StudentShare
Contact Us
Sign In / Sign Up for FREE
Search
Go to advanced search...
Free

Nursing Mental Health: Personal Disorder, Eating Disorder, and Nursing Prevention - Case Study Example

Summary
"Nursing Mental Health: Personal Disorder, Eating Disorder, and Nursing Prevention" paper examines possible psychodynamics or causes behind the development of Cassandra’s borderline personality disorder and nursing interventions in managing borderline personality disorder. …
Download full paper File format: .doc, available for editing
GRAB THE BEST PAPER98.5% of users find it useful

Extract of sample "Nursing Mental Health: Personal Disorder, Eating Disorder, and Nursing Prevention"

Nursing Mental Health - Personal Disorder, Eating Disorder and Nursing Prevention Total Numberof Words: 1,629 Type of DSM-IV Cluster Seen in Cassandra’s Behavior Cassandra’s behaviour is indicative of cluster B: Dramatic-Emotional-Erretic particularly the borderline personality disorder. Based on the features of borderline, Cassandra was able to meet six (6) criteria presented under this type of personality disorder. Upon analyzing the case scenario, the patient showed the following signs of borderline disorder: (1) pervasive pattern of instability of interpersonal relationship with her live-in boyfriend; (2) unstable mood swings which fluctuates from crying, pleading, sometimes charming, joking, and physically fighting the police using foul language; (3) terrified of abandonment which was evident when the patient was in the state of tears when I went out for my tea break and told me that all other nurses are mean to her and that I am the only one who understands her; (4) chronic feeling of emptiness which was evident due to the fact that her older sister and mother lives in another state and that her boyfriend left her 2 days ago; (5) recurrent suicidal behaviour which explains why she had cut her forearms; and (6) disturbed self-image (Zanarini, Frankenburg and Hennen). Even though the patient was well dressed, she was thin, pale, has dark circles under her eyes, and continuously wrings her bandaged hands in her lap. Likewise, several studies revealed that people with borderline personality disorder may also have eating disorder and substance use disorder such as drinking too much alcohol (Zanarini, Frankenburg and Hennen). In Australia, roughly 2 – 5% of the total population in the country are affected by borderline personality disorder at some stages in their lives (Sane Australia). Between men and women, women are three times more likely to become diagnosed with this type of personality disorder as compared to men (ibid). Possible Psychodynamics or Causes behind the Development of Cassandra’s Borderline Personality Disorder Given the fact that there is no single factor that could effectively explain the cause of developing borderline personality disorder, several studies revealed that past traumatizing events and severe emotional abuse during childhood are among the possible causes of developing this type of personality disorder (Brown, Cardena and Nuenhuis; Buckley, Michels and Mackinnon). As explained by Paris, biological factors like inborn temperamental abnormalities, psychological factor like traumatic experiences during childhood days, and social aspect like broken family also plays a significant role in its etiology. In the case of Cassandra, she has a bad experience with her father given that he physically, emotionally, and sexually abused her when she was still a young child. Because of her memory and thoughts about her negative life experiences, Breuer and Freud explained that Cassandra’s personality disorder was part of her psychological defense (Brown, Cardena and Nuenhuis). Over the years, such psychological defense can be converted into physical symptoms such as personality disorder which has been observed in the case of the patient. Three Major Issues / Problems / Risks The three major issues identified in the given case scenario include the patient’s repetitive suicidal tendency, eating disorder, and substance abuse related to excessive alcohol consumption. Repetitive Suicidal Tendency At least one out of every six young adults had tried committing suicide at one point in their life. (Gaynes, West and Ford) Specifically the research study that was conducted by Gaynes, West and Ford revealed that “suicide is the 11th leading cause of death and 7th potential life lost in the United States” (p. 822). The problem with patients that has history of repetitive suicidal tendency is that the fact that the clinical management of patients with suicidal risk is complicated especially when the patient has deliberately inflict self-harm such as in the case of Cassandra. In line with this, it is not easy on the part of the health care professionals to be able to tell when exactly would the patient inflict self-harm within the hospital area. In case the patient with borderline personality disorder died within the hospital setting due to suicidal acts, the hospital and health care professionals who are in-charge in the provision of patient’s