Melanie is a 16 year old who lived with her parents and two siblings in a suburban neighborhood until her parents separated 6 months ago. At that time her school performance began to decline and she was truant from school, frequently not returning home until after dark. When she arrived home, she was verbally abusive to her mother when asked where she had been. Three days ago, her relationship with her boyfriend of 1 year ended when he told her she had “changed” and he didn’t know how to “relate to her anymore”. That evening, Melanie became very disruptive at home, breaking lamps and mirrors and turning over furniture. When her mother attempted to talk to Melanie, her daughter threatened her. Melanie was admitted to the children’s psychiatric unit of the local inpatient mental health facility.
Since her admission, Melanie has refused to attend any group sessions or talk to staff and spends most of her time in her room. At change of shifts today, the staff heard a loud noise after which the nurse practitioner and two psychiatric technologists rushed to Melanie’s room. There they observed Melanie screaming incoherently and throwing chairs against the wall; clothes were littered across the floor (Broyles, 2006). You will need to answer the following questions and summarize in 1-2 paragraphs.
1. What is a potential diagnosis for Melanie?
2. What impact might Melanie’s level of growth and development have on her response to life stressors?
3. What are the priorities of care for Melanie at this time?
4. What other assessment data would be helpful for the nurse practitioner to have?
5. What factors should the nurse practitioner consider prior to approaching Melanie?
6. Do you think that Melanie’s behavior at home warranted hospitalization and why or why not?
7. Do you think Melanie’s present behavior warrants continued hospitalization, why or why not?
Melanie’s mother calls the unit every day to check on her daughter but is not sure whether she should visit Melanie because as she says, “I’m afraid I’ll upset her. I think she feels that this whole situation is my fault. I love my daughter and I just want her to get well.” How would you respond to Melanie’s mother?
REFENRENCES NO GREATER THAN 5 YEARS
