Concept Map Template: HESI patient review Jack Bell
Mental Health
List the signs and symptoms of the
illness
Mr. Jack Bell is a 40-year-old
homeless man who was admitted to
surgical unit one day ago for
frostbite of both feet and
schizotypal personality disorder.
S&S:
-Patterns of social isolation and
detachment from the environment.
- Peculiar, eccentric or unusual
thinking, beliefs or mannerism.
- Suspicious or paranoid thoughts.
-Belief in special power. i.e., mental
telepathy or superstitions.
List the psychosocial factors of
the illness.
- Intense social anxiety
- Poor social relationship
- Not have close friends or
confidants.
- Pervasive patterns of
strange or odd behavior,
appearance or thinking.
Drug treatment:
- Risperdal (risperidone)
What are treatments related to
the diagnosis?
- Psychotherapy (talk
therapy)
- Low-dose antipsychotic
(neuroleptic) medication
- Cognitive behavioral
therapy (CBT)
- Dialectical behavior
therapy
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Nursing Assessment of the illness
with the case study.
Subjective Assessment: Patient
mumbled unclear responses the
other two times; said, “hornby
answering." Patient states, “I’ve lived
on the streets before, I can do it
again.” He admits to having been a
patient at several psychiatric hospitals
across the state.
Objective Assessment: "Mr. Bell is
alert. Oriented to self. Knows that he
is in the hospital, but is not sure
which one. Knows that it is winter.
Does not know the date or day of the
week. Affect flat, except when asked
about his frostbitten feet. At that
point, he laughed. Verbal responses
to nurse's questions appropriate in
content three out of five times; very
brief responses.
Based on your data, what is the
nursing diagnosis/problem
statement? List 1 here.
- Risk for chronic low self-
esteem related to continued
failure to get needs met.
What is your goal for this client?
Write it here.
-Mr. Bell will keep his first surgical
clinic appointment after discharge.
- Mr. Bell will meet with his case
manager the first day after discharge.
- Mr. Bell will sleep at a safe shelter
for the first five days after discharge.
List your nursing interventions (at
least 3 with a rationale as to why
you pick the interventions. Write
them here:
-Recognize Mr. Bell’s strengths and
provide feedback about these
strengths. This will help in recognizing
his strengths and improving his self-
concept.
- Encouraging Mr. Bell to identify his
own needs: This will allow him the
opportunity to heave some control of
his situation.
- Promote self-acceptance and
positive self-image; The aim of this
goal is to help the individual develop
a positive perception of themselves
and improve their self-esteem.
Evaluate how the interventions are
working. Write the evaluation here:
Mr. Bell is being discharged after five
days in the hospital. He is able to
wear soft shoes and walk short
distances carefully with a cane, but
requires dressing changes twice a
day.
Mr. Bell is tolerating Risperdal
(risperidone) and will be followed by
the mental Health Clinic. He looks
clean and neat in new clothes
provided by the social services, but
seems uncomfortable with all the
attention he’s receiving.