Stress & Coping Case Study
Penny, age 61 years, was admitted to the behavioral health center
for short-term inpatient treatment following medical evaluation for
chest pain, shortness of breath, and experiencing a racing heart
rate after a myocardial infarction (MI) workup with a negative
stress test ruled out an MI. She was prescribed Wellbutrin and
Xanax by her PCP for anxiety attacks and discharged with a
prescription to an outpatient therapist to help her cope with her
anxiety. It has been identified that Penny has several stressors
currently: she is working two full-time jobs to help cover the
costs of her older brother’s long-term facility care to manage his
worsening dementia. Before the admission, Penny had been attempting
to care for her brother at home, but found that he required more
care and supervision than she was able to provide. She feels
tremendous guilt that she had to place her brother in a facility.
Additionally, her brother has not managed the transition from home
to the long-term care facility well, and there have been several
incidents of behavioral problems, which have resulted in the
administrator of the long-term care facility notifying Penny that
they may not be able to continue to provide care for her
brother.
Penny began having difficulty focusing at work and was spoken to by
her supervisor about her forgetfulness. She became restless and
irritable and described periods of apprehension and helplessness to
her therapist. Her anxiety attacks have worsened over the past 2
weeks, and she now has difficulty leaving her house. When Penny
does leave the house, she often experiences an attack where she
feels unsafe, has difficulty prioritizing and making decisions, and
feels like running home, where she is “safe.” It was decided to
readmit Penny for stabilization of her current symptoms.
Upon entering Penny’s room to complete the admission paperwork, the
nurse finds Penny crying, pacing back and forth, and wringing her
hands. She repeats over and over, “I just don’t know what to do. I
need to get out of here.”
a. What nursing diagnosis would the nurse apply to this
patient with the above history and behavior?
b. Which level of anxiety is Penny currently
experiencing?
c. What nursing interventions should be immediately
implemented by the nurse?Stress & Coping Case Study
Penny, age 61 years, was admitted to the behavioral health center
for short-term inpatient treatment following medical evaluation for
chest pain, shortness of breath, and experiencing a racing heart
rate after a myocardial infarction (MI) workup with a negative
stress test ruled out an MI. She was prescribed Wellbutrin and
Xanax by her PCP for anxiety attacks and discharged with a
prescription to an outpatient therapist to help her cope with her
anxiety. It has been identified that Penny has several stressors
currently: she is working two full-time jobs to help cover the
costs of her older brother’s long-term facility care to manage his
worsening dementia. Before the admission, Penny had been attempting
to care for her brother at home, but found that he required more
care and supervision than she was able to provide. She feels
tremendous guilt that she had to place her brother in a facility.
Additionally, her brother has not managed the transition from home
to the long-term care facility well, and there have been several
incidents of behavioral problems, which have resulted in the
administrator of the long-term care facility notifying Penny that
they may not be able to continue to provide care for her
brother.
Penny began having difficulty focusing at work and was spoken to by
her supervisor about her forgetfulness. She became restless and
irritable and described periods of apprehension and helplessness to
her therapist. Her anxiety attacks have worsened over the past 2
weeks, and she now has difficulty leaving her house. When Penny
does leave the house, she often experiences an attack where she
feels unsafe, has difficulty prioritizing and making decisions, and
feels like running home, where she is “safe.” It was decided to
readmit Penny for stabilization of her current symptoms.
Upon entering Penny’s room to complete the admission paperwork, the
nurse finds Penny crying, pacing back and forth, and wringing her
hands. She repeats over and over, “I just don’t know what to do. I
need to get out of here.”
a. What nursing diagnosis would the nurse apply to this
patient with the above history and behavior?
b. Which level of anxiety is Penny currently
experiencing?
c. What nursing interventions should be immediately
implemented by the nurse?Stress & Coping Case Study
Penny, age 61 years, was admitted to the behavioral health center
for short-term inpatient treatment following medical evaluation for
chest pain, shortness of breath, and experiencing a racing heart
rate after a myocardial infarction (MI) workup with a negative
stress test ruled out an MI. She was prescribed Wellbutrin and
Xanax by her PCP for anxiety attacks and discharged with a
prescription to an outpatient therapist to help her cope with her
anxiety. It has been identified that Penny has several stressors
currently: she is working two full-time jobs to help cover the
costs of her older brother’s long-term facility care to manage his
worsening dementia. Before the admission, Penny had been attempting
to care for her brother at home, but found that he required more
care and supervision than she was able to provide. She feels
tremendous guilt that she had to place her brother in a facility.
Additionally, her brother has not managed the transition from home
to the long-term care facility well, and there have been several
incidents of behavioral problems, which have resulted in the
administrator of the long-term care facility notifying Penny that
they may not be able to continue to provide care for her
brother.
Penny began having difficulty focusing at work and was spoken to by
her supervisor about her forgetfulness. She became restless and
irritable and described periods of apprehension and helplessness to
her therapist. Her anxiety attacks have worsened over the past 2
weeks, and she now has difficulty leaving her house. When Penny
does leave the house, she often experiences an attack where she
feels unsafe, has difficulty prioritizing and making decisions, and
feels like running home, where she is “safe.” It was decided to
readmit Penny for stabilization of her current symptoms.
Upon entering Penny’s room to complete the admission paperwork, the
nurse finds Penny crying, pacing back and forth, and wringing her
hands. She repeats over and over, “I just don’t know what to do. I
need to get out of here.”
a. What nursing diagnosis would the nurse apply to this
patient with the above history and behavior?
b. Which level of anxiety is Penny currently
experiencing?
c. What nursing interventions should be immediately
implemented by the nurse?
a, Nursing diagnosis:
Anxiety due to facing difficulty at work and
forgtfullness, restlessness and irritable
Acute pain due to an anxiety
attack
Depression due to her brother in a facility
Low self-esteem due to poor
decsion making.
b, The patient is with severe anxiety level, because the patient is
afraid, confused and withdrawn and finds diffculty to think clearly
and the patient had anxiety symproms of breathing diffculty and had
chest pain.
c, Nursing intervention:
-Assess the patient's level of anxiety.
-Assess patient physical reactions
-Promote communication and supportive
-Provide orientation to the environment.
-Accept patient words and never argue.
-Avoid harmful environment stimuli
-Allow the patient to talk more
-Help the patient to understand the coping strategies.
-Allow the patient to consider postive self talk about
herself
-Provide relaxation, deep breathing therapies and reassuring
self-statements.
-Strengthen her problem-solving strategies
-provide antianxiety medication
-Follow holistic approachs.
Stress & Coping Case Study Penny, age 61 years, was admitted to the behavioral health center...
Stress & Coping Case Study Penny, age 61 years, was admitted to the behavioral health center for short-term inpatient treatment following medical evaluation for chest pain, shortness of breath, and experiencing a racing heart rate after a myocardial infarction (MI) workup with a negative stress test ruled out an MI. She was prescribed Wellbutrin and Xanax by her PCP for anxiety attacks and discharged with a prescription to an outpatient therapist to help her cope with her anxiety. It has...
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