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CHAPTER 39, Clients with Medical Illnesses

In completing the case study, students will be addressing the following learning objectives:

Identify common medical conditions that can have accompanying psychiatric complications or symptoms. Describe general nursing implications for clients experiencing psychiatric disorders that are intertwined with other nonpsychiatric illnesses.

1. Carla, a 27-year-old white single mother of two preschool-age children, is in the psychiatric hospital for treatment of anxiety and depression.   Carla has a cardiac condition that requires surgery.  Carla is concerned over the financial cost of the surgery and caretakers for her children while she is in the hospital and undergoing rehabilitation. Carla is also worried that she may be unable to continue in her present employment as a salesperson due to the physical demands of this position.  Carla’s case is representative of many patients with medical conditions who develop psychiatric symptoms.

(Learning Objectives: 1, 2)

a. What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications?

b.What are some nursing implications for Carla that address both the psychiatric and nonpsychiatric illnesses?

Expert Solution Preview

In the field of healthcare, it is crucial for medical professionals to understand the intricate relationship between medical conditions and psychiatric symptoms or complications. This knowledge helps in providing comprehensive care to patients like Carla, who not only suffer from psychiatric disorders but also have underlying medical illnesses. As a medical professor responsible for creating assignments and evaluating student performance, I will address the questions regarding prevalent medical conditions that can have psychiatric symptoms as well as nursing implications for Carla to manage both her psychiatric and nonpsychiatric illnesses.

a. Prevalent medical conditions with accompanying psychiatric symptoms or complications may include:

1. Cardiovascular diseases: Conditions like heart disease, congestive heart failure, and arrhythmias can often lead to depression, anxiety, and adjustment disorders. Psychiatric symptoms can arise from the psychological impact of dealing with a chronic condition, fear of mortality, or limitations imposed on daily functioning.

2. Cancer: Patients diagnosed with cancer commonly experience psychiatric symptoms such as depression, anxiety, and post-traumatic stress disorder (PTSD). The emotional distress associated with the diagnosis, treatment side effects, and fear of recurrence contribute to the development of psychiatric complications.

3. Chronic pain: Conditions like fibromyalgia, arthritis, or back pain can lead to depression, anxiety, and substance abuse disorders. The constant pain and its impact on daily living activities may negatively affect a person’s mental health and well-being.

4. Neurological disorders: Conditions like Parkinson’s disease, multiple sclerosis, or stroke often result in psychiatric symptoms such as depression, anxiety, and cognitive impairment. The physical and cognitive decline, along with the effect on independence and social interactions, can contribute to psychological distress.

b. Nursing implications for Carla, addressing both psychiatric and nonpsychiatric illnesses may include:

1. Collaborative care: Collaborating with a multidisciplinary team, including psychiatrists, cardiologists, and social workers, is vital to ensuring holistic care for Carla. This approach allows for comprehensive assessment and intervention for both her psychiatric and cardiac conditions.

2. Psychoeducation: Providing Carla with information about her medical condition, its treatment, and potential psychiatric symptoms can empower her and reduce anxiety. Educating her about self-care techniques, medication management, and available support resources is essential for her overall well-being.

3. Emotional support: Offering empathetic and supportive communication can alleviate Carla’s concerns about the financial cost of surgery and childcare while she is hospitalized. Regularly assessing her emotional state, validating her feelings, and providing counseling or therapy options can help manage her anxiety and depression.

4. Assisting with work accommodations: Exploring potential work accommodations or job modifications can enable Carla to continue her employment as a salesperson despite her physical limitations. This may involve collaborating with occupational therapists and employers to identify reasonable adjustments that allow her to maintain productivity within her abilities.

In conclusion, recognizing the interplay between medical conditions and psychiatric symptoms is vital in providing comprehensive care to patients like Carla. By understanding prevalent medical conditions that can have psychiatric complications and implementing nursing interventions that address both psychiatric and nonpsychiatric aspects, healthcare professionals can support patients’ overall well-being and improve their outcomes.

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