*NURSING > CASE STUDY > NURS 6670 FINAL EXAM STUDY GUIDE CHAPTER 1 TO 39> WALDEN UNIVERSITY (All)

NURS 6670 FINAL EXAM STUDY GUIDE CHAPTER 1 TO 39> WALDEN UNIVERSITY

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Mental Health Case Study Case Study, Mohr: CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing In completing the case study, students will be addressing the following learning objective... s: Explain elements that contribute to mental health. Review trends, problems, and goals related to the delivery of mental health care and treatment of mental illness. 1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen has been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for depression. Karen and her boyfriend had been discussing marriage until he told her that he wanted to end their relationship. Karen became even more depressed and could not work for a week. Karen returned to work, refusing to discuss her issues with family, friends, or coworkers. She did, however, make an appointment to see a psychiatric nurse practitioner. Karen told the nurse that she was making some changes in her life. Karen said that she and a girlfriend were joining a gym program for workouts and a social group for young men and women. Karen stated that she realizes that her former boyfriend had not been committed to her, and she anticipates meeting and dating other young men from the adult social group. Karen also said that she thinks that the gym exercise will be beneficial to her mentally and physically. Learning Objectives: 1, 4) a. How will the psychiatric nurse assess if Karen has made progress toward self-realization? Karen had suffered from depression which is a form of mental disorder as a result of divorce and a broken relationship with her boyfriend. This situation according to Hypocriticus in 15th century BC, upholds the brain as the organ of consciousness; this occurs when both normal and abnormal behavior arise from the brain. The psychiatric nurse can assess if Karen has made progress towards self-realization by committing to diagnosing and treating her responses to the problems that caused her psychiatric disorder. In-addition, the nurse can make assessment based on Karen’s psychoanalytical disposition such as: trasferrence, defense mechanism, countertransference, acting out, denial of the reality befallen her and projection. b. Identify strengths that Karen has for progress in personal growth. The strengths Karen has for progress in personal growth include the followings:  Ability to make use of social support, that is, she visited a psychiatric nurse, social group and registered in a gym.  She was realistic about her situation, therefore made herself ready to face the reality before her.  Karen sought immediate medical attention where she was administered with Prozac to help mitigate her depression state.  Her cognitive behavioral responses showed optimism towards a better life as well as fighting against her depressed state. Hence, her willingness to date younger men. c. Karen has been seeking treatment for her depression. Analyze the factors that might contribute to Karen’s reluctance to discuss her depression with others. Karen’s reluctance to discuss her depression with others hinges on the fact that her depression was a kind called social depression. Social depression is a psychological disorder caused by several factors such as: interpersonal relationship which involves the relationship between a person and the interactions of emotions of each individual expressed directly and discreetly to each other. Another is a Common interpersonal relationship, this includes : Family, social environment (work place), and interaction among age groups and genders. Because Karen had divorce and broken relationship, she didn’t feel safe in herself discussing her depression with family and friends but to seek a professional whose job is to attend to her depressed case. Hence, her neuroticism was calm and strong willed. Case Study, Mohr: CHAPTER 2, Neuroscience: Biology and Behavior In completing the case study, students will be addressing the following learning objectives: Discuss neuroplasticity and how this concept relates to mental health and mental illness. Briefly explain the importance of interaction between genes and environment, the role of endophenotypes, and the stress-diathesis model of psychiatric illness. 1. Michael is a 22-year-old college senior whose GPA has declined with this semester’s grades. Michael plans to apply to medical school and thinks that the lower GPA may prevent his acceptance to medical school. For the last 2 weeks, Michael has skipped most classes because he has insomnia and fatigue. Michael is now very depressed and has been thinking of suicide. He took a loaded gun from his father’s gun cabinet and then wrote a suicide note to his family. At the last moment, he telephoned 911 and told them of his suicide plan. The police came, took the gun away, and then took Michael to the city hospital to be admitted for psychiatric treatment. In the admission interview with the psychiatric nurse, Michael said that his pastor thought that only weak-willed people experienced depression and that it was a punishment for personal sins and the sins of one’s ancestors. Michael told the nurse that he must be weak-willed and will never be able to accomplish anything. The psychiatric nurse explained that multiple factors are the cause of depression. The nurse told Michael that one theory holds that an imbalance of neurotransmitters, or chemical messengers of the brain, occurs in depression. Neurotransmitters influence the individual’s emotions, thoughts, and subsequent behavior. Recent research implies that neurobiology, heredity, as well as Psychological and environmental factors may be involved in the development and progression of depression. (Learning Objectives: 5, 6) a. Will Michael think that the psychiatric nurse’s explanation for the cause of depression is more