401013 Promoting Mental Health & Wellbeing 1
Question:
Assessment 2
- Please ensure your answers are typed using Word. Your work should not be hand
- A reference list with at least 6 different pieces of literature less than 5 years old must be included using APA
- You may want to use the table below as a way to structure your work. However, it is not compulsory. You can submit your work with a question number and answer as long as it is very clear which answer relates to which
Please ensure the table and reference list are included in the same word document.
- Please do not submit as landscape paper set up. It should be as
- If you are using the table, please do not change the side margins and ensure you double check that all your work can be clearly seen when you submit via
- The purpose of the assessment is to assess whether you are able to review the presenting situation for a client and to prioritize their care, in terms of safety management first and less urgent issues later.
Question:
1a) Using the case study provided, identify an urgent risk area. Ensure your answer details why you have identified this risk area including specific information about the client and current literature. (2 marks).
1b) Identify one nursing / midwifery intervention you would immediately undertake with your client to address the risk area noted in question 1a and include a rationale for the intervention. (2 marks for the intervention and 2 marks for the rationale)
Ensure the intervention includes who and when you would actually carry out the intervention.
Your rationale should state how and why you would carry out the particular intervention. Ensure literature is included.
- Before you answer questions 1 a and b, consider you are a health professional and have sat with your client to undertake a mental health assessment. You have gathered the information which is offered in the case study. What do you now see as the most urgent risk area to keep your client safe?
- Take care to ensure the risk area is focused on the client. You may identify risk areas for family members or members of the community, but this is not the immediate focus of your actual student assessment here.
- Identify the most urgent concern first in terms of immediate safety concern.
- We want to see your understanding of the client’s issue, so avoid writing brief details about the client such as: ‘the client has self-harm thoughts’. Expand on the detail of the concern ie. the client has presented with daily self-harm thoughts for 3 months, with intermittent / regular thoughts to cut his wrists using a razor blade. The client reports family contact as a possible cause of distress triggering self-harm thoughts which last for one hour daily immediately after seeing his family.
- You should then add in some literature about self-harm which has relevance to the case study ie. males and self-harm, incidence of self-harm. Remember 1a is only 2 marks, so the literature here doesn’t need to be expansive, but do make sure you provide some literature and provide details of the client’s main concern ie. safety concern.
- Identify one nursing or midwifery which you would undertake to address the concern you have noted in answer 1a. The intervention must be suitable for the concern you note otherwise it will not be awarded marks. For example: building a therapeutic relationship with your client; maintaining a safe environment; risk assessment; observations. You need to state exactly what you would undertake and how to gain marks. Ie. how would you build a therapeutic relationship with your client exactly? What approach would you take? What kind of language might you use? Who would be undertaken the activity ie. nurse / midwife on duty? Ie. the nurse / midwife will build a positive relationship with the client by meeting with them daily for 30 minutes using positive and recovery-based language to establish trust and report.
- Another example of a nursing / midwifery intervention: primary nurse / midwife to undertake a self-harm / suicide risk assessment with the client on initial contact and review on a continuous basis as new information is obtained or the client’s presentation changes.
- It must be a direct health professionals and client intervention not a referral to another service or practitioner.
- You should include a rationale with your intervention using literature and making reference back to the case study. Ie. why would you use recovery-based language when building a relationship with your client? Why would you undertake a risk assessment with your client?
2a) Using the case study provided, identify a mental health concern. Ensure your answer details why this is an area of concern. Include specific information about the client and current literature.
2b) Identify one nursing / midwifery intervention you would undertake with your client to address the mental health concern noted in question 2a and include a rationale for the intervention.
Ensure the interventions includes how, who and when you would actually carry out the intervention. Your rationale should state how and why you would carry out the particular intervention.
Ensure literature is included when you discuss the rationale.
- Question 2 a and b helps us to assess that you understand the difference between an urgent client concern ie. safety and a mental health concern. Question one was concerned with safety identification whereas question 2 is about mental health concerns ie. possibly low mood or
- Again, avoid simply identifying the actual concern and writing in brief. You need to say something about the details of the client’s experiences using literature. Ie. the client has been experiencing low mood for one month, with thoughts of reduced self- esteem, worthlessness, hopelessness and suicide ideation. You should add in some literature in relation to low mood in males; anxiety in males for example. Again, it’s only 2 marks so doesn’t need to be lots of literature
- Try to avoid highlighting depression in your answer to 1a, as depression is an actual diagnosis with a collection of experiences as opposed to one concern. Better to term this as low mood as opposed to
- Next identify an intervention which is suitable for the mental health concern in your answer to question 2a. Ie if you have identified low mood, what intervention can you do directly with your client to help / support them with low mood. Again, when writing the intervention think about who would carry out the intervention, when, how often, how exactly with details, actually describe what you would do.
- Again, a referral to another professional is not a direct face to face intervention, so please avoid
- You should include a rationale for the intervention you have offered in 2b. ie. why have you decided to carry out the intervention making reference to literature and your client?
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- Question 3 helps us to determine your understanding of some of the wider issues in relation to a person’s presentation and
- Re-read the case study to identify possible legal, ethical or professional
- For example: you might want to discuss the client’s presentation in terms of legal issues such as: Mental Health Act; Privacy Act; Health Records Act; ethical issues such as: the ethical principles such as building a relationship while undertaking risk assessment which may result in a client being scheduled under the Mental Health Act; asking the client lots of questions for mental health assessment knowing the client may find the actual questions distressing; professional issues such as: confidentiality and maintaining public safety; being involved with a clinical relationship with a fellow health professional who may work within your place of work ie. hospital.
