Reference no: EM133910068

Case Study, Obsessive-Compulsive and Related Disorders

James, a 24-year-old senior computer engineering student, was referred to the college's Positive Coping group by his engineering adviser when he failed to attend most of his classes. At the first group meeting, James refused to shake hands with anyone, awkwardly stating that he had been sick and did not want to pass his germs on to anyone. Initially, he stood, but when the group leader politely asked James to take a seat, he ignored the upholstered chairs forming the group circle and instead pulled a hard wooden chair over on which he precariously perched on the edge. He was careful not to touch his back or his arms to the chair.

After the group meeting ended, when the group leader asked James to meet with him privately, James admitted that he has a problem with being outside around other people. He stated, "I don't like to leave my room. There are so many germs out here! People have no idea. Just being around other people coats your skin with germs; you breathe them in, you take them back to your apartment, and then it's a lot of work to get rid of them. That's the reason I can't go to class. The cleaning takes so much time. But you have to do it, and you have to do it right; otherwise, you're never going to be clean."

James has continued to miss most of his classes, and his family has taken him to the mental health clinic for assessment.

1. What behaviors do you see in James that are indicators of obessesive-compulsive disorder?

2. Create a plan of care for James. Your plan of care should include your priority nursing diagnosis as well as one other nursing diagnosis, and goals and interventions specific to each one that should be immediately implemented by the nurse.