MODULE 07 CASE STUDY

S.is a 48-year-old divorced woman with one adult daughter and three grandchildren. She is currently working as an LPN part-time in a nursing home and also works at a convenience store one or two days per week. She has had many jobs over the last 22 years, usually changing every one or two years. S notes that she has been called less often to work in the convenience store and worries that they don’t like her anymore. She reports being written up several times for arguing with customers. She also reports that her supervisor at the nursing home “is a bitch”; although she really liked her supervisor at first, she says “Now I hate her; she’s trying to get me fired.” S. reports that she has tried to get fulltime jobs five times in the last four years, was hired for three, but only lasted one or two weeks at each one. 

S. reports that she is currently not talking to her daughter because “she is horribly mean to me and she needs to apologize or I won’t talk to her again”. She is upset that she hasn’t seen her three small grandchildren in about a year. She sends them presents and cards frequently that says “I still love you! Grandma”, but hasn’t called them since she stopped talking to her daughter. She is considering reporting to the county that her daughter is keeping her grandchildren from her. 

S. is very unhappy that she isn’t in a relationship. She was abused by her ex-husband and has a pattern of meeting and dating men who eventually abuse her. She states that her last relationship was very good, however; the man was not abusive and “I loved him very much”. The relationship ended for reasons that S. doesn’t understand, although she does report many arguments that ended in “scenes” such as her throwing chairs, stomping out of the house, making crank phone calls to his family, and calling the police with false reports. But S. also reports that she “couldn’t have loved him more and I showed it”. She gives examples of going to her boyfriend’s place of work with flowers, buying him expensive presents, surprising him with tickets to Mexico at the last minute – she was very upset that he wasn’t willing to drop everything and go with her. S. reports asking him why he didn’t love her and what she was doing wrong on a regular basis. When the boyfriend asked to break up, S. reports sitting outside his house for weeks, crying; she called his mother, called his boss, and called and texted him until he filed a restraining order. This occurred about 4 months ago.

S. admitted herself to the mental health unit when she felt suicidal. She reports that she had stopped her individual psychotherapy 3 months ago and stopped going to DBT. She also stopped her anti-depressant at that time, as she felt it wasn’t working, and missed her last two psychiatrist appointments.

Questions:

Read the case study about Borderline Personality Disorder and answer the following questions in your initial posting:

1. How would you use therapeutic communication and the principles of cognitive-behavioral therapy with the client?

2. Describe your assessment process. What are some likely co-morbid conditions? List one nursing diagnosis and appropriate nursing intervention.

3. What interdisciplinary referrals might be appropriate?

 

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 t is very important to differentiate between the different types of shock since treatment may depend on this. Complete the Comparison Table on the different types of shock. 

 

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The Department of Health and Human Services has created a website called Hospital Compare, a powerful online tool to enable consumers to learn about the quality of specific hospitals and compare them to other hospitals. You can find the site at Hospital Compare

Find information on the hospital closest to your home.
 List strengths and weaknesses of each. 

What does this website tell you about the quality of care?
 Hospital:
 Strengths:
 Weaknesses:
 What does this tell you about the quality at this facility?

Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

 

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Module 8 written paper. Fluid Imbalances

Your written assignment for this module should be a 1-2 page paper (not including title page and reference page) that describes the following:

Describe what a fluid and electrolyte imbalance is and how this is important to the function of the body?

You should include a minimum of 3 scholarly references. Include a title page, in-text citations, and a reference page in APA format.

Pick a fluid or electrolyte imbalance and describe how the patient would present, in addition to the treatment (nursing and expected medical)?

 

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For the Module Six worksheet task, you proposed marketing and communication strategies based on the target market and demographics for a department, program, or service at the Missouri Department of Health and Senior Services. For this follow-up worksheet task, you will complete a basic budget to implement the marketing strategies you proposed in that task.

 

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