Case Scenario 5:

 Marlon is a 19-year-old who withdrew from college after experiencing a manic episode
during which he was brought to the attention of the Campus Police (“I took the
responsibility to pull multiple fire alarms in my dormitory to ensure that they worked,
given the life or death nature of fires”). He had changed his major from engineering to
philosophy and increasingly had reduced his sleep, spending long hours engaging his
friends in conversations about the nature of reality.

 He had been convinced about the importance of his ideas, stating frequently that he
was more learned and advanced than all his professors. He told others that he was on
the verge of revolutionizing his new field, and he grew increasingly irritable and intolerant
of any who disagreed with him. He also increased a number of high-risk behaviors –
drinking and engaging in sexual relations in a way that was unlike his previous history. 

 At the present time, he has returned home and has been placed on a mood stabilizer
(after a period of time on an antipsychotic), and his Psychiatrist is requesting adjunctive
psychotherapy for his bipolar disorder.  The patient’s parents are somewhat shocked by
the diagnosis, but they acknowledge that Marlon had early problems with anxiety during
pre-adolescence, followed by some periods of withdrawal and depression during his
adolescence.  His parents are eager to be involved in treatment, if appropriate.

Questions:

1. If you are the assigned nurse assisting Marlon, how should you approach him
considering his present condition?
2. Assess the physical and mental condition of Marlon utilizing the phases of therapeutic
relationship according to Hildegarde Peplau?
3. From the book of DSM5, elaborate what is Bipolar Disorder?
4. How would you pacify Marlon when attending his needs, what should you do first if you
are the nurse on duty?
5. Utilizing the techniques of therapeutic communication, present in a role play the;
a.) Predisposing and risk factors in developing Bipolar Disorder?
b.) Psychodynamics and psychopathology of Bipolar Disorder?
c.) Various roles of the nurse in managing/caring client exhibiting Disturbance in Affect
particularly Bipolar Disorder?
d.) Current medical and psychiatric management of client with Bipolar Disorder?
e.) Best way to inform the parents of Marlon of the possibility that he might be
prescribed to undergo Electro Convulsive Therapy (ECT)?

NURS 18 – VIRTUAL RLE (Care of Client with Maladaptive Patterns of Behavior) February 20, 2022 RPA
NURS 18 – VIRTUAL RLE (Care of Client with Maladaptive Patterns of Behavior) February 20, 2022 RPA