NSG 4076 Developing a Care Plan
NSG 4076 Developing a Care Plan
Project Draft of Care Plan
My aggregate comprises three women between the ages of 35 and 44 years working in advanced eye care clinic (optometrist office) in Fort Pierce, Florida. Based on the previously conducted risk assessment, the main health risks encountered by my aggregate are depression and anxiety which have worsened ever since the beginning of the covid-19 pandemic. Consequently, work-related stress and burnout have also been associated with increased risk of depression and anxiety among other mental health problems among nurses (Ezenwaji et al., 2019). The purpose of this capstone project is to propose the priority nursing diagnoses for my aggregate and come up with the most effective strategy to address the identified nursing diagnosis.
The two priority nursing diagnoses affecting my aggregate are ineffective coping related to situational crises and hopelessness related to prolonged stress resulting from the fear of contracting the coronavirus (Huang et al., 2018). Both the two nursing diagnoses led to the utilization ofthe Patient Health Questionnaire (PHQ) and General Anxiety Disorder (GAD 7) questionnaires to determine the medical diagnosis for my aggregate. One of the 3 women scored 2 which indicates mild depression. The other two women recorded a total of 12 and 18 scores, which indicate moderate and moderately severe depression respectively.
Strategies to Address the Nursing Diagnoses
Ineffective coping and hopelessness are common among front-line healthcare workers contributing to mental health problems such as depressive disorder. The main goals in addressing these mental issues include determining the degree of impairment, assessing the coping skills and abilities, assisting the patient to deal with the current situation, and promoting wellness (la Fuente-Solana et al., 2019). To achieve these goals, several strategies will be applied. The first strategy is to provide for the physical needs of my aggregate by assisting with self-care at home and work and personal hygiene. The second strategy is to assume an active role in initiating communication with my aggregate by sharing my observation of the behavior of the patient, speaking in a low but clear tone, and giving the patient enough time to respond and talk about how they feel. Thirdly, the patient will be educated about depression in terms of presenting signs and symptoms and effective treatment options available in managing the symptoms. The last strategy will be to reiterate the mood for medication compliance for the patient to promote optimal care outcomes.
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Care Plan for Medical Diagnoses
Based on the conducted mental evaluation by use of PHQ, and GAD-7, the three female patients were diagnosed with mild, moderate depression, and moderately severe depression.Clinical guidelines recommend the use of psychotherapy and pharmacological interventions for the management of major depressive disorder among adults (Tully & Tao, 2019). However, the treatment choice depends on the severity of the condition. For instance, the first patient presents with mild depression, which can be managed bynonpharmacologicalinterventions like psychotherapy and life modifications. Psychotherapeutic approaches recommended for mild depression include behavioral therapy, problem-solving therapy, and self-management/self-control therapy.
The patient who presented with moderate depression can be managed the same way as mild depression. However, the patient’s symptoms must be monitored closely to determine the need for pharmacotherapy. If the patient responds well to psychotherapy, then there will be no need to initiate the use of drugs. For the last patient with moderately severe depression, the use of antidepressants as an adjunct to psychotherapy is recommended. The FDA has approved the use of antidepressants such as amitriptyline for the management of major depressive disorder among adults(Ezenwaji et al., 2019). Alternative treatment options which have proved to be effective in the management of depression through evidence include electroconvulsive therapy and simulation techniques among others.
Disaster Management Plan
Concerning my aggregate, residents from Fort Pierce Florida, U.S, are normally affected by hurricanes, floods, and tornado outbreaks. The town is located next to a large water body is responsible for all three disasters. Based on previous experience, hurricane seasons normally begin around 1st June and end on 30th November (Taeby& Zhang, 2019). Floods and tornado outbreaks are normally experienced at this time too. Ever since the 1850s, all of the Florida coastlines has been affected by at least one hurricane, associated with flood and tornado. As such, there is a need to promote pre and post-disaster management plans.
The strategies for handling hurricanes and floods are fur much similar, given that they can occur at the same time. The Florida Division of Emergency Management has outlined an essential guide to hurricane preparedness for both families and businesses. The family plan involves writing down the emergency phone number, preparing an emergency supply kit, and locating the nearest shelter and alternative routes from your home (Fraziere et al., 2020). Pet owners are recommended to pre-identify shelters and pet-friendly hotels, where they can take their pets in case of an evacuation. Families are also encouraged to gather emergency supplies such as food, water, medicine, and power source among other safety and personal items in preparation for the hurricane or flood season.
It is crucial for people at risk of disasters such as hurricanes and floods to create a kit of supplies that they can take with them if they are forced to evacuate as a result of the calamity. This kit is normally known as the disaster supplies kit. The kit can also be utilized when the family is unable to get out of the house due to huge storms which can lead to loss of power among other factors(Taeby& Zhang, 2019). Some of the recommended items that must be included in the disaster supplies kit include water, nonperishable food, first aid kit, flashlight, personal hygiene, and sanitary items, manual car opener, waterproof container with important documents and cash, medicine, battery operated radio, special needs items for pets or babies supplies and a documented evacuation plan for all family members.
The risk assessment results suggested that my aggregate, comprising of 3 women between the age of 35 to 44 years, were mainly affected by mental health problems associated with their duty as frontline healthcare workers. They were diagnosed with the major depressive disorder at three different levels, mainly managed by both psychotherapy and antidepressants based on the severity of the patients’ symptoms. Consequently, it was necessary to develop a disaster management plan, given that my aggregate is at high risk of hurricanes and floods, as a result of the adjacent large water body within their geographical location.
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Huang, C. L. C., Wu, M. P., Ho, C. H., & Wang, J. J. (2018). Risks of treated anxiety, depression, and insomnia among nurses: A nationwide longitudinal cohort study. PLoS One, 13(9), e0204224. https://doi.org/10.1371/journal.pone.0204224
la Fuente-Solana, D., Emilia, I., Suleiman-Martos, N., Pradas-Hernández, L., Gomez-Urquiza, J. L., & Albendín-García, L. (2019). Prevalence, related factors, and levels of burnout syndrome among nurses working in gynecology and obstetrics services: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 16(14), 2585. https://doi.org/10.3390/ijerph16142585
Taeby, M., & Zhang, L. (2019). Exploring stakeholder views on disaster resilience practices of residential communities in South Florida. Natural Hazards Review, 20(1), 04018028. https://doi.org/10.1061/(ASCE)NH.1527-6996.0000319
Tully, S., & Tao, H. (2019). CE: Original research: Work-related stress and positive thinking among acute care nurses: A cross-sectional survey. AJN The American Journal of Nursing, 119(5), 24-31. https://doi.org/10.1097/01.NAJ.0000557886.73585.d2