Question

Please read the following case study and answer the questions in its entirety. Please follow the case study rubric and APA guidelines. Be sure to cite appropriate researched references and use in-text citations.

Savannah has come by the free “drop-in” counseling clinic were you work to get some information and advice. She is a 22-year-old single woman who has been living with her boyfriend Chris in Dale City for the last four years. She and Chris have been heroin addicts for four years as well. When Savannah was 10 years old, her father, whom she says was a very heavy drinker, left her mom and the kids and never came back. At 14 she started drinking alcohol, smoking marijuana, skipping school, and hanging out with negative peer groups. At 16 she had dropped out of high school and at 18 she moved in with Chris. He introduced her to heroin. She reports using about a 1/2 gram of heroin per day just to be able to function and feel comfortable. In order to pay for the heroin and pay the rent on their apartment, Chris doesn’t work. Instead, Savannah "works the streets" at night. Savannah prostitutes herself to support her and Chris' heroin habit. She usually drinks a pint of vodka each night before going out to work. If she can’t score enough heroin, she will try to score either some Valium, Klonopin, or Xanax to “tide me over until I can get some ‘horse’”. She says she has tried cocaine but, “I really didn’t care for the high all that much.” Savannah tells you that the alcohol and heroin help to calm her nerves and get her through the night. She and Jack are not having sex all that much. When they do, he never wears a condom. He says that’s what makes him different from her “John’s” “Which is true because I won’t work without a condom.” Lately Savannah has noticed that her breasts have become swollen and more tender. She also hasn’t had her period in the last 12 weeks. She is pretty sure she is pregnant and believes that her boyfriend is the father of the baby. She can't stop using dope even though she believes she is pregnant. Chris wants her to keep it. She's really confused at what she should do and is asking for you as her intake assessment nurse to help her make some decisions. Her friend who works with her at night told her not to stop using dope if she is pregnant “Because it’s worse for the baby than to keep using.”. “I just don’t know what I should do?”

Case Study #2 Questions

1. What drug(s) does Savannah seem to be most addicted to? What makes you come to this conclusion?

2. Of the drugs she is abusing, which one(s) pose more of a danger to withdraw from? Why?

3. What are the concerns as you read this case? List at least 3 and prioritize them. Think about the dangers for Savannah and the dangers for the baby, explain in detail these concerns?

4. What treatment options would you offer Savannah and why? What referrals would you give to her? (Research treatment options in your area and include them as possible resources for Savannah.)

5. Is her friend correct in her advice for Suzanne not to stop her heroin use if she is pregnant? If she is, why?

6. What legal issues are more than likely to present themselves in this case if she decides to keep the child? Please explain?

Answer 1

1. Savannah is mostly addicted to heroin. I came to this conclusion because she started working on streets only to dope herself with heroin and if she is not able to get her dose than she would overdose herself with valium and other..

2. Valium pose more effect as it would be fatal and withdrawing from it due to its severity and long acting duration on brain due to coma and death.

3. The 3 concerns are * first of all risk of acquiring sexually transmitted disease because this pose an priority as savannah works on streets though she uses the condom but still when she is been doped there is a chance of wear and tear of the condom and she is at risk of STDs..

* complication to fetus the teratogenic effects of drug use affects the fetal development which leads the fetus to intrauterine death or any congenital anomalies.

* fatal to herself long duration of usage of drugs with other habits of alcoholism will lead to brain damage were she can go for sudden seizures coma and death.

4. The treatment option would be drug deaddiction, multiple treatment modalities with holistic approach of rehabilitation, alcohol and drug anonymous group. Proper medical management for seizures of withdrawal symptoms and others. Detoxification under complete monitoring and treatment. If she is volunteering the behaviour therapy can be done with complete collaboration ranging from medical treatment to the grass root level of counselling on withdrawal and de addiction.

5. Yes she would be right because stopping heroin without the medical treatment would make her have fatality hence withdrwl symptoms would be more .

6. The legal issues would be autonomy were by the mother would have had the freedom to decide but it would be harmful for the baby, non malefficience plays an important role were by here she would be harming the baby indirectly being addicted were by baby is born as drug dependent or may undergo the complications.