care can be legally sued for negligence. Eating Disorder Eating disorders alone could cause millions of people who are diagnosed with mental illness to suffer from physical deterioration which often leads to death. (Sullivan) Basically, eating disorders are considered as serious psychiatric and physical illnesses related to a person’s unusual eating habit or attitude and behavior on food consumption. Most of the people who have eating disorders are usually unsatisfied with their own body structure and weight. This often causes them to go through unhealthy weight management processes either by not eating at all or the extreme intake of food. Anorexia nervosa is considered as a serious eating disorder that is normally characterize by significantly decreasing the intake of calories and increasing the physical activity which often results to a sudden lost of body weight and mass. According to Lindsay, anorexia nervosa is very much associated with becoming hopeless and anguish towards one’s own body. Anorexic people in general have a very strong desire to become very thin. (American Psychiatric Association b) Such desire alters the person’s mentality about his or her own body image. Even though anorexic people have already lost so much weight, they would still see and think of themselves as fat. Because of low calorie intake and excessive exercise, almost all patients who are diagnosed with severe anorexia have protruding bones, deny the feeling of hunger, feels fat despite being underweight, and has the tendency to withdraw from social activities. Anorexic patients may also starve themselves by eating lesser food as compared with their body requirements or even nothing at all. (American Psychiatric Assocation a) These individuals may sometimes practice self-induced vomiting which may lead to significant physical and psychological changes related to constipation, abdominal pain, cold intolerance, lethargy, excess energy, emaciation and dryness of the skin. (ibid) The problem with a sudden reduction of body weight is the danger towards one’s health since people with anorexia may experience dehydration, malnutrition, heart, kidney, immune system, and liver problems, infertility, osteoporosis, personality disorder, and permanent health damage which could eventually lead to death. (Kushi and Glovannucci; Shikany and White) Likewise, the lack of nutrients could lead to a lot of biological changes that may cause disturbances in the normal functioning of the brain. Substance Abuse Related to Excessive Consumption of Alcohol With regards to substance abuse related to excessive alcohol consumption, this particular habitual practice could increase the patient’s risk of developing not only with health related problems like liver cirrhosis (DeGottardi, Spahr and Gelez) but also their social relationship with friends, family, and other people including their psychosocial and cognitive development. The research study of Barnow, Schuckit and Lucht revealed that people with drinking problem is associated with parental and peer rejection. Such behavioral problem often leads to excessive alcohol use which may cause them to end up not being able to develop a good relationship with other people. With regards to mental development, drinking too much alcohol could negatively affect the brain’s neurological and cognitive functioning. (Connelly) Nursing Interventions in Managing Borderline Personality Disorder Repetitive Suicidal Tendency To prevent the incidence of suicidal attempt within the healthcare institution, nurses should carefully monitor signs of self-harm and suicidal tendency of the patient in order to ensure the patient’s safety (Livesey). As part of keeping the patient feel safe and calm, nurses should constantly communicate with patients with suicidal tendency to allow them to unload some of their emotional burdens and teach them ways on how to cope with their problems (ibid). Aside from administering prescribed medication to control the patient’s mood swings and anxiety among others (Haw and Stubbs), nurses should keep the environment free from objects that could make them harm themselves. Likwise, nurses should also give patients some Vitamin B12 in order to reduce the patient’s depression (Tesar). Other useful nursing intervention includes: cognitive behavioral therapy and alternative therapy like providing the patient with chamomile tea to help reduce anxiety (Tarrier, Taylor and Gooding). Eating Disorder To treat anorexia, nurses should provide the patient with health care teachings regarding the negative health impact of not eating properly in order to correct the patient’s eating habit (Warin; Whitney, Murray and Gavan). Since there are quite a lot of young adults who are experiencing eating problems, nurses should encourage the patient to participate in group therapy and psychotherapy to enable them to gradually change their personal beliefs about good health and physical appearance (Whitney, Murray and Gavan). While at the hospital, nurses may provide nasogastric tube feeding upon the order of the physician to ensure that the