Sally had been calling her therapist all day, ever since their session this morning. But the therapist hadn’t called her
Posted: Tue Feb 15, 2022 3:52 pm
Sally had been calling her therapist all day, ever since their
session this morning. But the therapist hadn’t called her back,
even though all her messages said this was an emergency. She was
sure her therapist was angry at her and was probably going to drop
her as a client, then she’d have no one, she’d be abandoned by the
only person in the world she could talk to. Sally was upset and
crying as she began to run the razor blade across her arm. As the
blood trickled out, she began to calm down. Then her therapist
called and asked what the problem was. Sally was sobbing as she
told her therapist that she was cutting her arm because the
therapist didn’t care anymore that she was abandoning Sally just
like everyone else in her life. Her parents, her best friend,
everyman she had a relationship with. No one was ever there for her
when she needed them. How does the nurse help a client with
borderline personality disorder?
RATIONALE:
CASE SCENARIO #2 – The Client with Cognitive Disorder
(Delirium)
Meredith, who is 75 years old, and frail is admitted to the
hospital with a fractured hip. She undergoes surgery to repair the
hip and subsequently is sent to a general surgical unit. She
appears alert and oriented, although she is in pain. She is
receiving intravenous fluids and has an indwelling urinary
catheter, both of which are to be discontinued in the morning.
The evening of the first postoperative day, Meredith tells the
nurse that bugs are on the walls and that she wants to leave this
place. The nurse questions her and records that Meredith is no
longer oriented to place or time: she also is having visual
hallucinations. During the questioning, Meredith becomes mildly
agitated and tells the nurse to get out. The nurse notifies the
physician of the change in Meredith’s mental status.
The physician orders CT Scanning to rule out a possible injury
sustained in the initial fall. He also orders chest radiography and
a urine culture to rule out infections. Results of the CT scan and
chest radiography are normal; however, the urine culture reveals a
UTI. The physician prescribes antibiotics to treat the infection
and haloperidol as needed to treat the agitation. What is delirium?
What is the frequent cause of delirium in older adults?
RATIONALE:
session this morning. But the therapist hadn’t called her back,
even though all her messages said this was an emergency. She was
sure her therapist was angry at her and was probably going to drop
her as a client, then she’d have no one, she’d be abandoned by the
only person in the world she could talk to. Sally was upset and
crying as she began to run the razor blade across her arm. As the
blood trickled out, she began to calm down. Then her therapist
called and asked what the problem was. Sally was sobbing as she
told her therapist that she was cutting her arm because the
therapist didn’t care anymore that she was abandoning Sally just
like everyone else in her life. Her parents, her best friend,
everyman she had a relationship with. No one was ever there for her
when she needed them. How does the nurse help a client with
borderline personality disorder?
RATIONALE:
CASE SCENARIO #2 – The Client with Cognitive Disorder
(Delirium)
Meredith, who is 75 years old, and frail is admitted to the
hospital with a fractured hip. She undergoes surgery to repair the
hip and subsequently is sent to a general surgical unit. She
appears alert and oriented, although she is in pain. She is
receiving intravenous fluids and has an indwelling urinary
catheter, both of which are to be discontinued in the morning.
The evening of the first postoperative day, Meredith tells the
nurse that bugs are on the walls and that she wants to leave this
place. The nurse questions her and records that Meredith is no
longer oriented to place or time: she also is having visual
hallucinations. During the questioning, Meredith becomes mildly
agitated and tells the nurse to get out. The nurse notifies the
physician of the change in Meredith’s mental status.
The physician orders CT Scanning to rule out a possible injury
sustained in the initial fall. He also orders chest radiography and
a urine culture to rule out infections. Results of the CT scan and
chest radiography are normal; however, the urine culture reveals a
UTI. The physician prescribes antibiotics to treat the infection
and haloperidol as needed to treat the agitation. What is delirium?
What is the frequent cause of delirium in older adults?
RATIONALE: