Question

Mandeep is a 28 year old G3 P2 A1 L2. She is married to Altaz, 54 years old. They live with his parents in a single family home in Brampton. Mandeep immigrated to Canada from the Punjab region of India 24 months ago. Mandeep speaks and understands a limited amount of English; however her first language is Urdu. Mandeep worked in India in a sari shop but has not worked since her arrival in Canada. She does not drive and has found it difficult to make new friends. She misses her old life and is lonely at times. Altaz is the only member of the family working and as such, has 2 jobs and is home very little.

Mandeep vaginally delivered a 4000g healthy baby boy 4 days ago. She was discharged within 20 hours of delivery, refused to breastfeed and was not interested in holding her son.   Mandeep has remained in a dark room since discharge, has missed her doctor’s appointments and refuses to bond with her child. Her mother-in-law called an ambulance this morning because Mandeep was outside in her underwear talking to herself saying, “I need to end this-I need to end this-I need to end this.”

CASE STUDY

Mandeep, accompanied by her mother in law and newborn son, arrives in the Emergency Department via ambulance stating her son is possessed by the devil.    She states she has a voice in her head commanding her to kill her son to save him from the devil—she continually states “I need to end this-I need to end this-I need to end this.” Mandeep appears restless, withdrawn, agitated and is making irrational statements. Mandeep’s mother in-law seems taken aback by Mandeep’s behavior and states “she is not fit to be a mother—tie her down and keep her here.”

question:

List 3 priority nursing assessments. Why are each of these important?

List 3 priority nursing interventions. Why are each of these important?  

Answer 1

The priority nursing assessment and its intervention are

●Psychological /Psychosocial assessment:

Certain individual may have difficulty to adjust to the new environment due to immigration.A women in a family if can't adjust can make her feel lonely, depressed,isolated ,lack of concentration, disoriented,difficulty in doing daily activities. If a women experience this after delivery it is termed to be post natal depression. This makes them to avoid their newborn,consider them to be a sin or evil spirit,do not breast feed or cuddle the baby .This may even lead them to injure the baby

Intervention:

• Provide psychological support in form of talk therapy and orientbthem to adjust to the new atmosphere
• Involve the family members, spouce on care ,this creates an environment friendly the patient and feel supportive and confident
• Administer antidepressants to treat the long term illness
• Cognitive behavior therapy and supportive therapy can be helpful to relieve stress by expressing her feelings

●Physical assessment

The patient has all signs of depression and has aggravated after delivery .This makes her to detonate her physical health

• Encourage the mother to breastfeed the baby by explaining the importance and benefits of it to baby and mother
• Assess for the uterus and post natal bleeding if any to ensure the patient is regaining normal health
• Administer medication to relieve anxiety

●Cultural assessment

The knowledge and acceptance of changes, differs in accordance to their cultural accustom ,believes and practices

• Provide support therapy, group therapy, to encourage them to establish communication with others and society
• Assess the knowledge and cultural practices, which provides baseline information to plan for care
• Communicate in the way patient can understand or make 7se of a interpreter