- Clearly identify each issue in your work and then relate to the case study and use literature. If you are highlighting legal issues, you should relate to the Act directly and not secondary sourced literature.
- Make sure you refer back to the client in the case study and literature.
Answer:
1. a) The patient has been feeling insomnia, anxiety and sleeplessness for the past six weeks. He has lost 5 kilos and his appetite. The patient projects a low image about himself. He feels that he is incompetent both in professional as well as personal life. The patient seems to feel that he has let down his wife and his daughter. Mr. Chung spends his days feeling low and tearful. The decision making capacity of the patient is impaired, so he can possibly choose to end his own life to solve his issues. Suicide is the act of intentionally ending one’s life (Cho & Hong, 2001). So, it can be concluded that he is a suicidal risk.
1.b) The nurse should be supportive of the defenses of the patient in the beginning so that the patient can fight his thoughts. The nurse should listen to the patient and be kind and gentle.
The nurse will have to handle the patient Mr. Chung and the family as well in order to facilitate the complete recovery of the patient. The coordination and the support of the patient’s family are very essential in treating these conditions (Hwang et al.,2004). The nurse should make sure that the patient is spending enough time with his wife and his daughter so that he feels at peace and secure. The patient should not be left alone or made to feel lonely.
2.a) Mr. Chung is suffering from several symptoms such as feeling anxious, palpitations, breathlessness, and insomnia and so on. The patient has also lost 5 kilos in six weeks. He has also lost his normal appetite. All these symptoms add up to a condition of known as anxiety attacks (Smalbrugge et al., 2006). The anxiety attacks are random attacks, which make the patient feel the shortness of breath, dizziness, trembling and so on. The patient has been recently subjected to a lot of undue stress that has caused a high level of anxiety in him.
2. b) The various interventions, which the nurse has to take are:
- The nurse should be present with the patient always and especially during the time when his anxiety levels are high. The nurse should be calm although the patient is hyperactive.
- Whenever the patient becomes hyperactive to any situation, the nurse should shift him to a quieter environment (Sanson et al., 2018).
Rationale: The nurse should make the patient feel secure. The nurse should make the patient aware of the situations when his overacting and should always try to keep the patient calm (Grov et al., 2005). Mr. Chung has a risk of a drug overdose so the nurse should limit the access of the patient to any kind of drugs, that would decrease the suicidal thoughts (Shin et al.,2015).
3. The two ethical, legal or professional issues, which the nurse might face, are as follows:
The family might interfere with the treatment processes of the nurse and might try to manipulate and direct her according to their convenience . This is a common professional issue that the nurses face while treating their patients (Pereira et al.,2016).
The relatives and the visitors of the client might request some information regarding the condition of the patient. The nurses are forbidden to share any information about the condition of the patient except the immediate family of the patient (Eo et al.,2015).Therefore, this is another legal issue, which the nurses face while treating anxiety patients.
References
Cho, M. J., & Hong, M. S. (2001). A study on the effect of supportive nursing care to anxiety reduction of the patient immediately before surgery in the operating room. Journal of Korean Academy of Adult Nursing, 13(4), 632-640.
Smalbrugge, M., Pot, A. M., Jongenelis, L., Gundy, C. M., Beekman, A. T., & Eefsting, J. A. (2006). The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients. International Journal of Geriatric Psychiatry, 21(4), 325-332.
Hwang, Y. J., Park, Y. H., Park, I. S., Kim, N. Y., Kim, J. M., & Kim, J. Y. (2004). The effects of nursing education using CD ROM on the anxiety and knowledge of patients having minor surgery. Journal of Korean Academy of Adult Nursing, 16(1), 82-89.
Sanson, G., Perrone, A., Fascì, A., & D’agostino, F. (2018). Prevalence, Defining Characteristics, and Related Factors of the Nursing Diagnosis of Anxiety in Hospitalized Medical?Surgical Patients. Journal of Nursing Scholarship, 50(2), 181-190.
Pereira, L., Figueiredo-Braga, M., & Carvalho, I. P. (2016). Preoperative anxiety in ambulatory surgery: The impact of an empathic patient-centered approach on psychological and clinical outcomes. Patient education and counseling, 99(5), 733-738.
Eo, Y. S., Lee, N. Y., Lee, J. W., & Cha, H. J. (2015). The Effects of Supportive Nursing Intervention Using Video-Program of Operating Room Nurses before Operation on Laparoscopic Hysterectomy Patients Anxiety. Journal of the Korea Academia-Industrial Cooperation Society, 16(4), 2639-2646.
Shin, S., Park, J. H., & Kim, J. H. (2015). Effectiveness of patient simulation in nursing education: meta-analysis. Nurse education today, 35(1), 176-182.
Grov, E. K., Dahl, A. A., Moum, T., & Fosså, S. D. (2005). Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of oncology, 16(7), 1185-1191. Grov, E. K., Dahl, A. A., Moum, T., & Fosså, S. D. (2005). Anxiety, depression, and quality of life in caregivers of patients with cancer in late palliative phase. Annals of oncology, 16(7), 1185-1191.
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