Question

Case Studies for Unit VI- Promotion of health Self-Concept 1. Your patient is a 44-year-old male admitted due to an exacerbation of his multiple sclerosis (MS). During report, the nurse from the previous shift informed you he had to straight catheterize the patient due to urinary retention and bladder distention. You are in the room talking with the patient and his significant other when the primary care provider approaches them with the information that, due to a progression of the MS, the patient will need to catheterize himself for the rest of his life. The patient's responds: "Great, I might as well kill myself then." (Learning Objectives 4, 6, and 7) a. What variables influence this patient's self-concept? b. Discuss the potential impact of the patient's perception of the situation on his self-concept and his self-esteem. c. Identify possible nursing diagnoses related to the patient and nursing interventions that would 'address the nursing concerns Stress and Adaptation 2. You are a general practice nurse caring for a husband and wife who made an appointment to see the health care provider regarding how stress is impacting their well-being. The 72-year-old husband is a caregiver for his wife, who is in the early-middle stage of Alzheimer's disease. As a nurse for 40 years, the wife is very aware of what is going on (when she's oriented) and is very concerned about the responsibility her husband feels quite deeply. a. Which human dimensions are impacted by stress?

Answer 1

1.a.The factors which can influence this patient is by

• Age:inability to accept the disease progress at an early age and categorize self
• Low self esteem because of the disease condition

b.The potential impact of the patient's perception on the situation are

• Due to his self belief of how to lead a life ahead
• Loss of self image
• Can loss his personal traits,characters, roles
• Can be depressed due to the situation

c.Low sef esteem/Impaired communication/suicidal thoughts related to degeneration of the nerve cells as evidenced by verbalisation

Nursing intervention

• Assess the patient's coping strategies, baseline to plan for care
• Provide psychological support, to reassure the patient ,provide emotional strength
• Health educate about the disease condition and its management, so that the patient will be aware of what to be done
• Relieve bladder distention by catheterization and also teach him of how to be done when he is capable to understand

2.a.The main human dimension affected by stress

• Age :due to oldage there is loss of physical functions gradually and facing difficulty to care for each other
• Emotional stress of the wife in how to cope up and be supportive to her husband