healthypeople.gov/2020/Leading-Health-Indicators
  •   A description of a borrowed theory (expectancy-value theory and social cognitive theory) that could be applied to improve health promotion patient education in primary care clinic. Is this borrowed theory appropriate?
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Nursing Leadership Case Studies

Nursing leadership is essential for driving positive change and ensuring high-quality patient care. Our nursing leadership case studies examine effective leadership strategies, change management initiatives, and interprofessional collaboration in healthcare settings. Gain insights into the qualities of successful nurse leaders, explore innovative approaches to leadership, and learn how to inspire and motivate your team to achieve excellence in nursing practice.

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  • One nursing theory will be presented as a framework to resolve a problem occurring within one of the professional areas of leadership, education, informatics, healthcare policy or advance clinical practice.  The same nursing theory selected in Assignment One may be used to resolve the identified problem. 
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At NursingStudy.org, we strive to provide you with a comprehensive collection of nursing case study examples and solutions that align with the best practices recommended by YOAST and RankMath. By exploring these diverse case studies, you’ll enhance your clinical knowledge, critical thinking abilities, and overall understanding of nursing practice. Take advantage of this valuable resource and elevate your nursing skills to new heights.

Remember, success in nursing begins with knowledge and continues with lifelong learning. Explore our nursing case study examples and solutions today and embark on a journey of professional growth and excellence.

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Patient Case #1: 27-Year-Old Woman With Bipolar Disorder

  • Theresa Cerulli, MD
  • Tina Matthews-Hayes, DNP, FNP, PMHNP

Custom Around the Practice Video Series

Experts in psychiatry review the case of a 27-year-old woman who presents for evaluation of a complex depressive disorder.

sample case study psychiatric nursing

EP: 1 . Patient Case #1: 27-Year-Old Woman With Bipolar Disorder

Ep: 2 . clinical significance of bipolar disorder, ep: 3 . clinical impressions from patient case #1, ep: 4 . diagnosis of bipolar disorder, ep: 5 . treatment options for bipolar disorder, ep: 6 . patient case #2: 47-year-old man with treatment resistant depression (trd), ep: 7 . patient case #2 continued: novel second-generation antipsychotics, ep: 8 . role of telemedicine in bipolar disorder.

Michael E. Thase, MD : Hello and welcome to this Psychiatric Times™ Around the Practice , “Identification and Management of Bipolar Disorder. ”I’m Michael Thase, professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania.

Joining me today are: Dr Gustavo Alva, the medical director of ATP Clinical Research in Costa Mesa, California; Dr Theresa Cerulli, the medical director of Cerulli and Associates in North Andover, Massachusetts; and Dr Tina Matthew-Hayes, a dual-certified nurse practitioner at Western PA Behavioral Health Resources in West Mifflin, Pennsylvania.

Today we are going to highlight challenges with identifying bipolar disorder, discuss strategies for optimizing treatment, comment on telehealth utilization, and walk through 2 interesting patient cases. We’ll also involve our audience by using several polling questions, and these results will be shared after the program.

Without further ado, welcome and let’s begin. Here’s our first polling question. What percentage of your patients with bipolar disorder have 1 or more co-occurring psychiatric condition? a. 10%, b. 10%-30%, c. 30%-50%, d. 50%-70%, or e. more than 70%.

Now, here’s our second polling question. What percentage of your referred patients with bipolar disorder were initially misdiagnosed? Would you say a. less than 10%, b. 10%-30%, c. 30%-50%, d. more than 50%, up to 70%, or e. greater than 70%.

We’re going to go ahead to patient case No. 1. This is a 27-year-old woman who’s presented for evaluation of a complex depressive syndrome. She has not benefitted from 2 recent trials of antidepressants—sertraline and escitalopram. This is her third lifetime depressive episode. It began back in the fall, and she described the episode as occurring right “out of the blue.” Further discussion revealed, however, that she had talked with several confidantes about her problems and that she realized she had been disappointed and frustrated for being passed over unfairly for a promotion at work. She had also been saddened by the unusually early death of her favorite aunt.

