Question

1. Mr. Smith, a 52-year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. The patient has a history of smoking two packs per day of cigarettes for 35 years, and he drinks a six-pack of beer on weekend nights, but does not drink the rest of the week. He is the sole financial support for his family. He is a consultant for a company and is out of town during week days. Over the past year, Mr. Smith has gained 20 pounds. He is 5 foot 6 inches, weighing 200 pounds. His diet consists mostly of fast food. He rarely exercises. His wife cares for their three teenage children. The eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children's hospital in the intensive care unit in critical condition. Mr. Smith developed chest pain and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pils. The wife is in the waiting room while the nurses settle Mr. Smith into his room. The youngest son, 13 years of age, is at a friend's house. The teenage daughter is staying at the bedside of the critically ill eldest son. The wife blames her eldest son for her husband's heart attack and told the emergency department nurse that she does not care to see her son at all. a. What maladaptive responses to stress may have contributed to Mr. Smith's development of an illness? b. Based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family in crisis? C. What nursing interventions should be used to promote effective coping for the patient and his family?

Answer 1

1.

The maladaptive behavior in smiths life include Taking alcohol, smoking. thse are the main reson for making the problem for him.

Mother has been using the coping strategy of projection in the son for the whole family. But all the children in the teenages and had developed the malkdaptive practices may because problems in the parenting and the family were not able to spend time with the children. If the 17 year started using alcohol and driving and met with an accident and the 15 year old asking for birth control pills are part of the developmental mile stone in this age of risk taking behavior. The family especially the parents has a major role in this part o life. The father was busy in the week days in work and busy in the weekend with drinking. so this has been contributed to the problem

The coping strategy include to reduce the use of alcohol and smoking and along with that spending time with family and discussing the problems of the teenages and make them a feel of thinking that the parents are there for them. Apart from that the family can understand that there problem behavior with everyone and everyone has to accept this and try to reduce the problem.

2.

Steped on a nail , and has a one inch deep wound she cleaned with soap and water and hydrogen pyroxide and applied antibiotic oilment. After 5 days she has increased pain and swelling, and the assessment shows it is red and edematous with yellowish drainage

Histamine will help the healing process by reducing the oedema and as a result of it pain also get reduced. So the person can be free to do the day to day activities with little discomfort.

pain, oedema, red colour and yellow drainage or puss

Any underlying infections, temperature and other vitals blood routine investigations and to exclude the chances of having tetanus infection as it is a deep wound , so assess about the immunisation status against the same.