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Psychiatric-Mental Health Nursing

What Should the Nurse Do?

Psychiatric-Mental Health NursingWhat Should the Nurse Do?

What Should the Nurse Do?

1 .
Doris, a seventy-eight-year-old female, presents at the geriatric clinic accompanied by her daughter. Doris’s daughter expresses concern about her mother’s recent changes in behavior. Doris has been withdrawing from social activities, experiencing disrupted sleep patterns, and expressing feelings of sadness. Her medical history includes hypertension and osteoarthritis, and her vital signs are stable (heart rate of 78 bpm, respiratory rate of 16 breaths per minute, blood pressure of 130/80 mmHg, and temperature of 98.4°F).
How might Doris’s medical history of hypertension and osteoarthritis contribute to the analysis of her depressive symptoms, and what additional information might be valuable in understanding the context of her condition?
Randolph is eighty years old and is brought to the emergency department by his daughter due to acute changes in mental status. Randolph has a history of hypertension and recently underwent hip replacement surgery. His daughter reports that over the past twenty-four hours, he has become disoriented, agitated, and is experiencing vivid hallucinations. His vital signs show an elevated heart rate (100 bpm), increased respiratory rate (22 breaths per minute), elevated blood pressure (150/90 mmHg), and a mild fever (100.5°F).
2 .
How might Randolph’s recent hip replacement surgery and history of hypertension contribute to the analysis of his delirium symptoms, and what additional information would you seek to understand the context of his acute mental status changes?
3 .
As a nurse, how would you collaborate with the health-care team to investigate the potential causes of Randolph’s delirium, and what steps would you take to involve his daughter in the care planning process?
Vivian, a seventy-two-year-old female, is admitted to the geriatric clinic by her daughter due to concerns about her alcohol use. Vivian has a medical history of hypertension and osteoarthritis. Lately, her daughter has noticed increased forgetfulness, unsteady gait, and a distinct smell of alcohol on her breath. Vivian’s vital signs are within normal ranges (heart rate of 80 bpm, respiratory rate of 18 breaths per minute, blood pressure of 140/90 mmHg, and temperature of 98.6°F).
4 .
What interventions would you propose to address Vivian’s alcohol use, considering her age, medical conditions, and the potential impact on her overall well-being? How would you involve her daughter in the development of these interventions?
5 .
How should a nurse initiate a conversation with Vivian about her alcohol use, and what steps should a nurse take to address any potential resistance or denial? How might a nurse involve other health-care professionals in Vivian’s care?
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