The purpose of this midterm is to evaluate your comprehension

The purpose of this midterm is to evaluate your comprehension of course materials as well as your clinical reasoning skills. Follow the due dates on Moodle. Think of it as an open-book, group exam. You can work on this alone, or in a group of up to 3 people. If you are working in a group, please have only one person submit this assignment, but include everyone’s first and last names at the top of the document. *Please ensure that you answer each and every part of the question. You may do so in bullet points or paragraphs. *Please remember to cite ALL of your sources at the end of your Case Study. In text citations are not needed. No direct quotes from sources are allowed as this is a critical thinking exercise. Name(s): For this midterm, you will be walking through the care of your patient, Peter. Here is his story: Peter is a 17-year-old who identifies as male. He is in the ER following a significant car accident. Peter was upset when he failed make the varsity football team. He has been working hard for the past 3 years to train for this opportunity his senior year, and had just found out he did not make the team. To make himself feel better, he took a liter of vodka from the kitchen cabinet at home, drove to an isolated park, and drank most of the bottle of vodka while listening to music. After an hour or so, he felt dizzy, nauseous, and tired and decided to drive home. On his way home he crashed the car (which was totaled), and he suffered from several broken bones, a concussion and significant systemic bruising. 1) Peter is experiencing both a situational and a maturational crisis. 1. What part of this story would be considered a situational crisis and why? 2. What part of the story is considered a maturational crisis and why? Use Erickson’s theory of psychosocial development (Chapter 2: Pg. 32) to analyze the maturational crisis. What is the developmental stage is Peter in, what are the goals of this stage, and how does this scenario impact his progression to the developmental goal? (4 points) 2) At the start of your shift, you are meeting Peter and he says “I’m such a disappointment. My dad loves that car and won’t have the money to buy a new one. My parents are going hate me forever.” “I don’t even want to go home to face them.” (3 points) How would you respond to Peter? Give both the name of the therapeutic technique and two examples of what you would literally say to him after these comments. Also include the rationale for why you taking this approach. 3) Analyze Peter’s overall risk for suicide. (4 points) Explain 4 risk factors that make patients (in general) at risk for suicide. List 4 risk factors for suicide related to Peter specifically. Describe how you would assess Peter for suicide including at least three exact questions you would ask. List two clinical screening tools that are available for nurses to use that may assess suicidality (name of the screening tools)? 4) As you are talking to Peter, you get the sense that he is becoming increasingly anxious. What are some observations you would make that would indicate Peter has moved from moderate to severe levels of anxiety? (3 points) We’re looking for you to describe things you may notice during a mental status exam. What could someone moderately anxious have for symptoms? What could someone severely anxious have for symptoms? Describe three nursing interventions the nurse can utilize for someone experiencing a severe level of anxiety? 5) Identify 3 priority assessments/areas of concern you will focus on during your shift. Using the tables below, select 2 of the priorities you listed and identify two clear goals for the patient (using SMART format) for each that you will work on during your shift, with at least three nursing interventions to help meet this goal. (6 points) Priorities for Peter (Areas of most Concern) Remember to utilize Maslow’s Hierarchy of Needs (Pg. 28-29 in text) 1. 2. 3. Use the areas of concern above, select two for the below priorities. Create one goal and 3 interventions for each. Priority #1: Priority #2: Pt. goal (the patient will) Pt. goal (the patient will) Intervention (the nurse will) Intervention (the nurse will) Intervention Intervention Intervention Intervention SMART Goals Refresher (Use this to recall parts essential for the patient’s goal) Specific-Is the goal specific? Measurable- Can you measure the outcome with data? Attainable-Is this goal reachable for the patient? Realistic-Is it realistic for the patient? Time- What timeframe is necessary or reasonable to complete the goal? Assignment Rubric Midterm Case Study-N414 MH Rubric Guidelines- 20 pts Points Points Earned Identifies situational and maturational crisis and why. Identifies Erickson’s Developmental Stage: including the goals of this stage, and how it impacts patient progression to the developmental goal. 4 Accurately identifies 2 Therapeutic Communication techniques with two examples of each. Includes rationale for use of each type of communication. 3 Identifies accurate risk factors for suicide. Includes three exact questions to ask patient to assess for SI. Lists two screening tools that can be used for SI. 4 Outlines assessment findings possible for moderate and severe levels of anxiety. Describes three interventions for severe anxiety. 3 Completes all tables in question 5. 5 priorities, 2 goals and 3 interventions for 2 of the 5 priorities. Uses SMART format for goals. 6 Utilizes complete sentences and college level grammar and punctuation. References Listed. – Total Points There should be an in-text citation for the interventions and rationales 20

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