What Should the Nurse Do?
Jane, a 35-year-old woman, comes to the emergency department complaining of chest pain and difficulty breathing. She reports feeling overwhelmed and anxious for the past few weeks due to increased workload at her job as a project manager. She mentions experiencing frequent headaches, insomnia, and irritability. Jane has a history of hypertension and migraines but is otherwise healthy. On assessment, her blood pressure is elevated at 160/90 mm Hg, heart rate is 110 beats per minute, respiratory rate is 24 breaths per minute, and oxygen saturation is 95% on room air. She appears restless and diaphoretic.
1
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What psychological factors might be contributing to Jane’s presentation, and how do they interact with her physical symptoms?
2
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How can the nurse provide a supportive and calming environment for Jane to help alleviate her acute stress symptoms?
You are caring for a young adult who comes to the clinic for an appointment and physical exam for a sports requirement. The young adult did not have an appointment and is told she cannot be seen. Rather than viewing it as an inconvenience that she must schedule the appointment for another day, she begins to shout at the front desk and demand an appointment today. Her response seems exaggerated and irrational.
3
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As the nurse, what initial steps should you take when faced with the young adult’s exaggerated and irrational behavior at the front desk?
4
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Why is it important for the nurse to conduct an assessment of the young adult’s current perceived stress and threats?
5
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What potential factors might contribute to the young adult’s behavior in this scenario?
You are studying with a fellow nursing student who confides in you about being stressed due to school demands, limited income, and a new breakup with a boyfriend. She admits she cannot study and now has the added stress of doing poorly on the upcoming exam. She is tempted to cheat on the exam to pass.
6
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How can you support your fellow nursing student in developing healthy coping mechanisms to manage her stress effectively?
7
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What are some strategies you could suggest to help her address the school demands, financial challenges, and emotional distress caused by the breakup?
8
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How can an understanding of the physiological and psychological effects of stress help you provide empathetic and effective support to your fellow nursing student during this challenging time?
Ms. Greene, a 45-year-old woman, presents to the emergency department complaining of severe abdominal pain and tenderness. She reports experiencing intermittent fever and chills over the past few days. Ms. Greene has a medical history of type 2 diabetes and hypertension. On examination, her vital signs reveal a temperature of 38.9°C (102°F), heart rate of 110 bpm, blood pressure of 150/90 mm Hg, and respiratory rate of 22 breaths per minute. Upon further assessment, localized inflammation and guarding are noted in the right lower quadrant of her abdomen. Based on her symptoms and medical history, differential diagnoses include appendicitis, diverticulitis, or pelvic inflammatory disease. Further investigations are warranted to identify the underlying cause of her symptoms and initiate appropriate treatment.
9
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What clinical manifestations would prompt the nurse to suspect an inflammatory process in Ms. Greene’s case?
10
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What immediate nursing interventions would be appropriate to manage Ms. Greene’s symptoms and stabilize her condition?