Feedback: Case Study 2 - Part 2
Based on the assessment made by the nurse practitioner today, what should the nurse do?
Develop a problem list for Thomas with appropriate nursing interventions.
Assessment problem list:
- 60-pound weight gain in a year
- Social isolation
- Self-care deficit-hygiene
- Prehypertension
- Depression
- Poor school attendance
- Lack of confidence
Nursing Interventions
- Begin developing a trusting relationship with Thomas
- Validate depression using a depression scale
- Determine safety risk related to suicide
- Refer for counseling
- Develop a contract plan with Thomas regarding suicide
- Include his sister in a plan for emotional safety and nutrition and self-care, options for day care for her son, and medication administration for Thomas if prescribed
- Once Thomas is less depressed, refer to a nutritionist for management of obesity and physical activity plan
- Collaborate with the school nurse about bullying behaviors of students toward Thomas
- Assist Thomas in finding community services that will connect him to positive relationships and behaviors: Church or community or youth group
- Arrange for follow-up appointments for mental health and weight check