An object of this study is a woman in her late forties. She is a IV drug abuser who is recovering. Both her physical and moral condition is not good. She complains of feeling bad. The laboratory tests reveal elevated alanine aminotransferase and antibody positive for Hepatitis C and Hepatitis B. Besides, the woman observes malaise, anorexia, pain in the abdominal area, and slight jaundice. This study is aimed at revealing the additional data, providing a plan of care, and further support for the successful recovery.
Subjective and Objective Data
I suppose that a patient may observe headaches and changes of mood because of therapy. Hepatitis and high ALT may result in more severe abdominal pain. As for objective data, I would assess the condition of her liver.
Necessary Considerations
National Guideline Clearinghouse suggests the guidelines to consider. Some of them are Engaging clients who use substances, Assessment and management of chronic pain, and Hepatitis B virus (National Guideline Clearinghouse, n.d.).
I will order a blood test to check the general condition of a patient. Besides, I would suggest an ultrasound investigation to observe the condition of the liver. Since the patient reports having malaise, I would advise consulting a psychoanalyst. A psychiatrist may be helpful for the problem of anorexia. To control the development of Hepatitis B and C, I would suggest meeting a gastroenterologist and infectious disease specialist.
The medical diagnoses are Anorexia nervosa, Hepatitis B, and Hepatitis C. The nursing diagnoses are more numerous (“Diseases & Conditions A-Z List”). Here belong ineffective health management, fatigue, feeding self-care deficit, hopelessness, the risk for chronic low self-esteem, interrupted family processes, and impaired comfort (“NANDA Nursing Diagnosis List for 2015-2017,” 2016). Confidentiality should be considered in the treatment of drug abusers. It is both legal and ethical matter.
Plan of Care
Medical plan of care includes treatment of the diagnosed diseases that accompany the drug abuse and make the patient feel worse. The harmful influence of anorexia should be minimized since the patient needs good nutrition during the recovery period. The treatment for Hepatitis B and C is necessary too.
Nursing plan of care presupposes support for a person who decided to stop using drugs. A task of a nurse is to help in reducing anxiety. The family members should be involved in rehabilitation if possible.
The complementary therapies that may be effective in this case are acupuncture and acupressure, involvement in art groups, drumming therapy, mindfulness meditation, etc. Still, the three therapies should be used in the complex for the meaningful result.
Further Considerations
Among the objectives of Healthy People 2020 should be considered those of Global health, Heath-related quality of life and well-being, and Substance use (“2020 Topics and objectives – objectives A-Z”, 2017).
In case of this patient, the Circle of Caring should include the involvement of her children. Although they were not in contact for a long time, their presence will be very helpful for the progress in her recovery.
In addition to treatment and care, the patient may be taught the methods to decrease anxiety which bothers abusers during the period of rehabilitation.
The billing code may be 99205 which is office visit, new patient. It includes a comprehensive examination and medical decision of high complexity.
Conclusions
On the whole, treatment of drug abusers is among the complicated in medicine. The problem is that the patients often do not recognize the necessity of being cured. Both medical and nursing care should consider not only physical but also psychological and often psychiatric aspects.
References
2020 Topics and objectives – objectives A-Z. (2017). Web.
Diseases & Conditions A-Z List. (n.d.). Web.
NANDA Nursing Diagnosis List for 2015-2017. (2016). Web.
National Guideline Clearinghouse (n.d.). Web.