Situation
Mary is aged 42 years, divorced with two children, employed part time and cares for her mother who has Alzheimer’s disease. She has no extended family to help with caring for her mother. She reports feeling isolated from the world and lonely without a significant other.
Mary complains of feeling ‘stressed’ all the time and constantly worries about ‘anything and everything’. She describes herself as always having been a ‘worrier’ but her anxiety has become much worse in the past 12 months since her mother became unwell, and she no longer feels that she can control these thoughts. When worried, Mary feels tension in her shoulders, stomach and legs, her heart races and sometimes she finds it difficult to breathe. Her sleep is poor with difficulty getting off to sleep due to worrying and frequent wakening. She feels tired and irritable. She does not drink any alcohol.
Background
Mary has no significant past medical history, although she frequently makes appointments with her Primary Care Physician and Advanced practice nurse about problems experienced by her and her children. She was moderately depressed following her divorce 5 years ago and was offered antidepressants but declined them. She was referred for six sessions of counseling, which led to some improvement in her symptoms.
Assessment
Mary has difficulty focusing on interview questions; she is fidgeting in her chair, wringing her hands, and is slightly tremulous.
BP=156/92 HR= 120 Respirations=32
She reports that she is frightened because she has had some fleeting thoughts of “ending it all” so that is why she came to the Psychiatric Hospital seeking admission to the inpatient unit.
Recommendation
Follow the instructions below.
Follow the rubric carefully. Use your textbook or a nursing care plan text to substantiate your plan.
(Source: adapted from http://www.nice.org.uk/nicemedia/live/13314/54184/54184.pdf (Links to an external site.))
Instructions
Analyze the scenario and write your assessment findings. Create a list of PRIORITIZED patient needs. Use the template on the next page as it will be helpful to use Maslow’s Hierarchy Model for this section.
Format the care plan according to the template.
Using the template below: Develop a care plan based on the information and data analysis from the scenario. Include two NANDA nursing diagnoses. With each nursing diagnosis, formulate one goal, and two interventions for the goal.
One of the nursing plans must address patient and family education needs.
You may elect to use “Deficient Knowledge” or a different diagnosis with at least one intervention that includes patient/family teaching
All interventions and rationales must be supported from professional nursing literature such as your mental health textbook or a nursing care plan book.
Cite page numbers of the reference you are using, and follow APA format for in-text citation. Indicate criteria you would use to evaluate each established goal.
Indicate specific revisions you would use to modify the plan for partially or unmet goals to facilitate patient progress toward goal achievement.
Include a titcgole page and reference page.
