Chat with us, powered by LiveChat Ms. Blessing is a 78-year-old widow who has been a patient of her primary care physician (PCP), Dr. Le, for more than 10 years. She has a positive history of anemia, osteoarthritis, diabetes mellitus,… | paledu.org
  
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Ms. Blessing is a 78-year-old widow who has been a patient of her…

Ms. Blessing is a 78-year-old widow who has been a patient of her primary care physician (PCP), Dr. Le, for more than 10 years. She has a positive history of anemia, osteoarthritis, diabetes mellitus, and congestive heart failure. She was referred to the mental health acute care clinic for evaluation of complaints of not being able to sleep for days, and she reports feeling “nervous all the time.” Daughter states her mother is “unable to stop thinking about the night; it has been 4 months since the home invasion and her rape,” and she has become “more and more like this.” Patient lives alone and is independent but daughter reports she has become more and more nervous and jumpy, cries easily, and exhibits more helpless behaviors that have become more pronounced since her home was invaded and she was raped a few months ago. On evaluation she is tearful, shaking, trembling, and overtly distressed about challenges with sleep, specifically being able to sleep at night while fearing the rapist will return. She offers apologies for having to talk about this matter. 

Assessment: Objective Data 

  • Little if “any” sleep for days
  • Hands tremble; noted wringing of hands when talking about events; clutches rosary beads
  • Tearful and tense through interview
  • Eyes downcast and affect appears preoccupied 

Assessment: Subjective Data

  • “I just keep seeing him.”
  • “I know I will be okay; I just feel nervous and scared.”
  • “I constantly check to make sure my doors are locked.” 
  • “I have the best daughter and family; I just need to get some sleep. I will be okay.”
  1. Compare and contrast Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD). Include symptoms, treatment, and examples of triggering events in your answer.
  2. Develop Nursing Diagnoses with SMART outcome and three interventions with rationales for the care of Ms. Blessing.