Case Complexities
Mental health wellness has been considered as a key element to ensure over all well- being. In close relation to the case study provided, it can be significantly stated that the client is at a high risk of developing mental health related issues. The case study clearly reveals the client, Emily to experience symptoms that reflect a disturbed state of mind. Further, the case study states that the client was extremely distressed on receiving a failed grade in the subject that she was struggling with. The client has also reported feeling low and harboring suicidal ideation. Prevalence of self-destructive behavior has also been detected on analyzing the information provided by the case study. Hence, it can be stated that the client is on the verge of developing acute depression. This paper would deal with evaluating the mental state condition of the client and devising an appropriate plan in order to help the client deal with the present mental health status. The three key nursing priority aspects defined in relation to the condition of the client can be stated as treating the self-destructive behavior, effectively reducing the overdose of drugs and assisting the dietary intake pattern. The further sections of the essay would elaborate the manner in which the nursing priority goals would be achieved and the manner in which the interventions would be carried out so as to ensure an accelerated recovery of the client.
On closely evaluating the case study a number of factors can be enlisted that add a critical dimension to the case study. The client has been reported to be involved in the practice of overdose of drugs in order to relieve herself from stress. In addition she has been reported to feel fatigued most of the times with low energy levels. The client has also been reported to be engaged in over thinking and possess a low opinion about her. Moreover the client has reported to feel emotionally low and experience a flat mood for a long period of time. These factors can be directly correlated to the two vital components of the mental state evaluation tool, namely, ‘mood and affect’ and ‘thought content’. The client has revealed to harness ‘suicidal ideation’ which makes this case a high priority case. The client must be made aware about the legal implication about the suicidal ideation and self-harm behavior. The constant feeling of fatigue and being devoid of energy to carry out regular chores and the abnormal obsession with losing weight by refusing meals can also be linked to the symptoms of depression and anxiety. Therefore, all the cues gathered from the case study can be linked to the pathophysiology of stress related disorders and acute depression. It is extremely essential to actively indulge in drafting a family-centered effective care plan for the client so as to effectively treat the symptoms and prevent the mental health condition from worsening.
According to Levett Jones (2013) in order to deliver an effective nursing care, it is extremely important to critically reflect upon the medical condition of the client and accordingly develop an intervention strategy. Further as stated by Levett Jones (2013), it is also important to actively involve the client in the patient care so as to provide a holistic patient centered care and at the same time make sure that the patient takes charge and responsibility to enhance self-care. In order to effectively address the nursing care goals an effective strategy would be undertaken in compliance with the evidence based nursing strategies to treat depression and anxiety in adolescent individuals.
Discussion
A personal counselor would be appointed to administer counseling sessions to the client. Care would be taken to keep sharp instruments away from the reach of client so that she is not able to cut herself (Mehlum et al., 2014,pp.1085). Administration of mild sedatives and tranquillizers would effectively help in elevating the mood of the client and at the same time ensure sound sleep (Schweitzer & Feren, 2017,p.9). A dietician would be engaged in the personal care of the client in order to take care of the irregular eating habit. A strict diet tracker would help in effectively tracing the calories consumed by the client per day.
Prior to adopting measures in order to address the nursing goals designed for the client, the consent of the client would be taken so as to comply with the ethical nursing standards. At the same time, the family of the client would also be informed about the treatment procedure and actively involved in the treatment care plan. The client’s boyfriend Daniel would also be considered as a family member and a family centered care approach would be undertaken so as to avoid any complexities in terms of taking critical decision in the treatment procedure.
