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B760 Mental Health Nursing Questions 1 Hour Seen Component, Scenario Based Marcus is a forty-two year old man with a history of Bi-Polar Affective Disorder (ICD-10 – F31) which was diagnosed when he was twenty-four years old. He lives on his own in a bedsit near the city centre.  Marcus is currently unemployed and receives a Personal Independence Payment.  Marcus smokes cannabis daily.   His use has been escalating over the last three months and he is currently spending £50 per week on this.  He does not regard this as a problem.  His parents live two hours’ drive away and he doesn’t see them very often.  Marcus’ mother calls him every Sunday afternoon but over the last few weeks he has not been answering her calls, seemingly through lack of motivation.  He has not spoken to his father for a year.  Marcus has had three meaningful relationships with men and women in the past but currently does not have a partner.  He reports feeling lonely and misses having a sexual relationship and someone to confide in. Marcus has been isolating himself for the past three weeks.  He is not sleeping well – going to sleep in the early hours of the morning, waking several times in the night and getting up near lunchtime. He is overweight and describes an unhealthy diet and lifestyle which he would like to change.  Marcus’ mood is low and he is having suicidal thoughts.  Marcus is currently prescribed lithium carbonate 400mg daily for his mood disorder but he has not been taking this consistently for the last two months.   He attends for a routine monitoring appointment with his Community Psychiatric Nurse and reports these changes in mood.  Following assessment with his psychiatrist, Marcus is diagnosed with Bi-Polar Affective Disorder, current episode mild to moderate depression (ICD-10 – F31.3).  In relation to the above scenario you are expected to: 1. Define the diagnosed condition Marcus is presenting with including relevant anatomy, physiology pathophysiology in relation to the condition.   2. Using a systematic approach, critically analyse the priorities of nursing care related to the scenario and demonstrate an understanding of the bio-psycho-social factors that may influence Marcus’ care. Answers 1. The bipolar affective disorder is considered to be the psychological disease that consists of severe kind of mood swings which results in affecting the mental setup of any individual. The mood swings which used to take place results in the formation of mania that can last for a long period of time. In case of any depression, it can be seen that the patients are in guilt, great sadness, lack of sleep, and no appetite (Hayes et al. 2015). The physiology of the bipolar affective disorder is regarded as the condition in which there has been the occurrence of extreme mood swings followed by alteration within the states of depression and mania. These kinds of mental disturbance are also accompanied by psychosis. The pathophysiology related to the Bi-Polar Affective Disorder is regarded as the changes within the normal biochemical and physiological functions that are related to the disorder (Palmier-Claus et al 2016). Most of the scientist and clinicians are working hard for getting knowledge about the pathophysiology of the bipolar affective disorder. In general, it has been identified that bipolar affective disorders has been caused due to biological differences, genetics, hormones, and neurotransmitters. 2. The bipolar affective disorder is regarded as the mood disorders which is associated with one or more manic episodes with several periods of the normal functioning of the body parts. The patients suffering from bipolar affective disorders are found to be at higher risks for suicide. When the patients are within their manic phase during that time they are energized, agitated, and their underlying depression allows them to inflict any kind of self-injury (Nabavi, Mitchell and Nutt, 2015). The major duties of the nurses are about providing a safe environment for improving the self-esteem thereby meeting the psychological requirements and guiding the patients for maintaining an appropriate social behavior. The priorities of the nursing care related to the scenario are as follows: i) Risk related to the injury:Defenseless for damage because of natural conditions associating with the person’s versatile and protective assets, which may bargain wellbeing. ii) Risk related to violence:In danger of practices in which an individual shows that he/she can be physical, inwardly, or potentially explicitly unsafe to self. iii) Impairment of social interaction: The state within which an individual takes an interest in an inadequate or over the top amount or insufficient nature of social trade. iv) Interruption within the family processes: Change in family connections as well as working. v) Ineffective coping of individuals: Failure to shape a substantial examination of the stressors, lacking decisions of rehearsed reactions, as well as powerlessness to utilize accessible assets. vi) The deficit of total self-care: the Disabled capacity to perform or finish showering/cleanliness, dressing/prepping, encouraging, or toileting exercises for oneself.   The biopsychosocial model was first developed by Dr. George Engel and later on, it is being accepted by the healthcare professionals dealing with mental health conditions. According to the research, it has been identified that there are several biopsychosocial factors present that can result in influencing the care of Marcus. As to organic elements, it is realized that discouraged people are frequently fundamentally irritated with respect to endocrine (hormone), invulnerable, and synapse framework working (Upthegrove et al. 2015). Mental components impacting discouragement incorporate trademark antagonistic examples of reasoning, deficiencies in adapting aptitudes, justice issues, and disabled enthusiastic insight that discouraged individuals will in general show. Individuals can likewise wind up discouraged because of social factors, for example, encountering horrible circumstances, early partition, the absence of social help, or harassment. References Hayes, J.F., Miles, J., Walters, K., King, M., and Osborn, D.P.J., 2015. A systematic review and meta?analysis of premature mortality in bipolar affective disorder. Acta Psychiatrica Scandinavica, 131(6), pp.417-425. Nabavi, B., Mitchell, A.J. and Nutt, D., 2015. A lifetime prevalence of comorbidity between bipolar affective disorder and anxiety disorders: a meta-analysis of 52 interview-based studies of the psychiatric population. biomedicine, 2(10), pp.1405-1419. Palmier-Claus, J.E., Berry, K., Bucci, S., Mansell, W. and Varese, F., 2016. The relationship between childhood adversity and bipolar affective disorder: systematic review and meta-analysis. The British Journal of Psychiatry, 209(6), pp.454-459. Upthegrove, R., Chard, C., Jones, L., Gordon-Smith, K., Forty, L., Jones, I. and Craddock, N., 2015. Adverse childhood events and psychosis in bipolar affective disorder. The British Journal of Psychiatry, 206(3), pp.191-197.

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