Substance-Related Disorders and Dual Diagnosis

Reassuring the patient. It would be appropriate to show empathy by acknowledging and understanding Rebecca’s nervousness about the D&A service, while at the same time addressing her exaggerated or unfounded fears.

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Other health services. Rebecca is in need of a social worker to help her establish normal relationships, and a health practitioner due to her pregnancy.

Prioritizing the nursing interventions and strategies. The first objective of intervention after comprehensive assessment should be to engage Rebecca in reduction of or abstinence from cannabis and alcohol use, as such an achievement would substantially reduce the patient’s psychiatric illness and other associated psychological symptomatology. Recurring symptoms of mental illness after successful abstinence or reduction in use should be treated using tested and proven pharmacological and psychological interventions to avoid the risk of adverse drug interactions.

Crisis management. It involves the application of strategies designed to assist the patient deal with his or her problems. In Rebecca’s case, the strategies used to help her abstain from using drugs are a major component of crisis management.

Cannabis withdrawal. Symptoms include insomnia, irritability, anxiety, antisocial behavior, aggressiveness, and uncontrolled desires or urges.

Questions asked. They include the duration of drug use, the triggering factors, the environmental factors involved, intensity of use, and mental and psychological symptoms experienced.

Long-term follow-up. It should be arranged around community-based interventions (e.g., coping skills therapy, self-help and relapse prevention approaches) to provide her time to carry her pregnancy to term and take care of the child.

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Support services. Some of the available community-based support services for Rebecca include AA, Smart Recovery, social support networks, faith-based organizations, and community-based coping skills therapy.

Eating Disorders

Points covered by senior nurse. The condition may cause Terry to miss her menstrual periods and develop psychiatric and physical illnesses including depression, anxiety, and obsessive behavior.

Type of Condition. Anorexia nervosa is a mental illness, as the obsession with a thin figure and irrational fear to gain weight are related to the functioning of the brain.

Symptoms. Other symptoms are hypokalemia, amenorrhea, lanugo, depression, and solitude.

Alternative diagnosis. Include achalasia, lupus, Lyme disease and celiac disease.

Nursing responsibilities. Include developing relationship with Terry based on empathy and trust, promoting her sense of positive self-regard, and encouraging positive health behaviors.

Moral dilemma. Yes, because the condition may lead to death or disability if not treated.

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Medical Stabilization. Evidence includes stabilization of patient’s vital signs and electrolytes.

Nutritional rehabilitation. Evidence includes achieving appropriate weight gain and absence of dry scaly skin, dry hair, electrolyte disturbance, and malnutrition.

Therapeutic treatments. They include cognitive behavioral therapy and family therapy, which assist Terry to address her disordered eating habits and her general emotional health and happiness.

Receptivity. High school students will be receptive to Terry despite her young age as she is sharing a real-life experience on her encounter with anorexia nervosa.

Influencing factors. Among adolescents and young adults, the influencing factors include the need to diet or get in shape without having adequate information, the misplaced need to eat healthier and maintain an athletic shape, internalized social attitudes toward body appearance, and family influences.

Updating internet resources. The information to be included relates to what is anorexia nervosa, what causes the illness, who is affected, what kind of person tends to get the illness, symptoms of the condition, diagnosis, treatment, and possible complications. Information will be presented in an intuitive and easily understandable manner to attract young people to access the site.

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