Case Scenario:
The clinical nurse specialist is conducting an initial assessment of a client recently admitted to the acute care setting. When asked about their frequent habit of looking over their shoulder, the client became very anxious and evasive. The nurse says, “I can see that this interview is making you uncomfortable. Would you prefer to continue our discussion at a later time?”
- Discuss why the statement made by the nurse was appropriate at this time.
- Consider key physiologic conditions that should also be assessed and indicate why these issues may have an impact on the client’s mental health function.
Instructions
Read Thoroughly: Familiarize yourself with the case noting key elements like symptoms, medical history, and social factors affecting the patient.
Research: Conduct scholarly research to better understand the condition presented in the case study. Use at least five peer-reviewed articles to support your analysis.
Ethical Considerations: Examine any ethical considerations associated with the case. For example, consider patient consent, confidentiality, and duty of care.
Reflection: Write a 300-word reflection on what you have learned from this assignment and how it will impact your future practice.
Due Date: The initial post and peer responses are due every Saturday at 11:30 p.m.
Academic Integrity
Plagiarism will not be tolerated. Ensure that all sources are correctly cited and that you have not copied material from other sources unless appropriately cited.
Discussion on the Nurse’s Statement
The statement made by the nurse in this scenario is appropriate and demonstrates the nurse’s sensitivity to the patient’s emotional and psychological state. Recognizing the signs of increased anxiety and offering to pause the conversation allows the patient to feel more in control and less pressured, which is crucial in building therapeutic trust. It also illustrates an understanding of patient-centered care, where respecting the patient’s comfort level and readiness to engage is key. This approach can prevent exacerbation of anxiety, thereby fostering a safer and more effective therapeutic environment.
Key Physiological Conditions to Assess
In this scenario, it is important to consider several key physiological conditions that could influence the client’s mental health:
- Neurological Disorders: Conditions such as epilepsy, Parkinson’s disease, or multiple sclerosis can contribute to behaviors like looking over the shoulder due to muscle spasms or neurological deficits.
- Endocrine Disorders: Disorders like hyperthyroidism can cause symptoms of anxiety and jitteriness, possibly explaining the client’s anxious behavior.
- Cardiovascular Health: Poor cardiovascular health can lead to decreased blood flow to the brain, potentially causing symptoms of anxiety and paranoia.
- Substance Use: Assessment for substance use is critical as substances like stimulants can cause paranoia and anxiety, influencing the patient’s behavior and mental state.
- Psychiatric Conditions: Mental health disorders such as schizophrenia or severe anxiety disorders could manifest as paranoia or excessive vigilance, like looking over one’s shoulder frequently.
Understanding these conditions is vital as they can directly affect a patient’s mental health, influencing their behavior and how they interact during assessments.
Ethical Considerations
Ethical considerations in this scenario include:
- Consent and Autonomy: Ensuring the patient is comfortable continuing the conversation respects their autonomy and right to consent to their treatment pathway.
- Confidentiality: Maintaining strict confidentiality about the patient’s condition and treatment plan is paramount.
- Duty of Care: The nurse must balance the duty of care with respect for the patient’s emotional and psychological state, ensuring that the patient does not feel coerced or unduly stressed.
Reflection
Reflecting on this case scenario highlights the complexity of patient care where clinical, psychological, and ethical considerations intersect. It underscores the importance of communication skills in nursing, particularly the ability to read non-verbal cues and respond to them appropriately. This reflection reminds me of the importance of holistic care, considering not just the physical symptoms but also the emotional and psychological well-being of patients. Moving forward, I will ensure to apply these insights in my practice, aiming to create a supportive and empathetic environment for all patients.