Now, our patient has a past history of ADHD [attention-deficit/hyperactivity disorder], which was recognized when she was in middle school and for which she took methylphenidate for adolescence and much of her young adult life. As she was wrapping up with college, she decided that this medication sometimes disrupted her sleep and gave her an irritable edge, and decided that she might be better off not taking it. Her medical history was unremarkable. She is taking escitalopram at the time of our initial evaluation, and the dose was just reduced by her PCP [primary care physician]from 20 mg to 10 mg because she subjectively thought the medicine might actually be making her worse.

On the day of her first visit, we get a PHQ-9 [9-item Patient Health Questionnaire]. The score is 16, which is in the moderate depression range. She filled out the MDQ [Mood Disorder Questionnaire] and scored a whopping 10, which is not the highest possible score but it is higher than 95% of people who take this inventory.

At the time of our interview, our patient tells us that her No. 1 symptom is her low mood and her ease to tears. In fact, she was tearful during the interview. She also reports that her normal trouble concentrating, attributable to the ADHD, is actually substantially worse. Additionally, in contrast to her usual diet, she has a tendency to overeat and may have gained as much as 5 kg over the last 4 months. She reports an irregular sleep cycle and tends to have periods of hypersomnolence, especially on the weekends, and then days on end where she might sleep only 4 hours a night despite feeling tired.

Upon examination, her mood is positively reactive, and by that I mean she can lift her spirits in conversation, show some preserved sense of humor, and does not appear as severely depressed as she subjectively describes. Furthermore, she would say that in contrast to other times in her life when she’s been depressed, that she’s actually had no loss of libido, and in fact her libido might even be somewhat increased. Over the last month or so, she’s had several uncharacteristic casual hook-ups.

So the differential diagnosis for this patient included major depressive disorder, recurrent unipolar with mixed features, versus bipolar II disorder, with an antecedent history of ADHD. I think the high MDQ score and recurrent threshold level of mixed symptoms within a diagnosable depressive episode certainly increase the chances that this patient’s illness should be thought of on the bipolar spectrum. Of course, this formulation is strengthened by the fact that she has an early age of onset of recurrent depression, that her current episode, despite having mixed features, has reverse vegetative features as well. We also have the observation that antidepressant therapy has seemed to make her condition worse, not better.

Transcript Edited for Clarity

Dr. Thase is a professor of psychiatry at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania.

Dr. Alva is the medical director of ATP Clinical Research in Costa Mesa, California.

Dr. Cerulli is the medical director of Cerulli and Associates in Andover, Massachusetts.

Dr. Tina Matthew-Hayes is a dual certified nurse practitioner at Western PA Behavioral Health Resources in West Mifflin, Pennsylvania.

journey

Evaluating the Efficacy of Lumateperone for MDD and Bipolar Depression With Mixed Features

Blue Light, Depression, and Bipolar Disorder

Blue Light, Depression, and Bipolar Disorder

An expert discusses the role of cognition in bipolar disorder and the potential of modafinil as a treatment for it at the 2024 ASCP Annual Meeting.

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Four Myths About Lamotrigine

Four Myths About Lamotrigine

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An expert shares some clinical pearls from his lecture at the recent American Psychiatric Association Annual Meeting.

An Update on Early Intervention in Psychotic Disorders

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Common mental health problems: identification and pathways to care

Clinical guideline [CG123] Published: 25 May 2011

This guideline has been stood down. All of the recommendations are now covered in other NICE guidelines, or are out of date and no longer relevant to clinical practice.

For guidance on common mental health problems, see our guidelines on:

  • Depression in adults
  • Depression in adults with a chronic physical health problem
  • Depression in children and young people
  • Generalised anxiety disorder and panic disorder in adults
  • Obsessive-compulsive disorder and body dysmorphic disorder
  • Social anxiety disorder

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ACE.S Unfolding Cases

An unfolding case is one that evolves over time in a manner that is unpredictable to the learner. New situations develop and are revealed with each encounter. Every ACE unfolding case uses the highly regarded unfolding case model developed for Advancing Care Excellence for Seniors (ACE.S) . Each case includes the following:

  • A first-person monologue that introduces the family and the complex problems they are facing.
  • Simulation scenarios designed to help students practice assessing function and expectations of their patient(s), with links to appropriate evidence-based assessment tools. Suggestions for debriefing are included.
  • An innovative final assignment that asks students to finish the story .
  • Instructor toolkits with suggestions on how to use the various components of the unfolding cases and incorporate them into the curriculum.

