Discuss appropriate biopsychosocial factors and nursing management

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2809NRS
Mental Health Nursing Practice
Trimester 2, 2018
Assessment Item Two
Case Study Essay
Aim: to understand the importance of a thorough biopsychosocial assessment to reliably
identify factors that will lead to diagnosis of a mental health issue and appropriate
nursing care management.
Description:
You are to write an essay which analyses a case study in order to discuss appropriate
biopsychosocial factors and nursing management or interventions relevant to that case.
Recent and relevant literature must be used to support your discussion.
Instructions:
1) Select a case study provided.
2) Use recent literature to support your discussion:
2.1) Identify and discuss biopsychosocial factors that contribute to the
development of the selected disorder.
2.2) Describe and discuss nursing management or interventions appropriate for
your selected case study.
2.3) Outline and discuss ethical implications for the selected case study.
Other elements:
 Always refer to the HEALTH Writing and Referencing Guide
 Ensure that you use scholarly literature (digitised readings, research articles,
relevant Government reports and text books) that has been published within the
last 10 years.
 Provide a clear introduction and conclusion to your paper.
 You may use headings to organise your work if you wish.
Assessment Type: Case Study Essay – Assessment Two
Word Count: 2,000 words
Due Date and Time: Monday 3
rd September at 1700
Weighting: 50%
 Unless otherwise instructed, write in the third person.
 Use academic language throughout.
 Refer to the marking guidelines when writing your assignment. This will assist
you in calculating the weightings of the sections for your assignment.
 State your word count (excluding your reference list) on the Title page.
Submission:
Your written assignment must be submitted as:
As an electronic file to the campus-specific “final” Turnitin portal available from
the 2809NRS Learning@Griffith site.
You must submit this assignment as instructed to be eligible for a passing grade in this
course.
Marking Criteria Possible
marks
1. INTRODUCTION
– Assignment has as an opening paragraph that contextualises the assignment.
– Clearly identifies the aim of the assignment /3
2. IDENTIFY AND DISCUSS BIOPSYCHOSOCIAL FACTORS RELATED TO
THE CASE STUDY
– Clearly identifies and discusses biopsychosocial factors influencing the development
of the disorder in the selected case study.
/10
3. DESCRIBE AND DISCUSS NURSING MANAGEMENT OR INTERVENTIONS
– Using research evidence clearly identify and discuss nursing management or
interventions appropriate for the selected case study.
/15
4. OUTLINE AND DISCUSS ETHICAL IMPLICATIONS
– Clearly discusses ethical implications appropriate for the selected case study
/10
5. CONCLUSION
– Has a concluding paragraph that summarises the overall argument in the
assignment.
– Does not introduce any new information or references in the conclusion.
/2
6. RESEARCH AND REFERENCING
– Identifies, analyses and uses good quality evidence to support the outlined relevant
points. Uses at least 10 relevant sources from the scholarly literature published in
the last 10 years.
– Referencing as per APA Style 6th Edition
– Separate page for reference list headed “References”
/5
7. ACADEMIC WRITING
– Conforms to the Assignment Presentation Formatting Guidelines.
 Correct word count (2,000 words). Uses academic language
throughout.
 Essay is well presented, with correct spelling, grammar, and wellconstructed
sentence and paragraph structure.
/5
CASE STUDIES
Case 1: First episode psychosis
John is an 18-year-old student. He lives with his mother Anne, who is 50 years old,
and his stepfather Greg, who is 53 years old. Anne was remarried 9 years ago. John
is the youngest of three children and he is the only child to still live in the family
home with his parents.
John is now in Grade 12. He liked to socialise with friends and was fun-loving. In the
past seven months he started to have changes in behaviours and appearance. John
was disruptive and started to talk and laugh inappropriately in class. He also
became isolated and did not want to join in any activities at school. He used to
receive good grades but since the beginning of the year he started to lose his
concentration and attention. His school performance became poor and he was
frequently tardy. John had finally stopped going to school over the last two months.
John has a history of drug abuse. He started to use marijuana when he was in Grade
9 because the group of friends he was hanging out with also used drugs. John uses
amphetamines on a regular basis. He occasionally drinks alcohol and smokes
cigarettes.
