College of Health Sciences Education

3rd Floor, DPT Building

Matina Campus, Davao City
Telefax: (082)
Phone No.: (082)300-5456/300-0647 Local 141

A CASE STUDY ON
BIPOLAR I MANIC WITH PSYCHOTIC FEATURES

Presented to the Faculty of College of Health Sciences Education

Matina Campus, Davao City

Submitted to:

Noel Jonathan T. Tenchavez, RN, MN

Clinical Instructor

Submitted by:

Wencyll Joyce L. Cabuguang

Princess Michelle B. Moring
Mia Catherine A. Pasiliao
Shaira Mae B. Ibrahim
Mary Jane A. Bacquial
Zahra A. Macarimban
JB John P. Balbarona
Creandale S. Brutas
Lorelei G. Gonzales
Joan G. Hiquiana
Aljimar P. Kahal
Airen G. Dagas
Regin S. Bital

February 2015

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 ACKNOWLEDGEMENT

The group wishes to express their deepest gratitude and warmest

appreciation to the following people, who, in any way gave us the possibility
making this case study a success:

First of all, to the Almighty God, who never cease in loving us and for the
continued guidance and protection.

To the groups clinical instructor, Noel Jonathan T. Tenchavez, RN, MN for

his guidance and support in the duration of the study and during the psychiatric
nursing exposure, whose help, stimulating suggestions and encouragement helped
us in all the time of making this case study.

To our Dean, Mrs. Ofelia C. Lariego, we thank you for inspiring us, and
helping us realize our potentials. To our Alma Mater, University of Mindanao,
Matina Campus, Davao City which serves as our training ground to be a
competitive future registered nurses.

The group also wishes to acknowledge the invaluable assistance and

cooperation of the staff nurses of Southern Philippines Medical Center Institute of
Psychiatry and Behavioral Medicine (SPMC-IPBM), for allowing us to conduct this
study, for essential assistance in reviewing the clients file and giving us
opportunity to care for the mentally-ill clients.

Special appreciation is extended to the client subjected for this study and
other informants for their selfless cooperation, time and entrusting personal
information needed in this study.

To the group, we would like to show our endless gratitude to each other, for
the understanding, believing in each other, and team work. May we continue
working hard for future studies.
And lastly, to our parents who have always been very understanding and
supportive both financially and emotionally.
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 TABLE OF CONTENTS

Page

Title Page.1
Acknowledgement..................................................................................2
Table of Contents3
Introduction..4
Objectives.5
Definition of Terms..
Identification of the Case
Anamnesis
Informant
Informants Data
Family Tree
Family History
Personal History
Nursing Assessment
Physical Assessment
Review of Systems
Mental Status Examination
Baseline
Orientation Phase
Working Phase
Nurse-Patient Interaction
Orientation Phase
Working Phase
Termination Phase
Psychodynamics
Erik Eriksons Psychosocial Theory
Predisposing Factors
Precipitating Factors
Schematic Diagram
Ideal Medical Management
Actual Medical Management
Drug Study
Nursing Care Plan
Prognosis
Recommendation
Journal Reading
Bibliography

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 INTRODUCTION

Bipolar disorder, also known as manic-depressive illness, is a brain disorder

that causes unusual shifts in mood, energy, activity levels, and the ability to carry
out day-to-day tasks. Bipolar disorder was categorized as bipolar 1 and bipolar 2
disorder and bipolar 1 was defined as the most severe forms of mental illness and
is characterized by recurrent episodes of mania and depression, the symptoms
characterized by unusually euphoric or agitated moods, along with depression or a
mix of high and low moods has generally been estimated at 1.19 percent the onset
of bipolar disorder tends to occur In women than men. Globally, according to the
National Alliance of Mental Illness, an estimate suggests that about 72 percent of
Americans are diagnosed with bipolar disorder each year. National, the research
team in the Philippines found out that 2.5percent met the criteria for having had
bipolar disorder and 2.2 percent of teens had experienced it within the last 12
months. 1.3 percent of the kids had been diagnosed to this and 2.6 percent of
adults have had this in the last 12 months. In Davao City, Bipolar disorder has a
lifetime prevalence of 15 percent and this may go as high as 25 percent for
females.
Our client is a thirty three (33) years old woman and has a one (1) child and
has been diagnosed with Bipolar 1 disorder, Manic with psychotic Features she
has been admitted for seven times in Southern Philippines Medical Center (SPMC)
in the Institute of Psychiatric Behavioral Medicine (IPBM) second child among the
four (4) children. Every parent wants their child to be good and they want to make
their children better in every aspect of their lives. The family of our client decided to
seek consultation in the medical team because she observed that there is
somethings wrong with her child and then the client diagnosed with bipolar
disorder at her young age, her family tries to sustain her maintenance medication
but later on they stop the medication because the client refuses to take the
medication, she thinks that medication is useless and cannot treat her condition.

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 OBJECTIVES

GENERAL OBJECTIVES:
The case study aims to impart a deeper and broader knowledge and
understanding about Bipolar 1 Disorder, Manic with psychotic Features.

SPECIFIC OBJECTIVES:
At the end of the discussion the learner will be able to:
1. Able to define the bipolar disorder and its types
2. Discuss the anamnesis includes the informants, informants data, family
tree, family history, and personal data of the client.
3. Identify the nursing assessment includes the cephalocaudal
assessment and the review of systems
4. Discuss the Mental Status assessment of the client that includes the
baseline data and the orientation and working phase and also the
termination phase.
5. Discuss the Nurse-Patient Interaction of the client that includes the
orientation, working, and the termination phase of the identified client.
6. Present the psychodynamics includes the Erick Ericksons
Psychosocial Theory and also the predisposing factors, the
precipitating factors and the schematic diagram of the client
7. Discuss the Ideal Medical Management and the Actual Medical
Management that includes in the discussion the drugs study, nursing
care plan, the prognosis for the client, and the recommendation
8. Present the journal reading related to the clients diagnosis

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 IDENTIFICATION OF THE CASE

Patients Code Name: Violet

Age: 33
Sex: Female
Birthdate: Sept. 9, 1981
Birthplace: Davao City
Address: Sitio Soriano, Catalunan Grande, Davao City
Nationality: Filipino
Civil Status: Single
Educational Attainment: Secondary Level
Occupation: Pump Girl
Admissions: 1st 1995-Bipolar 1
2nd- 1997
3rd- 2001
4th- 2005
5th- 2009
6th- July 24, 2012
7th- Jan. 16, 2015
Agency: IPBM-SPMC
Reason for Admission: Aggressive Behavior & Threat to Community
Date of Discharge: Still Admitted
Admitting Diagnosis: Bipolar 1 Disorder with Psychotic Disorder
Duration of the Study: January 23-30, 2015

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