Clinical assessment of suicide risk

Running Head: CASE STUDY: CLINICAL ASSESSMENT
CASE STUDY: CLINICAL ASSESSMENT
Name of the Student:
Name of the University:
Author Note:

Answer 1
RLT nursing model (Williams, 2017) defines patient capability within the context of their age in -
procedure, their degree of risk, and essential factors in designing a treatment plan. Instituting the
Therapeutic thought process (Hunter & Arthur, 2016) includes an evaluation of the patient's
condition. Edward (Ted) Williams 82 is postoperative and has intermittent colostomy that may impact
different facets of his life. RLT nursing methodology is focused on everyday living activities (ADLs)
and measures improvements in the patient's health and quality of life (Roper, Logan & Tierney,
2009). Possibly having a stoma would contribute to patient seeking assistance for personal care,
dressing, stoma care and thereby becoming less confident and dependent for his ADLs (Williams,
2017). The cognitive behavioral difficulties Ted may encounter include poor self-esteem, fear,
pessimistic thinking or stoma-related feeling vulnerable. This is likely that he may suffer marital
problems and depression. He may be having sexual distress and stress (Aktas & Gocman, 2015). The
case study states that Ted has a companion named Gwen, who resides in the same retirement
community. He may worry about her seeing him in this condition. The other causes may have an
effect on the fact that Ted became a widow and might miss his wife and children. Even though, Ted
has a girlfriend that is just a few years younger to him but still he feel alone. Psychosocial change will
restrict his social network and free time, because Ted may even be reluctant to go out sense moral
health declining. In various societies the psychological influence of developing a stoma is viewed
significantly.
Answer 2
During this step of the CRC (Hunter & Arthur, 2016), nurses ought to closely evaluate Ted's
previous medical background, illness background, existing recovery strategy, test findings, and
present vital signs. The case study states that Ted had just undergone surgery following a bowel
resection and a temporary colostomy. Moreover, he previously was observed to have a malign mass
post undergoing a colonoscopy and a biopsy, active heart failure, type II diabetes mellitus, obese and
had gout. Observing the case study it has been revealed that Ted showed signs of nausea when he was

administered with his diabetes medicine on his fourth day post-surgery. He was seen to have vomited
twice and that was feeling dizzy.His elevated vital signs indicates the presence of any kind of
infection. The nurse may also note regarding the perioperative control of fluid and electrolytes.
Plasma volume management (EDWARDS & GROCOTT, 2015) is necessary to provide a sufficient
preload to the heart to improve ventricular contractility and cardiac performance. Adequate
intravascular volume is also required for optimum oxygen supply to the tissue. However, the supply
of tissue oxygen may be jeopardized by an increased amount of interstitial fluid, since this can result
in edema, microvasculature stress, and decreases in oxygen diffusion distances. Control of the pain
(Tan, Law & Gan, 2015) in Ted's situation is crucial because control of the pain may help accelerate
recovery of the patient and can decrease their risk of experiencing other problems following surgery,
such as pneumonia and blood clots.
The nurses may recognize according to the above signs some potential disorders that Ted
most definitely suffering from. As Ted is postoperative, has had no performance since the surgery. So,
it can be recognized that gastrointestinal motility dysfunction could have existed, most possibly owing
to the operation of bowel resection. It is termed Postoperative ileus (Venara et al., 2016). This is a
disorder that is distinguished by both bowel distention and a loss of digestive sounds. Ted has a
distended stomach, as well as slow bowel effects. Postoperative ileus is often marked by the
deposition of gas in the GI tract, resulting in impaired storage and flatus movement, as with Ted.
Vomiting and diarrhea (Doenges, Moorhouse & Murr, 2016) are often a primary symptom of the
disease. The patients were shown not being able to handle a liquid or semi-liquid diet. The medication
used to treat pain can even raise his likelihood of post-operative ileus. The surgical technique
activates the afferent nerves in terms of pathophysiology, owing to the incision produced.
Disintegration of sympathetic / parasympathetic nerves in the gastrointestinal tract contributes to a
corresponding protracted period of inflammation. Surgical stimulation of the macrophages contributes
to the entrance of infectious agents such as neutrophils and monocytes into the body. However, the
majority of this process remains as an open question.
The second crucial challenge Ted may experience is linked to his coarse motivating crackles
and painful cough. There is a large array of conditions which can contribute to inspiring coarse
crackles being made. Yet recognizing that Ted has a history of cardiac disease is important, so he is