Question

Discussion Topics, Mohr

Chapter 9, The Nursing Process in Psychiatric–Mental Health Care

Discussion Topics	Learning Objective
1. Wanda is a 34-year-old woman who was raped at the age of 17. She has never told anyone about her experience. Whenever she starts to think about the event, Wanda drinks heavily to forget about the emotional pain. She has been avoiding social situations because being in a crowd makes her very anxious. Two weeks ago while shopping, she suffered a panic attack and had to be taken to the hospital. She has pushed away all family members and has no one left in her immediate support system. Develop a nursing diagnosis that would be appropriate for Wanda. What assessment information from the case supports your diagnosis? Create a list of at least three short-term and one long-term outcome for the nursing diagnosis.	1, 3, 5
2. You are conducting an admission interview with Linda, a 47-year-old woman whose husband died from a car accident 2 months ago. She was admitted due to a suicide attempt and states during the interview that she has “nothing to live for.” She says that she has been drinking alcohol regularly to “numb the pain” and to help her sleep at night. After the interview, you develop a list of nursing diagnoses, which includes the following: Dysfunctional Grieving related to lack of adequate support secondary to loss of spouse as evidenced by client’s statement of having “nothing to live for.” Ineffective Individual Coping related to substance abuse and inappropriate coping mechanisms as evidenced by client’s statement of using alcohol to “numb the pain.” Sleep Pattern Disturbance related to lifestyle disruption as evidenced by client’s statement that alcohol is used to assist with sleeping. For each nursing diagnosis, develop appropriate long-term and short-term goals. For each nursing diagnosis, develop appropriate interventions. How will you evaluate if these nursing diagnoses were effective? Where will you document these nursing diagnosis and interventions and why?	7, 8, 9
3. After completing a care plan for a mental health client, you have been asked to document in the client’s record. Why is documenting in the care record necessary? When documenting the nursing process, why key components and principles need to remain consistent? Compare and contract narrative, SOAP, and PIE charting.	9
4. Your nursing instructor has just demonstrated a psychosocial assessment for you in the clinical setting. Your fellow nursing student did not see this demonstration, so you decide to enlighten her. What is a psychosocial assessment? Explain the components of the psychosocial assessment. Provide an example question for each dimension.	2
5. You are doing your student nurse clinical rotation on the inpatient psychiatric unit when you hear the physician mention the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). This interests you and you decide to investigate. What is the DSM-IV-TR? What is its purpose? Why do you believe knowledge of the DSM-IV-TR is important for psychiatric nurses?

Answer 1

(a) Nursing diagnosis:-

1. Panic anxiety
2. Fear
3. Powerlessness
4. Social isolation
5. Ineffective coping mechanism
6. Ineffective role performance
7. disturbed throught process
8. disturb body image
9. Disturbed sensory perception

(b) Support Diagnosis

1. Avoid activities
2. Feeling of detached
3. Patient is having effort to avoids thoughts
4. Feeling of flat
5. Social withdrawl
6. Outburst of anger
7. Irritability

(c) Short term goal

1. client will verbalise understanding of correlation between physical symptoms behaviour anexity
2. events.
3. Adoptive coping mechanism
4. Healthy grief resolution

Long term goal

1. Client will be able to resume role related responsibility by discharge.

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