Question

Alice, age 48, underwent a mastectomy of the right breast after her mammogram revealed a lump that proved to be malignant when biopsied. Since her surgery 6 weeks ago, Alice has refused to see any of her friends. She stays in her bedroom, speaks to her husband only when he speaks first, is having difficulty sleeping, and eats very little. She refuses to look at the mastectomy scar, and has refused to see the Reach to Recovery representative who has tried several times to help fit her with a prosthesis. Her husband has become very worried about her and spoke to the family doctor, who recommended a psychiatrist. She has been admitted to the psychiatric unit with a diagnosis of Adjustment Disorder with Depressed Mood.

Answer the following questions about Alice Remember to include in-text citations and your references at the end 1. What would be the primary nursing diagnosis for Alice? 2. Describe a short-term goal and a long term-goal for Alice? 3. Discuss a priority nursing intervention in working with Alice

Answer 1

1 Post Traumatic Stress Disorder

2 Short term goals - normal sleep (decrease insomnia), establishing sense of safety in the patient, identification of change in behaviour in recent times and more importantly identification of cause of change in behavior, grieving

Long term goal - accept the fact that the event is over and is a part of the past hence cannot be changed and starts to live the present healthily

3 Nursing interventions -

• Help her identify that she has changed and help her identify the cause of change
• Encourage Alice to talk And share her thoughts freely and be non judgemental
• Involve family members
• Talk positively to the patient