Reference no: EM133878745

Question

Monitoring Progress and Early Warning Signs: How will progress towards the person's recovery goals be monitored and what are the early warning signs that would indicate the person is at risk of relapse.

Consider relevant risk assessments.

Ensure you include relevant and specific early warning signs that may indicate poor progress or hinder recovery

Progress and monitoring must be explicitly aligned with the stated recovery goals

All aspects must be specifically related to the role of a nurse.

Progress monitoring plan must be supported with evidence.

Ben's symptoms of psychosis seem to be resolved. He was given the diagnosis of drug induced psychosis. The psychiatrist also questioned his previous diagnosis of borderline personality disorder, as this was mentioned from a previous admission history but didn't fit his current presentation, and will review this in the community.

On discharge from hospital he is prescribed Quetiapine 300mg BD for the psychotic symptoms, is also prescribed Diazepam 5mg TDS relating to Ben's withdrawal from his methamphetamine and cannabis whilst he was in hospital. Ben previously was on Diazepam at much larger doses due to his withdrawal symptoms. The psychiatrist would like this to be reduced and will review these medications with a view to discontinuing when appropriate. Ben has stated he was worried about this request and is not sure that he should reduce this medication as it has been working well to reduce his withdrawl.

When in hospital, Ben also started a SNRI called Desvenlafaxine 50mg Daily. The psychiatrist would like this to be monitored with an increase to 200mg if tolerated (updated), Ben was previously on other antidepressants before admission and stated, "they did nothing for him". He states he has not had Desvelafaxine before and doesn't know much about it.

Ben still reports his mood as "low" in mood "at times"; he states his girlfriend will leave him and he will lose his job and is embarrassed about how he was brought into hospital. While his girlfriend's comments and other information gathered don't support this, these statements may be related to his mood and do not fit delusional content.

He reports no auditory hallucinations at this time, he describes what was happening during his admission as scary and not wanting that to happen again and says that the big capsule seemed to have relieved those symptoms but he has numerous effects such as drowsiness, feeling hungry more than usual and feeling "hungover" when waking in the mornin.

In conducting a risk assessment he has stated that he has no plans to take own his life, but he does on occasion think about if he could just go to sleep and not wake up as his thoughts "don't stop" sometimes and he just wants to get away and he is fearful of relapsing and having to go back into hospital.

Overall, Ben still reports he isn't feeling like he is withdrawing from his substance use anymore He currently feels he cannot miss any doses of the Quetiapine and Diazepam, otherwise he may "lose it". He has also stated he is done with "this drug S#@%" and just wants to get on with his life, but worries as he still has urges to use again here and there and he might relapse and wants to know what he can do about it.

Ben has discharged, back to his home with his girlfriend. She has been very supportive during his inpatient stay. but she very is worried about future relapse and what she can do if he does. His mother Cathy has also been supportive to Ben during this time and has volunteered to help where she can, she seems to bring a lot of food with her each time she visits. Ben and his mother have a strained relationship in the past, due to his aggressive interactions when unwell.

Ben's workplace has organised him some sick leave. Ben's girlfriend has discussed with you that his employer is very supportive around mental health issues and wants him back at work when he is ready. Ben has discussed with you that he is worried about going back to work as he doesn't think he can do his normal full time job with the medications he is on as they make him drowsy at times and he doesn't want to have a workplace accident because of it.