patient will receive proper nutrition (Rigaud, Verges and Colas-Linhart). Substance Abuse Related to Excessive Consumption of Alcohol Nursing should teach the patient with regards to the adverse health consequences of alcoholism. (Ernst, Pettinati and Weiss) By letting the patient know the negative effects of excessive alcohol in the human body, the patient would be able to think twice before she decides to open another bottle of beer. Nurses should also use behavioral treatment like motivational interview to determine the main reason why the client has engaged herself in heavy drinking. Together with the patient’s participation, nurses should develop a nursing care plan which aims at gradually reducing the patient’s intake of alcohol (Ernst, Pettinati and Weiss). Recommended Strategy on How to Respond to Cassandra’s Statement The nurse should not give the patient false hope about her presence at the hospital since it could only increase the patient’s mistrust and depression. Instead, the nurse should explain that she will be back the next day to provide her with necessary care and treatment. Likewise, the nurse should help the patient realize that other nurses also meant good in terms of providing her with necessary care and treatment while she is still at the hospital. *** End *** References "American Psychiatric Association." 2000a. Associated Physical Examination Findings and General Medical Conditions - Anorexia. 10 September 2009 . "American Psyciatric Association." 2000b. Diagnostic Criteria for 307.1 Anorexia Nervosa. 10 September 2009 . Barnow, S., M. Schuckit and M. Lucht. "The Importance of a Positive Family History of Alcoholism, Parental Rejection and Emotional Warmth, Behavioral Problems and Peer Substance use for Alcohol Problems in Teenagers: A Path Analysis." Journal of Studies of Alcohol (2002): Vol. 63, pp. 305 - 312. Brown, R.J., et al. "Should Conversion Disorder Be Reclassified as a Dissociative Disorder in DSM–V?" (Psychosomatics (2007): Vol. 48, No. 5, pp. 369–378. Buckley, P.J., R. Michels and R.A. Mackinnon. "Changes in the Psychiatric Landscape." American Journal of Psychiatry (2006): Vol. 163, No. 5, pp. 757-760. Connelly, M. 2003. Adolescent Substance Abuse: Development and Normalcy. 10 September 2009 . DeGottardi, A., et al. "A Simple Score for Predicting Alcohol Relapse After Liver Transplantation: Results From 387 Patients Over 15 Years." Archives of Internal Medicine (2007): Vol. 167, pp. 1183-1188. Ernst, Denise B., et al. "An Intervention for Treating Alcohol Dependence: Relating Elements of Medical Management to Patient Outcomes With Implications for Primary Care." Annals of Family Medicine (2008): Vol. 6, No. 5, pp. 435 - 440. Gaynes, B.N., et al. "Screening for Suicide Risk in Adults: A Summary of the Evidence for the U.S. Preventive Services Task Force." Annals of Internal Medicine (2004): Vol. 140, pp. 822-835. Haw, Camilla and Jean Stubbs. "A survey of the off-label use of mood stabilizers in a large psychiatric hospital." Journal of Psychopharmacology (2005): Vol. 19, No. 4, pp. 402 - 407. Kushi, L. and E. Glovannucci. "Dietary Fat and Cancer." American Journal of Medicine (2002): Vol. 113, suppl 9B, pp. 63s - 70s. Lindsay, C. Conquering Anorexia the Route to Recovery. Chichester: Summersdale Publisher, 2000. Livesey, Anthony E. "Self-harm in adolescent in-patients." Psychiatric Bulletin (2009): Vol. 33, pp. 10-12. Paris, Joel. 2009. Borderline Personality Disorder: What Is It, What Causes It? How Can We Treat It? 10 September 2009 . Rigaud, Daniel, et al. "Hormonal and Psychological Factors Linked to the Increased Thermic Effect of Food in Malnourished Fasting Anorexia Nervosa." Journal of Clinical Endocrinology & Metabolism (2007): Vol. 92, No. 5, pp. 1623–1629. "Sane Australia." 2009. Borderline Personality Disorder: Fact Sheet . 10 September 2009 . Shikany, J. and G. White. "Dietary Guidelines for Chronic Disease Prevention." Southern Medical Journal (2000): Vol. 93, No. 12, pp. 1138 - 1151. Sullivan, P. "Mortality in Anorexia Nervosa." American Journal of Psychiatry (1995): Vol. 152, pp. 1073 - 1074. Tarrier, Nicholas, Katherine Taylor and Patricia Gooding. "Cognitive-Behavioral Interventions to Reduce Suicide Behavior." Behavior Modification (2008): Vol. 32, No. 1, pp. 77-108 . Tesar, George E. "Treating depression in a mother of five: what to do when the first step fails." Cleveland Clinic Journal of Medicine (2005): Vol. 72, No. 6, pp. 501 - 506. Warin, Megan. "The Individual Within a Condition: A Qualitative Study of Young Peoples Reflections on Being Treated for Anorexia Nervosa." Journal of the American Psychiatric Nurses Association (2008): Vol. 13, No. 3, pp. 368 - 375. Whitney, Jenna, et al. "Experience of caring for someone with anorexia nervosa: qualitative study." The British Journal of Psychiatry (2005): Vol. 187, No. 5, pp. 444 - 449. Zanarini, M.C., et al. "Axis I Comorbidity in Patients With Borderline Personality Disorder: 6-Year Follow-Up and Prediction of Time to Remission." American Journal of Psychiatry (2004): Vol. 161, No. 11, pp. 2108–2114. Read More

CHECK THESE SAMPLES OF Nursing Mental Health: Personal Disorder, Eating Disorder, and Nursing Prevention

Ongoing Mental Health Needs: Major Depressive Disorder

Thirdly, details of agreed treatment plan and nursing interventions would also be discussed.... Ongoing mental health Needs: Major Depressive Disorder Introduction This paper presents a case study of a chosen service user, one who is suffering from bipolar affective disorder.... Patient X, a 35 year old female was admitted to the mental health unit after her mother observed her sullen and melancholy behaviour persisting for about three weeks....
9 Pages (2250 words) Essay

Sociocultural Factors in the Development of Eating Disorders

The paper "Sociocultural Factors in the Development of Eating Disorders" focuses on the critical, and multifaceted analysis of the development of eating disorders from this sociological perspective by using new quantitative data about eating disorder sufferers.... Exploring the development of eating disorders, both on an individual and societal level is also important in such a study, and thus this paper will discuss how Westernization and eating disorder prevalence exhibit a positive correlation in the literature....
40 Pages (10000 words) Dissertation

Substance disorders - cocaine

When an individual decides to abuse a substance, it can also become difficult for them to stop.... In order to understand the factors involved, an individual must first understand the different.... ... ... This research paper examines the substances disorders that develop primarily from cocaine misuse....
12 Pages (3000 words) Essay

Is Bullying a Contributing Factor to Teenage Eating Disorders

On the other hand, eating disorder entails the abnormal eating habits characterized by excessive or insufficient intake of food to the detriment of mental or physical health of an individual (Nelson 2008, p.... The essay "Is Bullying a Contributing Factor to Teenage eating Disorders" describes that bullying has been shown to be on the increase in UK with teenagers who are being bullied doing everything at their capacity to avoid the bullies.... eating disorders have been linked with low self esteem....
10 Pages (2500 words) Essay

Anorexia in Teens

The paper "Anorexia in Teens" examines the ties between the media, body image, and eating behavior in teens.... media created an unpractical body image of thin models as ideal, and adolescents being unable to attain this body image, resulting in a feeling of body dissatisfaction, and eating disorders.... Anorexia Nervosa(AN) is one of the serious eating disorders which is characterized by low body weight(less than 85% of the expected body weight)and the false feeling of the patient that she/he is overweight driving the patient to starve and more weight loss....
5 Pages (1250 words) Literature review

Schizophrenia as a Very Serious Mental Health Disorder

The paper "Schizophrenia as a Very Serious mental health Disorder" describes that disability is not an inability, therefore we should kindly monitor and find what best can suit them so that we keep them busy to engage their mind, I wish to emphasize that an empty mind is a devils workshop.... Schizophrenia is a very serious mental health disorder characterized by changes in the way of life through mind disintegration and emotional responsiveness of the affected (Bentall, 2003)....
9 Pages (2250 words) Coursework

Mental Illnesses: Altered Perception

Depression is a public health concern in Australia because it is linked with a high prevalence of obesity, eating disorder, alcohol dependence and misuse, substance use like bhang as it is with Tom and drug use (AIHW,2011).... In reference to Tom's case (altered perception), this study will look at the prevalence of mental illness, signs, and symptoms of altered perception, physical health nexus mental health and impacts, the health practitioner and infrastructures system role in mental illness management, prevention, challenges, and solution....
12 Pages (3000 words) Case Study

Community Health Nursing

From the paper "Community Health nursing" it is clear that during hospitalization, he will remain safe, and by discharge, there will be increased self-control reported.... The client has some depression signs, the nursing care plans dig deeper to scrutinize the impairment degree, assess the client's coping abilities, and assist in dealing with the current situation for the psychological needs promoting health wellness.... Dennis was exposed to environmental stressors and inflammatory conditions at birth and inherited traits from relatives with mental illness, she has depression and substance use disorder, leading to unhappiness and decreased life enjoyment....
6 Pages (1500 words) Case Study
sponsored ads
We use cookies to create the best experience for you. Keep on browsing if you are OK with that, or find out how to manage cookies.
Contact Us