Reference no: EM133865724

Assignment:

Mrs. Cummings

Martha Cummings contacted Visiting Nurses Association (VNA) to discuss her concerns about her 29-year-old daughter Susan, who is a graphic designer. Martha explains that Susan has always been a shy person, has one or two close friends, and has difficulty dealing with new situations. Over the past 4 months, Martha reports, Susan has been increasingly reluctant to leave her apartment, making excuses about not visiting her family and asking her mother to run errands and even purchase groceries for her. Martha also states that Susan has quit going to the office, but has continued her job by working at home. Her employer has allowed her to do this for several weeks, but is becoming more impatient with Susan. Martha fears Susan may lose her job.

When Martha attempts to talk to Susan about this situation, Susan becomes very anxious and agitated. She doesn't want to discuss her problems, and keeps insisting she can't "go out there" anymore. Martha has not been able to convince Susan to see a doctor, so she contacted VNA to see if they would go to Susan's apartment to see her. Susan has agreed to talk to the nurse if the nurse comes to her apartment.

1. What assessments would the nurse need to make during the initial visit with Susan?

2. What type(s) of treatment are available for Susan?

3. How is Martha's behavior affecting Susan's situation? What suggestions might the nurse make to Martha?

Susan

Susan is a 24-year-old, married, mother of two children, aged 2 and 5. She has always described herself as a "neat freak," cleaning and scrubbing the car, the house, and even her children repeatedly. Susan has always secretly worried that lack of cleanliness would lead to disease or contamination and that she or her family might become deathly ill due to her negligence in protecting them from germs. In the past few months, Susan's thoughts of contamination and disease have increased as have her cleaning activities. Her children complain, and Susan's husband believes her cleaning is "getting out of control." He finds Susan cleaning in the middle of the night, and when he tries to interfere with her cleaning, she explodes. She is sobbing and yelling, and extremely agitated. Susan is taken to the emergency department of the local hospital, given a tentative diagnosis of OCD, and admitted to the inpatient unit.

1. What additional assessment data does the nurse need to plan Susan's care?

2. Identify three priority nursing diagnosis for Susan's care with rationale for your choices.

3. Identify an expected outcome for each nursing diagnosis.

4. Discuss nursing interventions for each of the priority nursing diagnosis.