These unfolding cases combine the power of storytelling with the experiential nature of simulation scenarios. They are intended to create a robust, meaningful experience for students, one that provides a simulated experience of continuity of care and that will help them integrate the Essential Knowledge Domains and Nursing Actions into their practice of nursing. We hope you will give them a try! Standardized/Simulated patients are recommended for all ACE simulations. If you are not already familiar with the Association for Standardized Patient Educators Standards of Best Practice, we encourage you to review them.

Learn more about unfolding cases by visiting the  How to Use an Unfolding Case  page.

Sherman "Red" Yoder

Nln leadership development program for simulation educators project mapping the ace.s unfolding cases to the aacn essentials.

Project Disclaimer: Simulation leadership projects are a requirement for the Leadership Development Program for Simulation Educators. All projects are then placed within SIRC for the benefit of the nursing education community. Inclusion of this specific project does not constitute an endorsement by the NLN of the AACN Essentials.

Unfolding Cases with Older Adults from Other ACE Programs

Butch sampson (ace.v), eugene shaw (ace.v), ertha williams (ace.z), george palo (ace.z), judy and karen jones (ace.z), mike walker (ace+).

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COMMENTS

  1. Sample CASE Study FOR Psychiatric Nursing

    emotions or mood (Videbeck, 2011). 2. lack of volition- absence of will, ambition, or to take action or. accomplish (Videbeck, 2011) 3. review the profile as well as the nursing and health history of the client; 4. identify significant changes of client's Functional Health Pattern and. abnormal findings during physical examination;

  2. Case Study 1: Psych Patient in ED

    Case Study 1: Psych Patient in ED. Aaron Smith, age 20, is a psychiatric patient with bipolar disorder. At the request of his father, he is brought by police to the Emergency Department. This is his third visit to the ED for psychiatric treatment this year. Click each item to learn more and to continue with the course.

  3. Case Examples

    Sara, a 35-year-old married female. Sara was referred to treatment after having a stillbirth. Sara showed symptoms of grief, or complicated bereavement, and was diagnosed with major depression, recurrent. The clinician recommended interpersonal psychotherapy (IPT) for a duration of 12 weeks. Bleiberg, K.L., & Markowitz, J.C. (2008).

  4. Case 28-2021: A 37-Year-Old Woman with Covid-19 and Suicidal Ideation

    Dr. SooJeong Youn: This case highlights the importance of attending to the intricate, multilevel, systemic factors that affect the mental health experience and clinical presentation of patients ...

  5. Interactive Case Study

    Unrecognized Bipolar Disorder in Patients With Depression Managed in Primary Care: A Systematic Review and Meta-Analysis. Daveney et al explore the characteristics of patients with mixed symptoms, as compared to those without mixed symptoms, in both bipolar disorder and major depressive disorder. Practice your mental health screening, diagnosis ...

  6. Faculty Case Studies

    The case studies are contained in 4 categories: Family (13 case studies), Fundamentals and Mental Health (14 case studies) and Medical Surgical (20 case studies). In addition the folder labeled minireviews contains PowerPoint sessions with combinations of case studies and standalone items. ... University of Maryland School of Nursing 655 W ...

  7. Sample Case Presentation in Psychiatric Nursing Case Analysis

    Adler James W. Because the pros and cons for the use of medicine in psychiatry are not absolutely clear or agreed upon, strong arguments have risen on all sides. The objective of this paper is not to create a division in the clinical practice. Rather, to present an example of how to use a model in the analysis of understanding the patient behavior.

  8. Mental Health and Psychiatric Nursing: Study Guides

    Mental Health and Psychiatric Nursing. The field of mental health often seems a little unfamiliar or mysterious, making it hard to imagine what the experience will be like or what nurses do in this area. This is an overview of the history of mental illness, advances in treatment, current issues in mental health, and the role of the psychiatric ...

  9. Smith: Mental Health Nursing at a Glance

    Case 5: Denise. Denise, a 19-year-old woman, has been admitted informally to an acute mental health ward; this is Denise's first admission. Denise was being treated for depression by her GP; prior to her admission Denise attempted to kill herself by cutting her wrists. Subsequently a short admission was arranged with the aim of devising a ...

