Question

Clark is in jail for scamming an elderly couple out of their money. As the jail’s evening nurse makes her rounds, she stops to see if Clark has any health problems. He tells her, “You’re too pretty to be a nurse. You should be a model.” He engages the nurse in conversation and then asks, “If you would make a phone call for me, I’d give you $60. It’s just between us. Don’t tell anyone about this.” The nurse schedules Clark for a visit with the psychiatrist who comes daily to the jail. After examining Clark and getting a history, the psychiatrist writes a diagnosis of Antisocial Personality Disorder (APD). He adds Alcohol Abuse and Marijuana Abuse. Clark has a pending driving while intoxicated (DWI) charge, and his drug screen is positive for marijuana. The psychiatrist writes an order for carbamazepine (Tegretol XR), with vital signs taken every shift.

Questions

1. As the nurse, how would you respond to Clark’s comments about your looks and his proposition regarding the phone call?

2. What criteria must the client meet to qualify for a diagnosis of APD? Does this client’s history support this diagnosis?

3. Why did the psychiatrist prescribe carbamazepine? What do you need to teach the client about carbamazepine?

4. Do clients with APD get better or is it impossible to change antisocial personality traits?

5. What nursing interventions would you implement for Clark?

Answer 1

Answer: Being a nurse, it is important to assess patient. Nurse need to be patient with this kind of patients. These kind of patients should be handled with proper care and nurse should be calm.

The client shows symptoms of APD:

• irritability
• Poor listening skills
• Abnormal comments on others
• Negative thinking
• aggression

So, the client symptoms shows the diagnosis for the APD.

Carbamazepine can be used to treat bipolar disorder, it treats the neuropathic disorder. APD is a kind of bipolar disorder. The patients should be educated as he should avoid consumption of alcohol because it may increase the sedative effects.

The APD could be cure by the medications, withdrawal of the alcohol etc. can provide better result.