Nursing care of a patient with adjustment disorder and attempted suicide by taking lorazepam overdose

Abstract

Abstract

An adjustment disorder is an emotional or behavioral disorder, caused by various events that severe stress until unable to see also that event affects serious mental health problems, such as depressed mood and suicide attempts. In a case study, a 21-

year-old Thai female patient was taken to the hospital with significant symptoms of unconsciousness after taking lorazepam about 70 tablets. The patient was treated at Somdetphraphutthaloetla Hospital for 7 days and sent for therapy at Gaya Rajanagarindra Institute. This study aims to study problems and nursing care plans according to the nursing process in a patient with adjustment disorder who attempted suicide by taking lorazepam overdose. The result of the study shows that the patient had an important problem-focused nursing diagnosis of the physical: (1) The risk of harmful side effects of lorazepam due to overdose and treatment limitations, nursing care including monitoring for bradycardia, seizures, and respiratory arrest  (2) The risk of harm to the patient and another person due to aggressive and agitated behavior from side effects of lorazepam, nursing care including creating a safe environment and reducing stimulation, taking care of receiving tranquilizer drug, restrain the patient. An important problem-focused nursing diagnosis of the psychological: (1) An attempted suicide due to severe stress and depressed mood, nursing care including close monitoring of behavior at every time, open an opportunity to express uncomfortable emotions and feelings, explain the effects of suicide. (2) A pattern of coping due to impairment in adaptive emotions, nursing care includes evaluating the patient’s coping methods, recommending methods for coping and managing problems, and decision-making deciding how-to of problem-solving. The evaluation of nursing was that physical problems have been resolved or tend to improve as for the psychological problems there was a risk of suicide and unable to cope appropriately therefore patient was referred to a higher potential hospital to help with diagnosis and treatment. A nursing care plan that is consistent with the problem safe from the effects and side effects of lorazepam, safe from repeated suicide attempts, and receive timely referral before a patient is in danger of life.

Keywords: Adjustment disorder, Attempted suicide, Taking lorazepam overdose

*Professional registered nurse, Somdetphraphutthaloetla Hospital, Samutsongkhram province