  10. Case Studies

    The case study is an effective teaching strategy that is used to facilitate learning, improve critical thinking, and enhance decision-making Sprang, (2010). Below are nine case studies that educators may employ when working with students on mental illness and addiction. The case studies provided cover major concepts contained in the RNAO Nurse ...

  11. Bipolar II disorder case study

    Abstract. When a patient suffering from bipolar II disorder is misdiagnosed as experiencing unipolar depression, the recommended treatment of the latter may precipitate a hypomanic or manic episode. Unchecked hypomanic symptoms may include risky behaviors, through which a patient could sustain irreparable damage to relationships, careers, and ...

  12. PDF NCMHCE Sample Case Studies

    NCMHCE Sample Case Study. You are a licensed mental health counselor working in a community agency. Your client self-referred for services because "my mother won't stop bugging me for staying in bed all day. I can't help it. I am in a rut and cannot find a way out.".

  13. Nursing Case Study Examples and Solutions

    Mental Health Nursing Case Study Examples . Mental health nursing plays a crucial role in promoting emotional well-being and providing care for individuals with mental health conditions. Immerse yourself in our mental health nursing case studies, which encompass a wide range of psychiatric disorders, therapeutic approaches, and psychosocial ...

  14. Patient Case #1: 27-Year-Old Woman With Bipolar Disorder

    We're going to go ahead to patient case No. 1. This is a 27-year-old woman who's presented for evaluation of a complex depressive syndrome. She has not benefitted from 2 recent trials of antidepressants—sertraline and escitalopram. This is her third lifetime depressive episode.

  15. Evidence for Psychiatric and Mental Health Nursing Interventions: An

    This state-of-the-evidence review summarizes characteristics of intervention studies published from January 2011 through December 2015, in five psychiatric nursing journals. Of the 115 intervention studies, 23 tested interventions for mental health staff, while 92 focused on interventions to promote the well-being of clients.

  16. Mental health nurses' experience of challenging workplace situations: A

    International Journal of Mental Health Nursing is a mental health journal examining trends and developments in mental health practice ... highlighted that 13.7% of MHN were at high risk of developing PTSD following a case of completed suicide among a large cohort (n = 292) of MHN ... While this study encompassed a large sample of MHN, it was ...

  17. ⁠Psychiatric Nursing Notes With Example

    Enhance your psychiatric nursing skills with comprehensive notes and real-world examples. Explore key concepts, practical insights, and case studies to excel in the field of psychiatric nursing. Elevate your knowledge and confidence today.

  18. Common mental health problems: identification and pathways to care

    For guidance on common mental health problems, see our guidelines on: Depression in adults. Depression in adults with a chronic physical health problem. Depression in children and young people. Generalised anxiety disorder and panic disorder in adults. Obsessive-compulsive disorder and body dysmorphic disorder. Social anxiety disorder.

  19. Nursing Case Study for (PTSD) Post Traumatic Stress Disorder

    Hi everyone. My name is Abby, and we're going to go through a case study for PTSD together, also known as post-traumatic stress disorder. In this scenario, Mr. Bryant is a 32-year-old male. He presents to the ED after being brought in by law enforcement for possible drug and alcohol intoxication, as well as for displaying erratic and aggressive ...

  20. Free Nursing Case Studies & Examples

    Click on a case study below to view in our Nursing Case Study Examples course which holds all of our 40+ nursing case studies with answers. Acute Kidney Injury Nursing Case Study. Continue Case Study. Cardiogenic Shock Nursing Case Study. Continue Case Study. Breast Cancer Nursing Case Study. Continue Case Study. Respiratory Nursing Case Study.

  21. (PDF) Clinical case studies in mental health by means of ...

    OBJECTIVE. This study aimed to describe and analyze, from the perspective of human development, on-line. clinical case discussions among nursing students in. the Psychiatric Nursing course ...

  22. ACE.S Unfolding Cases

    ACE.S Unfolding Cases. An unfolding case is one that evolves over time in a manner that is unpredictable to the learner. New situations develop and are revealed with each encounter. Every ACE unfolding case uses the highly regarded unfolding case model developed for Advancing Care Excellence for Seniors (ACE.S). Each case includes the following: