This is an unfolding case history. Please answer each question based on the knowledge of the information above it.
1. At a local university, a busy walk-in mental health clinic employs nurses who see a variety of clients with mental health disorders. Today Sandy Jones, RN is working the evening shift. Julie Sherman, a 20-year-old sophomore, comes into the clinic.
Julie fills out the patient history and current health assessment form. Julie’s patient information indicates she works in a local nightclub and lives with her mother. Her responses to the abuse screening questions indicate she has a history of repeated sexual abuse by her uncle and she is afraid of her current boyfriend. Her complaint that brought her to the clinic is difficulty sleeping. After reading this data, Sandy enters the exam room.
A. What assessment questions should Sandy ask? (15 points).
B. What topics of information should be included in the psychoeducation of abused clients? (15 points).
2. Julie states that she came to the clinic today because she has difficulty sleeping, and even the slightest sounds make her jump. She is having vivid images of sexual assault that cause intense anxiety. The last few weeks she reports having nightmares of her uncle coming into her bedroom. Her uncle sexually abused her as a child, and now she has difficulty in relationships with the opposite sex.
Her boyfriend has been pressuring her to have a more intimate relationship and this week found out he was unfaithful. She told him she did not want to see him anymore. Julie said, “Breaking up was all my fault, I shouldn’t have told him no when he wanted to go farther even though I wasn’t sure I wanted to.”
1.Julie’s emotional responses are characteristic of post-traumatic stress disorder. What are three potential nursing diagnoses for Julie? (20 Points).
2.What non-pharmacological interventions might Sandy use to help Julie? (15 points).
3. Julie has been taking a cross fit class and has recently quit going because she didn’t feel up to it. The provider prescribes Prozac (fluoxetine) for her symptoms of post-traumatic stress disorder.
1.Discuss what outcomes would indicate a positive response to treatment. (15 points).
4. While Sandy was finishing her charting, a group of male university students are seated in the waiting room prior to their physical exams. You overhear their conversation about the big dance after the football game this weekend. One of the students says he has big time plans for after the dance. He says he has Rohypnol, the sedating drug used for date rape. Suddenly he looks over at Sandy and maintains eye contact.
1.How should Sandy respond to this situation? What is the nurse’s responsibility in this situation? (10 points