Case Study: Septic Shock Affecting Mental Capacity

1961 Words 8 Pages
Septic Shock Affecting Mental Capacity
The assignment is to support an insight into a safeguarding issue where the patient is self-neglecting due to the lack of circumstantial mental capacity to take a decision. I have chosen the Gibbs’ reflective cycle (Oxford Brookes University, 2016) to comprehend and reflect the scenario. The Gibbs’ reflective cycle will enable to follow step by step; focusing on the description of the issue, how I felt about it, initial evaluation and the analysis of the situation and action planning. (Jones, 2014). In respect to “people’s right to privacy and confidentiality” (Nursing & Midwifery Council (NMC), 2015), names and places have been changed. I am an adult nurse focusing on a safeguarding issue of an older
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The MDT had to consider all the options that are available before making the best decision for Mary. The consultant explained and written down the nursing intervention needed and showed to Mary, however she started saying, “you are trying to poison me, I don’t need anything, why can’t you understand, let me die”. Consultant requested for a logical reason why she doesn’t want any medication, by providing such an answer, it is possible to understand her mental capacity and respect her wish. However Mary couldn’t provide any reasonable answers, and as she has chronic kidney disease, admitting to the same ward most of the time when she is not well, subsequently staffs and consultant knows Mary’s behaviour well. Mary’s husband also agrees that Mary’s behaviour has changed, requested the doctor to do what is best for Mary and left the ward as he could not see her like this. Considering all this MDT make the decision to carry on with sedating her. They concluded that the only way to avoid her having a cardiac arrest is by sedating her and giving the life-saving medications. Doctor called Intensive Treatment Unit (ITU) Special Registrar (SpR) for assistance to give haloperidol. Haloperidol is an antipsychotic drug used to treat schizophrenia, other psychoses, mania and also helps to reduce agitation and violent behaviour. The drug cannot cure the …show more content…
Self-neglect is considered to be one of the commonly reported amongst the elderly and also patients with mental health illness. (Social Care Institute for Excellence (SCIE), 2011). A safeguarding case has been raised and a strategy meeting has been set. (Social Care Institute for Excellence (SCIE), 2015). MDT, hold Mary while the doctor gave her 2 bolus of haloperidol 5mg and 2.5 mg, total of 7.5 mg. SpR advised that a total of 20 mg of haloperidol can be given as Mary was still agitated. The doctor mentioned that the haloperidol might have pooled in the oedematous subcutaneous tissue of her upper thigh. Further dosage of haloperidol was given added up to 13mg, and finally Mary was settled and all the nursing interventions were commenced resulting in improved vital

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