QuestionCase scenario four: GrahamGraham is a 53-year-old male who has a diagnosis of bipolar affective disorder. Graham was diagnosed in hismid-twenties and has been managing well with his diagnosis with a combination of medication therapy(sodium valproate, a mood stabiliser), social supports and regular contact with his GP. Graham has a familyhistory of mental illness – his maternal aunt had bipolar, and his father has depression and passed away fromsuicide when Graham was 22 years of age.Graham has one son and is recently separated from his wife, Suzan, who he maintains an amicable andsupportive relationship with. Graham owns and operates a small printing company however as a result of theCovid19 pandemic has seen a significant downturn in business, which has placed considerable stress on himfinancially. Graham has started to use alcohol to help manage his stress consuming 2 bottles of wine per night.Graham has presented to the emergency department for a mental health review after his ex-wife raisedconcerns over his wellbeing. Suzan reports Graham has been awake through most nights over the past week,as he has been calling her several times throughout the night. When she tries to talk to him Graham talks sofast and loudly that she finds it hard to respond to anything he is saying before he quickly moves on to thenext topic, she states Graham is like a ‘thought machine’ at the moment, verbalising everything that passesthrough his mind even though they are not connected. Suzan has also noticed that Graham has had large spendson his credit card, which is out of character for him and has not been paying their son’s school fees and hasmissed his past two mortgage repayments.When the nurse meets with Graham, they observe him to be Caucasian male of stated age, slightly overweight,wearing a business suit, short brown hair and facial stubble. Graham is initially cooperative with the interviewand has good eye contact however quickly becomes impatient and informs you he has many business meetingstoday with multi-million-dollar companies to help his printing company go global which will then help to finda cure for the Covid19 pandemic. In amongst talking about the business, he talks about the three dams projectin China, the destruction of the orang-utan’s rain forest in Southeast Asia and the economic impact of Brexit.When Graham speaks, he talks quickly and at times is difficult to understand as he trails off. Graham is notentirely sure why he needs a mental health assessment as he is feeling “great, the best I’ve ever felt, I feelunstoppable”, but does admit that he ran out of his sodium valporate medication a week ago and is asking fora script for this.1.a The Mental Status Examination [250 words 10%]? Using the MSE format from your weekly tutorial guide, provide acomplete MSE of the person, linked to the data from your chosencase study.? Use health terms accurately (e.g. Instead of ‘talks fast’, use thecorrect term ‘pressure of speech’).? In-text references are not needed in this section.1.b Clinical Formulation Table [250 words 10%]? Use information gathered from the case study to complete a ClinicalFormulation under the headings of Presenting, Precipitating,Predisposing, Perpetuating and Protective factors (5 Ps).? Relate this to biological, psychological, and social factors relevant to thepresentation of the person described in your chosen case study.? Support your responses with in-text peer reviewed references.1.c Plan for Nursing Care [400 words 10%].? Identify two (2) priority nursing interventions (non-pharmacological) forthe person and briefly justify why each is a priority, drawing from peerreviewed evidence.? Identify one long-term intervention that may be indicated for this person’slong term goals. Justify selection by drawing on peer reviewed 1.d Clinical handover [100 words 10%]? Synthesize the results of your MSE and clinical formulation usingSBAR format post admission for next shifts clinical handover.? No intext references required.Health ScienceScienceNursing NSB 204

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