Case Study
Harry is a 27 year old male who has presented to accident and emergency brought in by police following an incident at the local nightclub. According to the police Harry was at a night club with a group of friends last night and was involved in a fight and argument with a fellow patron at the nightclub. The ambulance officer treated a small laceration to his right forearm which did not requiring suturing. On initial assessment; Harry presented as irritable; argumentative; stating “let me go home; I am fine”; he was casually dressed in jeans and t-shirt; short dark hair; brown eyes and dark skin. He presents with breath smelling of alcohol; speech is slurred; gait is unsteady and as reported by the police Harry returned a PCA of 1.19 of alcohol and was positive for cannabis when tested at the nightclub.
Harry was accompanied to hospital by two friends who stated; “He hasn‘t been himself for a while; he has been getting to work late; they have threatened to fire him; he has been spending all his money on grog; and he has been ringing his ex girlfriend all hours of the day and night while intoxicated”.
Harry stated he smokes 30 cones per day of cannabis; and drinks 2-3 Bundaberg rums; “ all my friends do the same there is nothing wrong with it”. He added that he has increased his use of drugs and alcohol; over the past 6 weeks. He states he has used cannabis and alcohol since he was 16. Three (3) weeks ago Harry broke up with his girlfriend after an argument; “she said I can’t cope with you being stoned and pissed all the time; either give up or I’m gone”. He states being stoned and smashed “helps me forget”. Harry states “my life is out of control; I can’t fix it; there’s no point”.
In taking Harry’s history; he stated “I am just like my father; he liked a drink”. On further questioning Harry reveals to you that when he was 15 he was sent to juvenile detention for six months charged with damaging property and assault. Harry described a poor relationship with his father who left him and his mother when he was 14. Harry stated” I was a bit scared of him; he used to hit my mother a lot”.
Using the above Case Study; please answer the following six (6) questions:
1. Using the DSM IV TR criteria for Substance Abuse; provide evidence from the case study that indicates that Harry may meet the criteria for a Substance Abuse disorder.
2. Investigate and outline the epidemiology of Cannabis use in Australia.
Your answer needs to cover the following areas: prevalence/incidence; possible causes; hospitalisation rates and burden of disease.
3. Discuss two (2) possible factors behind the development of Harry’s substance use disorder
( using current literature).
400759 – Mental Health Nursing 1
Learning Guide – Spring 2013
©School of Nursing and Midwifery Page 14 of 27
University of Western Sydney
4. Harry is currently experiencing a number of substance and mental health related problems; using evidence from the case study list three 3 MAJOR problems or risks.
Your problem/risk identification should focus on nursing Harry in the next 1-5 days.
5. Outline and describe three 3 nursing interventions in the management of each of the three 3 problems or risks you have identified in questions 4.
Your interventions should be focused on nursing Harry over the next 1-5 days.
6. With reference to current literature (within the last 5 years); provide a rationale for each of the nine 9 nursing interventions.
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