NURS2098: Recovery Focused Mental Health Care- James Heggarty Case Study- Nursing Assignment Help

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Case Study 1: Rachelle- The Client with Depression

Clinician Role: Admitting Nurse: Inpatient Mother and Baby Unit. Identifying information: Rachelle is a 21-year-old married woman referred to the Inpatient Mother and Baby Unit by her GP. She is a practising Catholic and has worked as a secretary for 9 years at a local private school as the office manager. Rachelle lives with her husband, Martin, and their 10-week-old daughter, Claire, in their own home.

Presenting Complaint: Rachelle states, “I’m not coping at all with the baby; I’m sad and upset all the time, and I’m a bad mother”. History of Present Problem: Rachelle states that over the past 10 weeks (since the birth of Claire), she has experienced increasing dysphoria, anhedonia, feelings of guilt and worthlessness, intense crying, social isolation, and has struggled to bond / care for her daughter.

Rachelle sleeps 10 to 15 hours per night, experiencing no difficulty falling asleep or middle-of-the-night or early-morning awakening. Her appetite has
diminished during the past 2 months, with a reported weight loss of 8 kilograms. She eats erratically, usually snacks, and meals are prepared by her
husband and mother. She has not been able to provide effective care to her daughter, cook, or do household chores and generally spends the day in bed.

She has had become increasingly insular and has avoided social contact, tending to avoid friends and family who have come to call: she has not attended the Mothers group meetings that her MCH nurse had linked her into. Rachelle describes no interests or involvements outside the home,
except for weekly attendance at Church. Her husband and mother have assumed the primary care for Claire however with her husband due to
return to work in 2/52 this is becoming a concern for the family.

Current life stressors reported by Rachelle include:

• Her brother’s death in a car accident 6 months ago. Rachelle had not seen him in 1.5 years and expresses guilt that they were not close.

• Her sister’s surgery for cancer 5 months earlier. Whilst she has made a good recovery Rachelle is fearful that she will die in the near future.

• The transition to parenthood and caring for Claire. Rachelle and Rachelle had been planning for their first child for some time and had been very excited about the impending change in their lives. Her pregnancy and birth had gone well though she had struggled to breastfeed, eventually giving up after 5 weeks of trying. Rachelle feels very guilty about this and thinks she should have tried harder.

• Loss of her sense of role / structure she had gained from her job. Rachelle had been in her role for many years, was well like and respected and was very committed to the job. She stopped work when 32 weeks pregnant and has struggle to organise her time since then.

Case Study 2: James Heggarty

James is a 22 year old single male, who has been an inpatient for the last 11 days and is due for D/C in 2/7 to return home to his parents’ home.

• You are his Case Manager and have visited him on the ward to start work on his Recovery Care Plan.

• James has been diagnosed with Schizoaffective Disorder, has had 2 recent inpatient admissions in the last 6 months.

• James is currently experiencing intense Derogatory Hallucinations on a frequent basis telling him he is useless and stupid.

• This has been an ongoing issue causing him distress and contributes to his anxiety.

• He has been experiencing thoughts of harming himself in the context of themes of hopelessness and helplessness because of these voices.

• James lives with his parents, who provide considerable support.

• James requires assistance with some activities of daily living due to his level of amotivation.

• James has noticed that he can become uneasy and anxious in crowded public places, though is able to control this, using mindfulness techniques.

• James has become socially isolated and has few friends but is keen to develop a new a social network.

 

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Posted on : April 07th, 2018
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