correct than that of his pastor? No. It is indeed difficult for Michael to accept the doctor’s opinion since before he fell sick, he had information from the pastor on depression on which he solely believed and now he is a living prove. b. Michael asks the nurse why he has to have psychotherapy. He states that he only needs to take a couple of pills to get better. How should the nurse respond to Michael’s question and comment? The nurse has to explain to Michael why he should consider psychotherapy. Because of the many misconceptions about psychotherapy, you may be reluctant to try it out. Even if you know the realities instead of the myths, you may feel nervous about trying it yourself. Overcoming that nervousness is worth it. That’s because any time your quality of life isn’t what you want it to be, psychotherapy can help. Taking only pills will not help but increase the effects because most of these medication have side effects which would have been avoided by psychotherapy. c. Develop an assessment question for each of the following possible causes of Michael’s development of depression: Genetic, Environment and Stress. From the Geriatric Depression Scale: “Do you prefer to stay at home rather than going out and doing new things?” This question asks for a yes or no answer and recognizes that isolation and withdrawal are common signs of depression — especially in the elderly. From the MADRS: “How is your sleep?” Answers include: Sleeping as usual, slight difficulty, sleep reduced by at least two hours, or getting less than three hours of sleep at night. Greater sleep disturbance signals a greater risk for depression. From the Beck Depression Inventory: “How is your energy?” Declines in energy level are a common sign of depression — the more significant your lack of energy, the higher your depression risk rating. Possible answers to this question include: As much energy as ever, less energy than before, not enough to do much, or not enough to do anything Case Study, Mohr CHAPTER 3, Conceptual Frameworks and Theories: In completing the case study, students will be addressing the following learning objective: Give examples of behavioral and cognitive-behavioral interventions. The student nurse has been assigned a 37-year-old woman admitted to the psychiatric hospital with an anxiety disorder. This morning, the student notices that the client has a tense facial expression and is walking constantly around the group room. The student walked over to the client and used reflective communication by stating, “I see that you have a tense expression and are walking around almost all of the time. Is there something that we could discuss?” The client replied that she has talked on the telephone to her mother who was keeping her children while she was in the hospital. The client said that her mother had told her that she was not a good mother, and then said, “I guess I am a bad mother, but I could never measure up to my mother’s expectations.” The student has learned that negative self-talk can greatly aggravate anxiety and lead to depression. The student decided to use a behavioral intervention with the client and asked the client who is a good artist and why the client liked the artist’s works. The student and the client then made a list of activities that the client liked. The student taught the client to engage in one of these activities when an unpleasant experience evoked negative thoughts. The following day, the student decided that the client needed some cognitive restructuring for her relationship with her mother. The student taught the client that during discussions with her mother, feelings of incompetence might be experienced when the mother made negative comments. The client was instructed that if her mother made negative comments about parenting, she was to immediately tell her mother that she was a good parent to her children and terminate the conversation at the first opportunity. (Learning Objective: 3) a. Will the client be able to learn cognitive restructuring in her relationship with her mother? Yes, she will learn because by keeping positive thought, her cognitive restructure will develop to the positive. Based on the above facts and behavioral intervention made between client and the student nurse it is possible to established a good and collaborative relationship with her mother. Besides, client can also be able to gain of cognition to maintain a fruitful relationship with her mother. Anxiety is a normal reaction to certain situations. A small level of anxiety is normal, but severe anxiety can be a serious problem. Academic anxiety can become more detrimental over time than community based anxiety. Much evidence supports the notion that social anxiety causes impairment in many domains of life, such as romantic relationships, friendships, work, and physical health. b. How will engaging in activities help the client with her anxiety? Based on the everyday behavior of client the patient nurse decided a plan that how to solve this problem. Then the student nurse asks client what happened? From this nurse learn that some phone call received from home relative to negative thought. The student has learned that negative self-talk can greatly aggravate anxiety and lead to depression. That is why nurse decided some plan and asked to each client who are great artist their favorite items or activities. Then, according to that nurse can able to engage the client into her favorite hobbies, when an unpleasant experience evoked negative thoughts. The next day, the student decided that the client has been gaining some cognitive restructuring for her relationship with her mother. Finally, the student nurse had advice to the client that in future when her mother made some negative thought or narration regarding parenting she should immediately and confidently tell her mother that she was a good parent to her children and closed this [Show More]

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