No one cares what I do anyway. It’s Just a way to bring home a paycheck. ” a 12. Isolation l. “ Look, Mom! I ironed this blouse all by myself! ” m. “ If only I could live my life over again. I’d do things so c _ 13. Generatively much differently. I feel like a nothing. ” n. “ l could never be a nurse. I’m not smart enough. ” m _ 14. Stagnation _p_15. Ego Integrity o. Miss, I will be the chairperson for the cancer drive. ” k 16. Despair p. “ I have been the Girl Scout leader for Troop 259 for 7 years The Nursing Process: A Case Study Read the following case study and follow the directions given below for application of the nursing process.
Case Study: Sam is presented through the emergency department to the psychiatric unit of a major medical center. He was taken to the hospital by local police who were called by department store security when Sam frightened shoppers by yelling loudly to “ imaginary’ people and threatening to harm anyone who came close to him. On the psychiatric unit, Sam keeps to himself, and walks away when anyone approaches him. He talks and laughs to himself and tilts his head to the side as if listening. When the nurse attempts to talk to him, he shouts, “ Get away from me. I know you are one of them! He picks up a chair, as if to use it for protection. Cam’s appearance is unkempt. His clothes are dirty and wrinkled, his hair is oily and uncombed, and there is an obvious body odor about him. The physician admits Sam with a diagnosis of schizophrenia and orders Titration and Connecting on both a scheduled and PRNG. Basis. 1. Identify four segments of information from the assessment data that would be significant to nursing. A. The patient is guarded issues b. _the patient has trust c. He is listening and responding to internal stimuli d. He is a danger to self and could be diagnosed as failure to thrive 2.
List appropriate nursing diagnoses from analysis of the data described in question . A. Self-neglect b. Fear c. Risk for acute confusion d. Risk for self-directed violence 3. Provide outcome criteria for the four nursing diagnoses. A. Awareness of self- neglect as evidenced by client performing daily Addles and taking responsibility for personal care. B. Client expresses less fear as evidence by learning to trust the nurse and express feelings more often. C. Client shows less confusion and is alert to person, place and time. D. Patient starts trusting staff and discloses all impulses to harm self. . Select appropriate nursing interventions to achieve the outcome criteria. 1 . Assess client’s physical needs, promote self-hygiene, encourage addles, assist client to improve grooming and to accept responsibility for personal care. 2. Gain the client’ trust, avoid an overly warm approach; a neutral approach is less threatening, stay with client when he is frightened, and reassure client that the environment is safe. 3. Reorient client as necessary, do not go along with client’s delusions or hallucinations, help client establish what is real and unreal, and monitor for altered thought process. 4.
Maintain a safe environment, monitor for suicide risk, provide brief, frequent intact with the client, and provide opportunities for the client to express concerns, fears, feelings, and expectations in a nonjudgmental environment. Ethical and Legal Issues in Psychiatric/Mental Health Nursing Identify the following key terms associated with ethical and legal issues in psychiatric/mental health nursing with the descriptions/definitions listed below. A. Assault Kantian B. Battery K. Malpractice C. Beneficence L. Natural law D. Christian ethics M. Malfunctioned E. Torts N. Slander F. Common law O. Tutor law G. Libel P. Utilitarianism H. Ethical egoism Q. Civil law l. False imprisonment R. Rimming law S. Veracity _J_ 1. Ethical theory by which decisions are based on a sense of duty _g_2. Writing false and malicious information about a person _b 3. The uncontested touching of another person. R 4. Provides protection from conduct deemed injurious to the public welfare. L 5. Abstaining from negative acts toward another, including acting carefully to avoid harm _a_ 6. An act that results in a person’s genuine fear and apprehension that he or she will be touched without consent _m 7.
