Read Following Case Explained for Students (Easy Guide)
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Key Explanation
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Original Question
Read the following case study and answer the questions with the concept of STRESS AND COPING in mind: You are working the afternoon shift in an inpatient psychiatric unit. The patients are in the day room watching a movie when suddenly someone starts yelling. You and other staff members rush to the day room to find J.J., a 38-year-old male patient, crouched in the corner behind a chair, yelling at the other patients, “Get down. Get down quick.” You and the other staff are able to calm J.J. and the other patients and take J.J. to his room. He apologizes for his outburst and explains to you that the movie brought back memories of his experiences when deployed in the Middle East. He had forgotten where he was and thought he was in combat again. He describes to you in detail the memory he had of being ambushed by the enemy and watching several of his comrades be killed. You review J.J.’s chart and noted he was a veteran and admitted with posttraumatic stress disorder (PTSD). Chart View PRN Medications Acetaminophen (Tylenol) 650 mg PO every 6 hours prn for pain Alprazolam (Xanax) orally dissolving tablet, 0.5 mg by mouth every 4 hours prn for anxiety Zolpidem (Ambien CR) extended release, 12.5 mg PO at bedtime prn for sleep In addition to medications, J.J. has expressed interest about relaxation therapy. He understands it may help with his anxiety and would like to know more about it. Over the next 2 weeks, J.J. participates in individual and group therapy sessions. He mentions to you that he is able to come to terms with his fears and experiences that occurred during his deployment to the Middle East. He tells you that he feels “encouraged” and wants to help others with the same problems. Assessment (Recognizing Cues) Which patient information is relevant? What patient data is most important? Which patient information is of immediate concern? (Identify at least 4 critical cues that are significant and could impact the patient condition. May consider both subjective and objective data.) Analyzing Cues/Conditions Which patient conditions are consistent with the cues? Do the cues support a particular patient condition? What cues are a cause for concern? What other information would help to establish the significance of a cue?(Based on identified cues, create 3 to 4 supporting connections between the relevant cues and client conditions/problems.) Prioritizing Hypotheses What explanations are most likely? What is the most serious explanation? What is the priority order for safe and effective care? (Based on identified connections between cues and patient conditions/problems, identify and RANK 3 client conditions/problems critical to positive patient outcomes, with the most urgent problem first.) Planning (Generate Solutions) What are the desirable outcomes? What interventions can achieve these outcomes? What should be avoided? (SMART Planning- specific, measurable, attainable, realistic/relevant, time-restricted- Goal setting) (List 5 solutions/outcomes with appropriate nursing interventions that will positively impact client outcomes and are appropriate to the care of the client. Outcomes/goals are listed in SMART format.) (ex: Within 30 minutes of breathing treatment and application of supplemental oxygen via nasal cannula, client will obtain and maintain oxygen saturation levels >95%.) Implementation (Take actions) How should the intervention or combination of interventions be performed, requested, communicated, taught, etc.? What are the priority interventions? (Describe how each of the 5 identified nursing interventions will be performed, implemented, administered, communicated, or taught.) Evaluation (Evaluating Outcomes) What signs point to improving/declining/unchanged status? What interventions were effective? Are there other interventions that could be more effective? (Describe how you will determine the effectiveness of the 5 priority nursing interventions you implemented. How will you know if your interventions are effective or not?)
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