11 Apr Stress and Coping Case Study
The nurse is caring for Madeline Moore, a 45-year-old woman who has come to the clinic
seeking care for depression symptoms. Madeline indicates she has experienced depression in the
past but is not currently taking any medications for depression. The client takes a multivitamin
and calcium supplement each day. Madeline informs the nurse that she is going through a
divorce and the relationship has been fraught with emotional and physical abuse; she currently
feels safe. The client is no longer living with her husband as the divorce proceeds; she does not
have children. After completing the Beck Depression Inventory, the nurse finds the client’s score
to be 20, indicating borderline clinical depression. Additional symptoms Madeline reports is a
30-pound weight loss over 2 months, a loss of appetite, and difficulty coping due to a lack of
social support. Madeline lost her job 3 months prior due to the company downsizing; she has
only found part-time work since then. She is unable to pay rent to live on her own with her parttime job. The client’s main support comes from one friend who no longer lives in the area and
her parents. Madeline is now living with her parents. Madeline denies thoughts of harming
herself or others.
Assessment Questions
1. Identify the relevant subjective and objective assessment information related to the client’s
condition and place the findings in the assessment data box below. (Recognizing Cues;
Assessment)
2. Based upon assessment information, identify and prioritize the top 3 client problems. Write
one client problem in each of the Client Problem boxes below. (Analyze Cues; Analysis and
Prioritize Hypothesis; Planning)
3. Below each client problem, determine and enter the relevant assessment information that
supports the identified client problem. (Analyze Cues; Analysis and Prioritize Hypothesis;
Planning)
4. Identify important nursing interventions that should be taken to address each client problem
and enter them in the related intervention box for the associated client problem. (Take Action;
Implementation)
Complete the following discussion questions:
1. Discuss special considerations to be made for clients from diverse backgrounds. (Recognize
Cues; Assessment)
a. Elderly client with no family support.
b. Clients from diverse backgrounds (i.e. age, culture, socioeconomic status).
The remaining questions are specific to the case study of Madeline Moore.
2. Identify potential client problems. (Analyze Cues; Analysis) Include rationales for your responses.
3. Discuss nursing interventions to address the identified potential client problems. Include rationales for your responses. (Generate Solutions; Planning)
4. Discuss the desired client outcomes related to the performed interventions identified as well as for potential client problems. (Generate Solutions; Planning)
a. Discuss client responses that demonstrate an improvement of the client problem.
b. Identify client responses that indicate worsening of the client condition.
5. Discuss safety considerations that should be included when planning care for this client. (Generate Solutions; Planning)
6. Identify client education the nurse should provide for this client (i.e. safety, action plan, diet, activity, ADLs).
(Take Action; Implementation).
Discuss client outcomes you would anticipate based on the performed nursing interventions.
Identify how the achievement of client outcomes would be evaluated. (Evaluate Outcomes; Evaluation)
7. Discuss ways to modify or revise the plan of care when client outcomes are not met. (Evaluate
Outcomes; Evaluation)
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