Case Study 2
1. What assessment questions should Sherrie ask?
Sherrie may be limited to what Madeline’s anticipated diagnosis, but Sherrie may be able to ask general questions that may help narrow down possible causes to Mayfield’s concern. Questions that Sherrie should ask are:
-What do you mean when you say you feel like you’re going crazy?
-What about your mental health is making you feel concerned?
-Throughout the day, do you feel in distress about various things?
-Are you restless at night?
-Do you find yourself worrying constantly about a variety of different things at one time?
-Do you feel your reactions to stressful situations are too intense that you feel out of control?
Though the nurse is limited to what the patient is displaying, the nurse may be able to further look into the situation by reviewing Madeline’s medical history. Some things that Sherrie may seek are current prescribed medications, past medical diagnosis, previous psychiatric diagnoses as well as if Mayfield is currently visiting a psychiatric facility.
2. What objective and subjective data indicate Madeline is having generalized anxiety?
Objective: Madeline shakes her leg constantly, makes no eye contact, clears her voice frequently, and fidgets when talking.
Subjective: Madeline reports that she worries about everything, is easily irritated, feels high strung, has difficulty concentrating. In addition, she reports feeling muscle tension all over her body, and feels out of control of her unjustified fears.
3. What interventions can Sherrie suggest to help Madeline deal with some of her anxiety?
Though many interventions may be in place and prescribed to Madeline, Sherrie should provide reassurance that her anxiety will decrease if she follows the treatment regiment (Varcarolis & Halter, 2010). One example of how reassurance is effective is a finding in cancer care. Studies have shown that effective communicative
References: Bristol-Myers Squibb Company. (2010, November). Buspar®. website: http://packageinserts.bms.com/pi/pi_buspar.pdf Grohol, J. (2009, October 18). 7 myths of depression. Retrieved from World of Psychology website: http://psychcentral.com/blog/archives/2009/10/18/7-myths-of-depression/ Varcarolis, Elizabeth M., and Margaret J. Halter. Psychiatric mental health nursing. St. Louis, MO: Saunders, 2010. Print. Villiers, J. D. (2010, Summer). Partnering and providing reassurance within medical relationships: Patient/nurse interactions during oncology interviews. website: http://sdsudspace.calstate.edu/xmlui/bitstream/handle/10211.10/462/de_Villiers_Jackie.pdf?sequence=1