What Should the Nurse Do?
Vanessa, a forty-five-year-old female, has presented to the clinic with complaints of persistent anxiety and difficulty expressing her emotions. As a single mother of two teenagers, she reports feeling overwhelmed and emotionally drained. Vanessa has a medical history of hypertension and a recent family loss, contributing to her heightened stress levels. Vital signs are blood pressure of 150/90 mmHg, heart rate of 80 beats per minute, and respiratory rate of 20 breaths per minute. During the initial assessment, Vanessa exhibits signs of emotional distress, such as tearfulness and difficulty maintaining eye contact.
1
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What therapeutic communication strategies can the nursing student employ to address Vanessa’s emotional distress and establish a trusting relationship?
2
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As a nursing student, what specific actions can be taken to address Vanessa’s emotional needs and contribute to her overall well-being?
3
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Discuss the impact of recognizing and respecting physical, emotional, and social boundaries in the nurse-client relationship on the overall quality of care for Vanessa.
4
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As a nursing student, identify potential barriers to therapeutic communication in Vanessa’s case, and propose specific interventions to overcome these barriers.
5
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Explain how inappropriate self-disclosure or lack of empathy could lead to a nontherapeutic nurse-client relationship in Vanessa’s case.
Tony, a thirty-year-old male, has presented to the psychiatric clinic reporting symptoms of persistent sadness, insomnia, and social withdrawal. He describes feeling overwhelmed by irrational fears and an inability to focus on daily tasks. Tony has a history of generalized anxiety disorder. During the assessment, he expresses concerns about seeking help for his mental health, citing the stigma associated with psychiatric illness in his community. Vital signs are blood pressure of 120/80 mm Hg, heart rate of 100 beats per minute, respiratory rate of 16 breaths per minute, and temperature of 98.4°F (37°C). Tony shows signs of restlessness, constant fidgeting, and guarded body language.
6
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How might Tony’s cultural background and past experiences contribute to his perception of mental illness, and what implications does this have for the nursing care plan?
7
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How will a nursing student determine the effectiveness of interventions addressing Tony’s concerns about stigma, and what adjustments might be necessary based on ongoing evaluation?
Lucia, a twenty-eight-year-old female, arrives at the psychiatric clinic presenting with a range of concerning symptoms. She reports persistent low mood, changes in sleep patterns, and social withdrawal, indicating a potential recurrence of her depression and anxiety. Lucia’s vital signs are stable, with a blood pressure of 120/80 mmHg, heart rate of 80 beats per minute, respiratory rate of 18 breaths per minute, and temperature of 98.6°F. Her medical history reveals a previous diagnosis of depression and anxiety, and she is not currently on any psychiatric medications.
8
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Given Lucia’s symptoms and history, what problem should be prioritized in developing a nursing care plan, and how does this guide the selection of interventions?
9
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What interventions can be generated to address both the emotional distress and the psychosocial issues Lucia is facing, and how might these interventions be integrated into her care plan?