Scientific studies have effectively revealed the use of mindfulness strategies and contemporary nursing practices to treat critical cases related to anxiety and depression (Cox et al., 2014,p.11). The most important aspect of developing an effective intervention for depression includes extracting in depth details about the emotional status of the client. Administration of narrative therapy can help in critically deriving a detailed description about the current mental status of the client. Engaging the client in narrative therapy would help in providing effective counseling so as to promote positive thought content. The client has been reported to engage in drug overdose in order to relieve herself from stress causing elements. Maintenance of a positive and healthy environment could help in improving the condition of the client. Administering family therapy can be found to be effective. Educating the family members about the critical condition of the client can help in involving the family members to contribute effectively in the intervention process by means of maintaining a positive environment. The client has reported to feel extremely low on staying home as she feels that her parents might perceive her presence at home to be futile and a waste of time. Family therapy would comprise of the family members spending quality time with Emiley and assuring that she is wanted in the family. Daniel, the client’s boyfriend could also actively participate in the process. Appreciating Emiley’s efforts and assuring her that she could get over the negative phase can help instill confidence and hope in her (Diamond et al., 2013,p.70). Self-destructive behavior and suicidal ideation have been documented to be the most fatal aspects of mental state deterioration. Engaging the client in rehabilitation programs and channelizing the destructive thoughts into positive thoughts could help in speeding up the process of recovery. One to one counseling and involving the client in taking up a hobby such as gardening or painting could help in effectively instilling positivity in the client. Involvement in social work could also help in raising the spirit and self-esteem of the client and avoid thoughts relate to suicidal ideation. Moreover, administration of medication such as mild dose of valium could help in providing effective sleep to the client.
Contemporary nursing practices such as administration of music therapy and involvement in routine work out such as yoga or ‘zumba’ could also help in instilling positive thoughts about life. The client has reported an obsession to lose weight and hence interventions devised could incorporate the addition of a fitness regime to harbor positive feeling in the client. Depression is a condition that is not detected easily and is difficult to deal with for the individual as well the family members of the individual. The difficulty in the treatment and care of anxiety and depression mainly depends upon the absence of external symptoms (Cox et al., 2014,p.11).
While devising a care plan, it is extremely important to render an effective form of treatment as per the professional and ethical standard of nursing practices and engaging the client in a healthy therapeutic relationship. As per the registered nurse standards of practice (2016), “the use of delegation, supervision, coordination, consultation and referrals in professional relationships are the key to achieve positive patient outcomes (Nursingmidwiferyboard.gov.au, 2018)”. Effective treatment care majorly depends upon the concept of providing holistic patient centered care that involves active participation of the family members in entire treatment procedure. Hence it can be said that applying the evidence based strategies to deal with mental health problems can effectively help in improving the medical condition of the client mentioned in the case scenario.
Conclusion:
Hence, to conclude it can be said that the client in the case study has presented symptoms indicating the development of anxiety and acute depression. In order to prevent further development of the symptoms, it is extremely important to devise a primary nursing care plan. On thoroughly evaluating the case study, it can be stated that the client is extremely depressed and even exhibits self-destructive behavior. Further, the client also reports feeling devoid of any energy and flat in the mood, accompanied with feelings of worthlessness and incapability. These factors essentially indicate the deteriorating mental health condition and in order to address the same nursing strategies involving patient centered holistic care is undertaken. It is expected that on adhering to the devised nursing interventions the mental health condition of the client can effectively be improved. It can also be said in this regard that on complying with the standard nursing care plan developed the patient can expect to feel better within a time frame of 6 months. Essential participation of the client’s boyfriend Daniel and the family members can help in speeding up the treatment process.
References:
Cox, G. R., Callahan, P., Churchill, R., Hunot, V., Merry, S. N., Parker, A., & Hetrick, S. E. (2014). Psychological therapies versus antidepressant medication, alone and in combination for depression in children and adolescents. Cochrane database of systematic reviews, (11).
Diamond, G. S., Diamond, G. M., & Levy, S. A. (2014). Attachment-based family therapy for depressed adolescents. American Psychological Association, pp. 70
Levett-Jones, T. (Ed.). (2013). Clinical reasoning: Learning to think like a nurse. Pearson Australia,pp.65
Mehlum, L., Tørmoen, A. J., Ramberg, M., Haga, E., Diep, L. M., Laberg, S., … & Grøholt, B. (2014). Dialectical behavior therapy for adolescents with repeated suicidal and self-harming behavior: a randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 53(10), 1082-1091.
Nursingmidwiferyboard.gov.au (2018). [online] Nursingmidwiferyboard.gov.au. Available at: https://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD16%2F19524&dbid=AP&chksum=R5Pkrn8yVpb9bJvtpTRe8w%3D%3D [Accessed 20 Sep. 2018].
Schweitzer, P. K., & Feren, S. D. (2017). Pharmacological treatment of insomnia. In Clinical handbook of insomnia (pp. 97-132). Springer, Cham,pp.9
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