John was brought to a mental health unit by his parents after he had been noted
wandering around the house and talking to himself for over a week. This is his first
admission. On admission, John appears suspicious and has unkempt hygiene. He
stated he heard voices from a group of two men and a woman. The voices kept
telling him that he was “no good” and “everybody hated” him. Sometimes they told
him to kill himself and sometimes to kill older people. John also believes that he has
special powers and he is a spy working for the government. John is argumentative
and sometimes becomes aggressive. He has a history of aggression and violence.
John’s mother told the admitting nurse that John’s father has schizophrenia and he
was abusive to her and the children. They divorced when John was 8 years old. After
the divorce, John’s family relocated to different cities. John also had to move to
different schools, so he did not have any close friends.
Case 2: Eating disorder
Charlie is a 19-year-old girl. She is a second year university student. Charlie shares a
flat with two other students who have always been very supportive of her. Jo, one of
Charlie’s flatmates, has contacted Charlie’s parents and expressed concern over
Charlie’s appearance and behaviours. Charlie used to go out and have dinner
together with her flatmates. She started to isolate herself about four months ago.
She spends much of her time alone in her room. Charlie eats very little throughout
the day and takes laxatives on a daily basis. After eating, Charlie immediately goes to
the toilet and spends at least half an hour in the bathroom. Charlie has lost 10
kilograms in the last three months and her menstrual periods have ceased. Charlie is
pale and thin. Her hair is dry and brittle. Though it is summer, she is wearing several
layers of clothing.
Charlie is the youngest daughter of Pam, who is a registered nurse, and Jack, who is
a dentist. Both parents work full time and lead busy lives. Charlie always sets high
standards for herself. She feels that she needs to be as perfect as her parents. She
describes her relationship with her parents as overprotective and controlling.
Charlie has a brother who is working in a well-paid company.
Charlie was taken to see the family doctor who has referred her to the Eating
Disorders Unit in Brisbane. Charlie’s family reports that Charlie was a high achiever
at school. The nurse interviews Charlie although she is pleasant the nurse gains little
information as Charlie is guarded and reluctant to talk about her eating. Charlie,
however, says she is “too fat” and believes that she needs to lose more weight to be
more attractive. Charlie feels worthless. She believes she is not as smart as her
brother and this has made her parents do not care much about her. Charlie
sometimes has self-harm urges. She feels that it is the only time she can control
herself.
Charlie is admitted to the unit and is prescribed multivitamins, antidepressants, and
anxiolytic medication.
Case 3: Depression
Amy is a 75-year old woman. She has been diagnosed as having depression for ten
years. She started to feel depressed after she was diagnosed with diabetes and
hypertension. She felt more depressed after the loss of her husband three years ago.
She was hardly eating anything and wasn’t sleep. She felt like she had no one to talk
to. After the death of her husband, Amy moved to a retirement village. While living
at the retirement village, Amy manages her medications by herself. Sometimes she
forgets to take her medications.
Amy has two daughters. They live in another city, about one hour drive from her
home. They visit her almost every month. Amy is a quiet but caring person. She likes
to keep things to herself. Amy has similar characters to her mother who also had
depression and passed away fifteen years ago.
Amy was brought to a mental health hospital by Sue, one of Amy’s daughters, after
the retirement village manager contacted her. This is her fourth admission to the
hospital. Over a period of two weeks, Amy has experienced a loss of interest in her
activities and sleep disturbance. Amy was restless at night and she found it hard to
fall asleep. Over the past two weeks, Amy has felt increasingly tired and fatigued,
resulting in her not wanting to get out of bed. Amy has lost her appetite. She has lost
six kilograms in the past two months. Amy expresses feelings of worthlessness,
helplessness, and hopelessness. She feels she is a burden for her daughters. Amy
reported low mood and stated “If I were gone, things would be easier for my
daughters”.
The doctor prescribes Amy another group of antidepressants. While she is in an
inpatient unit, she attends cognitive behavioural therapy as well as art and craft
group activities.