Question

is a 73-year-old woman who presents to the women's health clinic for an annual physical exam. She states she is having difficulty sleeping and has been having panic attacks for the past year since the death of her son Subjective Data Lives with husband Daughter, age 50, lives nearby Had a son, age 52, who passed away in the last year from drug overdose Objective Data Vital signs: T 37, P 80, R 18, BP 140/68 Weight: 140 HT: 5 feet 6 inches Questions: 1. On which components of the health history will the nurse focus the mental health exam? 2. What are the specific observations that the nurse should make in regard to mental status? 3. Why is it important to obtain a thorough past medical history for this patient? 4. What specific questions from the past medical history should the nurse consider asking? 5. What specific questions should the nurse ask regarding the panic attacks? 6. Create a problems list from the data provided. 7. What teaching and nursing interventions should be included in the plan of care for this patient?

need help answering questions 1-7

health Assessment

book: Health Assessment for Nursing Practice

mental health examination

Answer 1

1.The women is having panic attack for past 2 yr since the death of her son on the basis of that health history the nurse focif on mental health exam.

2.the specif observations regard to mental status are -In case of panic attack patients, mini mental status examination is performed.
The specific observations that the nurse should make in regard to this MMSE are-
1. General appearance- sweaty and confused.
2.Cognitive performance, memory,serial-7, and proverb interpretation- should appear intact and consistent .
3.Speech- may reflect anxiety or urgency and difficulty in speaking.
4. Mood- Anxious with congruent affect.
5.Thought process- should be logical, linear, and goal directed.
6. Insight and judgement- present and intact.
7. Thought content should also be ovbserved.

3. The medical history, being an account of all medical events and problems a person has experienced is an important tool in the management of the patient.

DANI the medical history, being an account of all medical creats l problems a pesson has experienced is an important tool su the management of the patient It is an important issice to obtain a thorough . padl medical history for this patient because t he : &t will help to determine the cause of the panic attacksicit from any disease condition or other problem, ů) Presence of any previous history of diseases. - ) Any history of medications (which may en- Heract with the new prescribed medicatiefns) - This all will help to make proper diagnosis of the problem & help in further management for proper outione. Elcs Seanñed with CamScanner

4 .the questions which the nurse should asked to the women is

--was she taking any anticonvulsant medication before ?

- was she taking antihypertensive drug to controll her blood pressure ?

- was there any problem related to sleeping ?? Or was she taking sleeping pills ??

- was there any history of convulsions ?

- was she suffered with any kind of cardiac disease ?

5.

5 6 onset acute subacute or insidious. 1 Duration 2 time : 1 Presence of siezure during the panic attack - Yeo or No ? (of yes, then time I interval). 0 Type of seexiere - (either tonic clonie, tonic, or generalined if more than 5 mens o then status epilepticus) ♡ Exaggeiakiong fáefors? ( If medical treatment needed or decreases Scanngradually covet treatment Camskannen

6.A list of problems from the given data are-
1. Difficulty sleeping
2. Panic attacks
3. High systolic blood pressure.

7.1.Nursing interventions to reduce panic anxiety-(a) Stay with the patient and offer reassurance
of safety and security.

(b) Maintain a calm, non-threatening matter-
of-fact approach.
(c) Use simple words and brief messages,
spoken calmly and clearly to explain
hospital experiences.
(d) Keep immediate surroundings low in
stimuli (dim lighting, few people).
(e) Administer tranquilizing medication
as prescribed by physician. Assess for
effectiveness and for side-effects.
(f) When level of anxiety has been reduced,
explore possible reasons for occurrence.
(g) Teach signs and symptoms of escalating
anxiety and ways to interrupt its progression
(relaxation techniques, deep-breathing
exercises and meditation, or physical
exercise like brisk walks and jogging.

2.Nursing interventions to improve self-control in anxious patients:(a) Allow patientto take as much
responsibilityas possibleforself-care
activities,providepositivefeedback
for decisionsmade.
(b) Assistpatientto setrealisticgoals.
(c) Help identifylifesituationsthat are
withinpatient's control.
(d) Helppatientidentifyareasoflifesituation
that are not withinhis abilityto control.
Encourageverbalizationof feelingsrelated
to thisinability.