What Should the Nurse Do?
1
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Amber, a twenty-two-year-old female, has come to her primary care physician accompanied by her concerned mother. Amber’s mother reports that she has been restricting her food intake in the past six months and appears to have lost a lot of weight. She has been avoiding family meals, exercising excessively, and staying home favoring online classes rather than in-person ones. While Amber has not had any medical problems in the past, she does report strong feelings of anxiety. During the initial assessment, Amber’s vital signs are as follows: blood pressure of 100/60 mm Hg, heart rate of 50 beats per minute, respiratory rate of 16 breaths per minute, and BMI of 17.5. Amber appears visibly fatigued and demonstrates signs of social withdrawal. She expresses feelings of guilt after eating even small amounts of food and has difficulty concentrating on her studies.
Identify advantages and disadvantages of each treatment setting. What are the pros and cons of inpatient treatment, intensive outpatient services, and telehealth for treating Amber at this stage and which is best?
2
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Lawrence arrives at a community mental health clinic seeking support for persistent symptoms of social anxiety and depression. He reports challenges in forming and maintaining relationships, both personally and professionally. Lawrence, a graphic designer, expresses difficulty collaborating with colleagues and a tendency to avoid social gatherings. He mentions a history of childhood trauma, which he has never addressed in a therapeutic setting. During the initial assessment, vital signs reveal a slightly elevated blood pressure of 130/85 mm Hg, a heart rate of 78 beats per minute, and a respiratory rate of 16 breaths per minute. Lawrence shows signs of restlessness, constantly fidgeting, and displays guarded body language.
What verbal and nonverbal cues did Lawrence exhibit during the initial assessment that indicated potential suitability for group therapy?
James, a forty-five-year-old male, visits a psychiatric-mental health clinic accompanied by his wife, Sarah. He presents with symptoms of severe anxiety, insomnia, and emotional withdrawal. James, an accountant, recently lost his job due to the economic downturn, adding financial stress to the existing burden. His medical history reveals a family background of mental health issues, with a sibling diagnosed with bipolar disorder. Vital signs during the initial assessment show an elevated blood pressure of 140/90 mm Hg, a heart rate of 88 beats per minute, and a respiratory rate of 18 breaths per minute.
3
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How might James’s family history contribute to his symptoms, and in what ways could the recent job loss act as a trigger for his anxiety and emotional withdrawal?
4
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What are some potential family-centered interventions that address both James’s individual symptoms and the broader family context? How might involving Sarah in the treatment plan contribute to James’s recovery?