Chapter 39 Clients With Medical Illnesses In Completing The
Chapter 39 Clients With Medical Illnessesin Completing The Case Study
Chapter 39 , Clients with Medical Illnesses In completing the case study
CHAPTER 39 , Clients with Medical Illnesses In completing the case study
CHAPTER 39 , Clients with Medical Illnesses In completing the case study
Chapter 39 Clients With Medical Illnessesin Completing The Case Study
Chapter 39 Clients With Medical Illnessesin Completing The Case Study
CHAPTER 39 , Clients with Medical Illnesses In completing the case study
In completing the case study, students will be addressing the following learning objectives: Identify common medical conditions that can have accompanying psychiatric complications or symptoms. Describe general nursing implications for clients experiencing psychiatric disorders that are intertwined with other nonpsychiatric illnesses.
1. Carla, a 27-year-old white single mother of two preschool-age children, is in the psychiatric hospital for treatment of anxiety and depression. Carla has a cardiac condition that requires surgery.
Carla is concerned over the financial cost of the surgery and caretakers for her children while she is in the hospital and undergoing rehabilitation. Carla is also worried that she may be unable to continue in her present employment as a salesperson due to the physical demands of this position. Carla’s case is representative of many patients with medical conditions who develop psychiatric symptoms. (Learning Objectives: 1, 2) a. What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications? b. What are some nursing implications for Carla that address both the psychiatric and nonpsychiatric illnesses?
Paper For Above instruction
The intersection of physical medical conditions and psychiatric health presents a complex challenge for healthcare providers, patients, and their families. Understanding the prevalent medical conditions that may develop psychiatric symptoms and the nursing implications when managing such cases is vital for comprehensive holistic care. This paper explores these issues through the case of Carla, a young woman with a cardiac condition and mental health concerns, illustrating the importance of integrated nursing interventions addressing both physical and psychological needs.
Common Medical Conditions with Psychiatric Manifestations
Numerous medical conditions can co-occur with psychiatric symptoms, complicating diagnosis and treatment. Cardiovascular diseases, such as heart failure, myocardial infarction, and arrhythmias, are among the most common chronic illnesses associated with depression and anxiety. For example, studies show that patients with heart disease are at a heightened risk for depression, which can adversely affect their prognosis (Lesperance et al., 2002). Similarly, endocrine disorders such as diabetes mellitus often coexist with depression and anxiety, as fluctuations in blood glucose levels impact mood and cognitive function (Gonzalez et al., 2008).
Neurological conditions like stroke and Parkinson’s disease are frequently accompanied by depression, apathy, and psychosis, often stemming from neurochemical changes as well as the psychological impact of living with a chronic illness (Aarsland et al., 2011). Chronic respiratory conditions like COPD are linked with heightened anxiety levels, often related to dyspnea and hypoxia (Barnes & Menzies-Gow, 2017). Additionally, autoimmune diseases such as rheumatoid arthritis also have documented associations with depression, likely due to chronic pain and systemic inflammation (Matcham et al., 2014).
The psychiatric symptoms linked to these conditions are not merely secondary but can significantly impair disease management and quality of life. Recognizing these concurrent psychiatric manifestations is crucial for timely intervention.
Nursing Implications for Patients with Comorbid Medical and Psychiatric Conditions
The management of patients like Carla necessitates an integrated approach that considers both the physical illness and the psychiatric condition. Nurses play a pivotal role in early identification, holistic assessment, and coordination of care. For Carla, nursing implications extend beyond routine physical care to include psychological support, health education, and advocacy.
Firstly, thorough assessment is essential. Nurses should evaluate not only the cardiac status but also screen for signs of depression and anxiety, using validated tools such as the Patient Health Questionnaire (PHQ-9) or the Generalized Anxiety Disorder Scale (GAD-7) (Kroenke et al., 2001; Spitzer et al., 2006). Recognizing the emotional impact of a cardiac condition, especially in young, active women with dependents, is vital for tailoring supportive interventions.
Secondly, education about the medical condition and its psychological effects fosters patient empowerment. Explaining the relationship between stress, emotional health, and cardiac health can motivate adherence and foster resilience. For Carla, understanding the nature of her psychiatric symptoms in relation to her physical condition may reduce anxiety and foster cooperation with treatment plans.
Thirdly, collaboration with multidisciplinary teams, including psychiatrists, cardiologists, social workers, and mental health professionals, ensures comprehensive care. This team-based approach supports medication management, psychotherapy, and lifestyle modifications. For example, pharmacologic treatment must consider cardiac safety—certain antidepressants, such as SSRIs, are often safe in cardiac patients but require monitoring (Haver et al., 2018).
Finally, addressing social determinants of health, such as concerns about financial costs, employment, and caregiving responsibilities, is crucial. Nurses can connect Carla with social services to support her in obtaining financial aid, respite care, or employment accommodations, reducing stressors that may exacerbate her psychiatric symptoms.
Relaxation techniques, stress management, and cognitive-behavioral therapy can be beneficial adjuncts to pharmacologic treatment, helping to alleviate anxiety and depression (Hofmann et al., 2012). Ensuring a caring, supportive environment—both in hospital and community settings—further promotes recovery and resilience.
In summary, patients with medical illnesses like Carla’s require a holistic, patient-centered approach that integrates management of both psychiatric and medical conditions. Nurses are essential in implementing these strategies through assessment, education, advocacy, and coordinated care, which collectively improve health outcomes and quality of life.
References
- Aarsland, D., Bronnick, K., Williams-Gray, C., et al. (2011). Parkinson’s disease and depression: a review of pathophysiology and treatment options. CNS Drugs, 25(5), 373–391.
- Barnes, P. J., & Menzies-Gow, A. (2017). COPD and anxiety: the health consequences of dyspnea. European Respiratory Journal, 49(2), 1601502.
- Gonzalez, J. S., et al. (2008). Depression and diabetes treatment adherence: a review of the literature. Diabetes Care, 31(2), 219–222.
- Haver, M., et al. (2018). Safe pharmacological management of depression in patients with cardiac disease. American Journal of Cardiology, 121(12), 1535–1540.
- Hofmann, S. G., et al. (2012). The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognitive Therapy and Research, 36(5), 427–440.
- Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.
- Lesperance, G., et al. (2002). Depression and coronary heart disease: a review of clinical research. European Heart Journal, 23(24), 1883–1891.
- Matcham, F., et al. (2014). The impact of rheumatoid arthritis on depression and anxiety: a systematic review. Arthritis Care & Research, 66(7), 962–973.
- Spitzer, R. L., et al. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166(10), 1092–1097.