Case scenario report
This assignment is of 1500 words. The referencing is Harvard Referencing guide.
Assessment #1 – Case Report (Graded)
Students are required to submit a written report on the analysis of a case scenario. Two case scenarios will be available via the Learn online Course Website and students must choose one (1) from the two. The main aim of case scenario report will be to apply selected theories from the course content to simulated problem solving and decision-making, reinforcing the applicability of theory to practical situations.
Further detailed information including assessment description, marking criteria and academic writing requirements are located on the course learn online webpage.
I have attached all the other requirements for this assignment.
Case Scenario 1 Report
From the review of the case scenario and the friend’s account, it is evident that the relationship breakdown between Jeremy and his family is the main issue at hand. This has consequently resulted into depression, loneliness, and a feeling of abandonment that are the underlying causes of his persistent stress hence the intense and prolonged headaches. To counter the pain, Jeremy takes long-acting painkillers and for the feeling of loneliness and abandonment Jeremy abuses alcohol. This interferes with his judgment and, therefore, he misuses the pain drugs and forgets to take his insulin drugs which further worsen his physical condition. In addition, alcohol is contraindicated in diabetes treatment due to the drug interaction that renders the drugs ineffective. From his emotional state at arrival in the hospital, Jeremy seems to have been attempting to commit suicide using an overdose of painkillers taken with alcohol a combination that is clearly contraindicated in medicine. Therefore, apart from the medicine Jeremy is currently using he requires psychiatric therapy to deal with his underlying emotional problems.
In reference to the case scenario, the questions of interest here include:
- What are the effects of family breakdown on adolescents?
- How do adolescents adapt to family breakdowns?
- How effective are pharmaceutical interventions in treating the symptoms associated with family breakdowns?
- What effect does alcohol have on pain and drugs used in Type 1 diabetes?
- What is the effectiveness of psychotherapy in the treatment of Jeremy’s condition?
In the case scenario, Jeremy seems to be suffering from a condition that is psychological and affecting his emotional well-being and judgment. These questions will be critical in determining whether the family breakdown is the underlying cause of his stress that in turn requires him to be on constant pain killing medication. In addition, the questions will help determine whether his constant partying, alcohol abuse and the suicide attempt are possible adaptive mechanisms to deal with the emotional distress. Furthermore, they will highlight the effectiveness of pharmaceutical and psychological interventions in handling Jeremy’s case and how alcohol use affects the efficacy of drugs.
In the last 30 years, there have been social and demographic changes leading to increased diversity and complexity in the family structure. Today, more couples are cohabiting and becoming parents, and the risk of separation among this group is higher compared to that of divorced parents (Mooney, Oliver, & Smith 2009). However, even among married parents the rates of divorce are significantly increasing. Therefore, children are experiencing parental separations or situations where they have a single parent. This parental separation and family breakdown often has a negative impact on educational achievement, behavior, mental health, self-concept, social competence, and the overall long-term health on the adolescent (Mooney, Oliver, & Smith 2009). Therefore, the question that arises is what the psychological effects of family breakdown on children are.
Per Rodgers and Pyror (1998; 2001) who conducted a review of evidence-based literature on the impact of family breakdown on a child’s outcomes found at those children had an increased risk of developing behavioral problems, poorly performing in school, and required more medical treatment. In addition, they were leaving school and home early, and developing depressive symptoms including higher degrees of smoking, drinking, and other drug use and becoming addicts in adolescence and or adulthood (Mooney, Oliver, & Smith 2009).
Erikson’s Psychosocial Development Theory
According to Erik Erikson, child development occurred under certain predetermined stages and order. Erikson focused on the social development of the child and how this affects their sense of self. He, therefore, developed the Psychosocial Theory of Development that comprises of eight developmental stages (Sigelman & Rider 2014). Each of these stages has two possible developmental outcomes and per the theory, the successful completion of each of the stages results into the development of a healthy personality and proper socialization with others. However, failure to complete a particular stage is associated with a decreased inability to successfully complete the subsequent stages hence development of an unhealthy personality and a poor sense of self. In case a stage is not completed and resolved successfully, this can occur at a later time in the individual’s life. These stages are, “Trust vs. Mistrust, Autonomy vs. Shame and Doubt, Initiative vs. Guilt, Industry vs. Inferiority, Identity vs. Role Conflict, Intimacy vs. Isolation, Generativity vs. Stagnation, and Ego Integrity versus Despair” (Sigelman & Rider 2014).
