Psychiatric problems in my renal patient

[ValWai]

Just wanna to share this with other renal nurses. I have this patient M/57 who came to our centre a few months ago. He came with his maid whom he claimed to be his girl friend. He is divorced living with the son. On the first day, we had a long talk about his medical history, his family and on everyting we need to know. He got very poor family support. His wife left him >20 years ago and her daughter left him a few years later. He drinks, smokes and gambles. Delusion of grandeur.

1. He said that he's a cop and can help us to settle our PROBLEMS

2.His son is a lawyer.

3. The girl who accompanied him is his girl friend.

4. He said that the chairman in the charity group is his classmate that's why he didn't apply to their dialysis center

5. He said that he scolded everyone in the hospital for not serving him well

His compulsive behaviour

1. He eats compulsively

2. He put on 10 kg over weekends

3. He always comes at the wrong time on the wrong day

Hallucination

1.He c/o that the hospital was lousy that he saw bugs in his bed.

2. He called a few time after defaulting the appointment saying that he was admitted. But was found out taht he was never admitted.

This gentleman is a case of typical schizophrenic or some sorts of other mental problems. Of cos, he was sent to the psychiatrist for treatment. No one could fetch him there. Social worker can not help. So he went there by himself. He came back with nothing but saying that the doctor said he's fine. What can I do?

[TELEpathicRN]

We have a female pt in our outpatient unit that is bipolar, schizophrenic. We never know when she is going to "snap". She doesnt have delusions of grandeur, but thoughts of persecution, stating that we are out to get her and are trying to kill her!!! She also demands who puts her on the machine, what time she gets her epo, etc... We are sick and tired of this, our DON or Dr. won't do anything about her behavior. We know how you feel!!!!

P.S. This pt is on Depakote,and I read that the levels can flucuate by 20% while the pt is being dialyzed. Do you have any other info on this?? I wanna approach the Dr. about it, but wanna have all the facts. Any help will be appreciated.