Psychosocial history: Mr. C., a 60-year- old man, was brought to… Psychosocial history: Mr. C., a 60-year- old man, was brought to the hospital by ambulance immediately following a suicide attempt by hanging. This hospitalization marked his first contact with the mental healthcare system. Mr. C. arrived at the ER combative and in four-point restraints. During the assessment he stated, “I just wanted to die. . . . I feel hopeless and lost.” According to the client, he had been feeling depressed for 2 months preceding the attempt and had experienced diminished appetite, insomnia, anhedonia, hopelessness, helplessness, and worthlessness during the 2 weeks prior to his suicide attempt. The client identified that his troubles began 1 year prior, when his cardiologist advised Mr. C. to leave a job that he had held for over 30 years because of his compromised physical condition following a coronary bypass operation. Although Mr. C. had not planned an early retirement, he heeded the physician’s advice and applied for disability payments. He soon fell into debt, resulting from the lengthy waiting period for disability payments, family weekend gambling excursions to Atlantic City, and accumulating medical bills. Mr. C., who had always been the head of household in his traditional family, felt that he had no choice but to return to work. He also became noncompliant with his heart medications, began to withdraw from social events, had frequent arguments with his wife, and experienced a reemergence of chest pain. Mr. C. finally terminated his employment a few months later, upon receipt of disability checks. A month prior to the suicide attempt, Mr. C. received notification from the disability office that he was ineligible for the entitlement because he had worked for those few months after having applied and that he owed $4,000 in back pay. It was also around this time that his teenaged grandson was incarcerated for armed robbery. Mr. C. had no previous psychiatric history. He did not use drugs or alcohol but has smoked one pack per day for 40 years. His medical history was significant for heart disease. Mr. C. had a family history of hypertension and heart disease. He reported that his mother suffered from postpartum depression after the birth of her third child, which resolved without treatment. Mr. C. was the oldest of three children in a middle-class family. Mr. C. met normal developmental milestones. Mr. C.’s father died when he was 14 years of age, after which Mr. C. was forced to drop out of school in order to work to help support his family. Although Mr. C. was close with his siblings in his youth, he fell out of touch with them after their mother passed away. He and his wife had been married for nearly 40 years at the time of the hospitalization. Their two grown children were living out of state. Mr. C. was normally in close contact with his children by telephone. He had several close friendships through his job and from his church, but lately had not been socially involved with anyone besides immediate family. Although Mr. C. had never earned his high school diploma, he had a successful career with the local utilities company until his recent health problems. Mr. C. verbalized a strong belief that the male in the household should be the primary provider for his family and that the woman should tend to the home. Mr. C. considered himself religious, regularly attended services, and took comfort in his belief in God. When asked about coping skills, Mr. C. reported that in the past he talked about his problems with friends and his priest. He reported that smoking gives him some relief from anxiety. On the mental status examination, Mr. C. was a well-groomed Caucasian man who appeared older than his years. His posture was poor, and he exhibited psychomotor retardation. He was cooperative with the interview for 20 minutes, after which point, he stated that he was too tired to continue. The client’s mood was depressed, with a depressed affect that was constricted in range. His speech was slow, soft, and nonspontaneous. Mr. C. evinced no formal thought disorder. Mr. C. denied experiencing hallucinations, and there was no evidence of delusional thought. He expressed ambivalence about having survived his suicide attempt but stated that he had no plan to try again while in the hospital, because he wanted to see if we could help him with his problems. Mr. C. stated that perhaps his surviving the attempt was God’s way of telling him that other people needed him here on earth. His impulse control, judgment, and insight were poor to fair, as shown by his gambling, going back to work against his doctor’s advice, noncompliance with cardiac medications, impulsive suicide attempt, and ambivalence about his survival.Mr. C. was alert and oriented to person, place, and time. His memory for recent history was intact, and his concentration seemed mildly impaired. His level of intellect was deemed average, and he seemed to be a reliable historian. Mr. C. rated his depression by using the Beck Depression Inventory, scoring in the range indicative of severe depression. The review of Mr. C.’s activities of daily living was significant for diminished appetite with a 20-pound weight loss as well as initial insomnia over the past year. His laboratory tests were all within normal limits. Mr. C.’s physical examination was significant for hypertension. *Questions: Answer ALL questions thoroughly providing ALL the necessary details required. Answer in complete sentences attending to grammar, spelling and typos. What is Mr. C’s chief complaint? What is the history of present illness? List the risk factors or stressors, biological, genetic, and psychosocial, that gave rise to MR. C’s depression and resultant suicide attempt.What is anhedonia? What are some subjective and objective assessment findings from the case study?What coping skills did Mr. C utilize? Were they positive or negative? What are some priority nursing diagnoses identified for Mr. C?If you were caring for Mr. C what are some achievable goals you will formulate for him? List as many as you can identify based on the mental status assessment in the case study.What are some nursing interventions (actions) that you can perform to help Mr. C achieve the goals? Health Science Science Nursing NUR 3028 Share QuestionEmailCopy link Comments (0)
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