Application to the Scenario
Due to the family breakdown, Jeremiah was separated from his family at a crucial time when he needed the support of the parents to complete the particular developmental stage that is the identity versus role conflict stage fully, and this resulted into role confusion. In addition, Jeremy was moved to a new country, and since the previous stage was not completed, it became even difficult to complete the next stage (intimacy versus isolation) as these were new people hence he developed feelings of isolation, loneliness and depression hence the headaches.
Health Detrimental Beliefs and Attitudes
From the Scenario, Jeremy seems to have health destroying beliefs and attitudes regarding his condition. Due to the family breakdown and separation, Jeremy has clearly developed a psychological condition (depression) and feelings of loneliness and isolation. However, to deal with the stress associated with these feelings he constantly takes painkillers for the stress related pain and to deal with the negative feelings and depressive mood he constantly parties and abuses alcohol as remedies for his state. This negatively impacts his judgment and even he forgets about his diabetes pills. As a final resort, he believes suicide is best for dealing with his problems.
Pathophysiological Processes of Depression
The clinical and etiological heterogeneity related to depression has made it difficult to elucidate the pathophysiology of depression. The current theories in neurobiology having the most-valid foundations empirically and reviewed of the basis of their strengths and weaknesses and selected theories are based on the investigation of psychosocial stress and the stress hormone (Hasler 2010). Stress is attributed to be a cause of depression and the sensitivity to stress is partially gender-specific. While men and women exhibit almost equal sensitivity to stressful events that can lead to depression, the responses differ depending on the type of stressor. Men experience episodes of divorce following separation, divorce, and difficulties in working while women are sensitive events that happen close to their social network (Hasler 2010).
The Corticotropin-releasing hormone from the hypothalamus is released when psychological stress is detected in the brain regions and this critical in the pathogenesis of depression. This hormone brings about several physiological and behavioral alterations that resemble depression. The sickness behavior is as a result of the released hormone with the significant risk factor being suicide (Hasler 2010).
In reference to the case scenario, the main problem that to be addressed is the depression. Depression is a mood disorder that results to the development of persistent feelings of sadness and lack of interest. The condition interferes with the thought process and behavior and results into several physical and emotional problems (feelings of worthlessness) (Moragne 2011). Depression is life-threatening and occurs at any age causing severe distress and disruption of life. Due to the negative beliefs regarding depression, ignorance, and a lack of knowledge some of the coping techniques used include alcohol use, drug use, painkillers, comfort eating, self-mutility shopping, suicidal thoughts and even suicide (Brigitta 2002).
To support the client (Jeremy) as a nurse, assessment of the client’s clinical symptoms of depression would be the most important and first in the patient-centered approach. For Jeremy, I would assess of his feelings, behaviors, and verbal response. Once this is done, in a collaborative manner, I would help him conceptualize his treatment goals through the identification of his strengths and weaknesses. Finally, I would provide depression nursing intervention techniques such as close interaction, encouragement, attentive to the client’s needs, appraising the client’s strengths, and help the client understand the meaning of life and to develop a sense of purpose in order to feel worthy of living. Moreover, I would notify the client of his other medical conditions and the need to adhere to treatment to avoid other negative health consequences that would further worsen his depression.
Therefore, per the Nursing and Midwifery Board of Australia (2006), planning nursing care in consultation with the individual, practicing within the professional and ethical framework, and practicing using a framework that is based on evidence are the ANMC RN Competency Standards required (NMBA 2006).
Depression is life threatening and requires special care from a personal and professional level. I think that the beliefs, attitudes, behaviors, and lifestyle choices that a person having depression has and makes are at the centre on how this disease will progress. For Jeremy, I think if consuming alcohol will worsen his condition. Given the fact that he has another health conditions it is critical that he adheres to the drugs provided and keeps away from the alcohol. A lifestyle change for him would be beneficial as this will help cope with the negative emotions on a long-term basis. From my nursing practice experience, I have realized that many people with depression often engage in health-damaging adaptive mechanisms just like Jeremy, and this often worsens their condition and at times results in death
Brigitta, B, 2002, Pathophysiology of Depression and Mechanisms of Treatment, Dialogues Clin Neurosci., 4 (1), 7–20.
Hasler, G, 2010, Pathophysiology of Depression: Do we have any solid evidence of interest to clinicians? World Psychiatry, 9 (3), 155-161.
Mooney, A, Oliver, C & Smith, M, 2009, Impact of Family Breakdown on Children’s Well-Being: Evidence Review, University of London, Institute of Education, London: University of London.
Moragne, W, 2011, Depression, Minneapolis, MN, United States of America, Twenty-First Century Books.
Sigelman, C & Rider, E, 2014, Life-Span Human Development. Stamford, CT, United States of America, Cengage Learning.
The Nursing and Midwifery Board of Australia, 2006, National Competency Standards for the Registered Nurse, 1-11.
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