The theory on which decisions are based in which evil acts are never condoned, even if they are intended o advance the noblest of ends e 8. A violation of a civil law in which an individual has been wronged. _p 9. The ethical theory on which decisions are based that ensures the greatest happiness to the greatest number of people. I 10. The deliberate and unauthorized confinement of a person within fixed limits by the use of threat or force. _k 11. The failure off professional to perform or to refrain from performing in a manner in which a reputable member within the profession would be expected to do so. _ 12. An ethical principle that refers to one’s duty to benefit or promote the good of others. 0 13. Law that has been enacted by legislative bodies. N 14. Verbalizing false and malicious information about a person. H 15. An ethical theory that espouses making decisions based on what is most advantageous for the person making the decision. F 16. Law that is derived from decisions made in previous cases. _q_17. Law that protects the private and property rights of individuals and businesses. _d 18. The ethical theory that espouses “ Do unto others as you would have others do unto you. S _ 19. Ethical theory that refers to one’s duty to always be truthful. Case Study Mental Health and Mental Disorders: Fighting Stigma and Promoting Recovery A 16- ear-old high school student whose mother has severe depression decides to design a health education project on the effects of mental illness on individuals and their families as her health class assignment. The student knows first hand the stigma of mental illness because the student’s mother has experienced shame, disgrace, and the disapproval of others because of her depression.
Others’ opinions and behavior toward the mother have made it difficult for the mother to accept that her depression is a treatable medical condition rather than simply a “ flaw in her personality. ” As a result of her depression, the mother lost her Job a year ago. The father also left the family, stating that he was “ fed up” with the mother’s “ laziness” after she lost her Job, that she was incapable of functioning independently, and that he was tired of having to carry the burden.
As a result, there have been severe financial difficulties, including transient housing issues. The student attempts to care for the mother’s basic needs because the mother is not able to do so because of the severity of her depression. The health project includes the fact that depression is the leading burden of disease in the United States and that one of four adults experiences depression. As well as the fact that depression is a treatable illness. A The health project also discusses how mental disorders are diagnosed using the ADSM-IV-TRY multimedia diagnostic system.
What are the five axes or domains of information that should be explained? The five axes are: 1 . Axis I: refers to the collection of signs and symptoms that together constitute a particular disorder (schizophrenia) or a condition that may be a focused treatment. 2. Axis II: refers to the personality disorders and mental retardation. It is separated from axis I to ensure that the possible presence of long term disturbance is noninsured when attention is directed to the current disorder. 3.
Axis Ill: clinical indications of any general medical conditions believed to be relevant to the mental disorder in question (neurological dysfunction). 4. Axis lb. Is for reporting psychosocial and environmental problems that may affect the diagnosis, treatment, and prognosis of a mental disorder (occupational problems, educational problems etc. ). 5. Axis V: called Global Assessment of Functioning, gives an indication of the person’s best level of psychological, social, and occupational functioning year, rated on a scale of 1 to 100. Is the lowest level of functioning. When outlining the 10 fundamental components of mental health recovery in the health project, which component speaks to recovery being a growth experience that is a step-by-step process but also includes some expected setbacks? Non-linear component Cultural and Spiritual Issues Related to Mental Health Care A 47-year-old single Filipino woman is referred to an outpatient mental health clinic by Social Services for evaluation of depression. While the patient is being interviewed on intake, the patient reports that this is her first contact with mental health providers.
She tells you that her 23-year-old daughter died 8 months ago from a drug overdose after having been addicted to heroine for many years. The daughter had never received drug treatment because the patient was embarrassed and did not wish to attract unwanted attention to her daughter’s problem. Now the patient is attempting to raise her daughter’s three young children, ages 6 years old, 3 years old, and 18 months old. The patient has been very stressed with the additional financial burden because she has been on-long term disability because of an injury to her back at her Job as a CAN at a nursing home several years ago.
Presently, the patient admits to feelings of helplessness and powerlessness regarding the future because the disability checks are not enough to buy food for herself and the three children and also cover the rent. She is being threatened with eviction from her one-bedroom apartment. The patient also reports low energy, fatigue, weakness, poor memory, and poor sleep. She tells you that she attends church regularly and that her faith is important to her. Family supports are minimal because most of her family is in the Philippines. A. In what way can the RAN best demonstrate cultural competence to this patient?
Listen to the patient. Knowledge about her world views and those of the patients without stereotyping or Judging the patient. Also, find out about the patient’s belief and illness. B. Given what you know about traditional Asian American beliefs regarding mental illness, what might be a priority goal during the orientation phase of the therapeutic relationship? Gain the patient’s trust. Respect their beliefs. Don’t be offended if they don’t shake your hand. Ask open questions, give the patient a chance to talk, and respect the patient for taking the first step towards receiving care.
