Nursing Care Plan | Case Study

Running head: NURSING CARE PLAN
NURSING CARE PLAN
Student Name
Student ID
Author Note

1PUBLIC HEALTH
Case Study: Rachelle
Rachelle is a thirty-one year married woman who had given birth to her daughter ten
weeks ago. Rachelle is catholic in religion. She had been working in a private school for the
last nine years and known to be a very hard working employee. Rachelle used to be a
concentrated and coordinated individual until her child born. She is suffering
from peripartum onset disorder and was dealing with feelings of worthlessness and
hopelessness as a mother.
She is suffering from dysphoria, emotions of poor self-esteem, and felt unable to care for the
baby adequately as a mother during the ten weeks of the postpartum period.
Rachelle has issues with bonding with her newborn baby, social-isolation problem in addition
to that she has anhedonia.
Rachelle is also suffering from a lactation problem, which triggers the depression problem in
her.
Rachelle has a problem of role identity as a mother and acquires low self-esteem.
Rachelle is often getting anxiety attacks. The condition can be triggered by her family related
traumatic experience of her brother's death six months back, with whom she did not meet for
one and a half years. The second trigger is the cancer diagnosis of her elder sister, who is
thirty-seven years old and divorced.
Rachelle is ignoring her self-care and lacking nutrition for that.
Rachelle is also suffering from suicidal thoughts.

2PUBLIC HEALTH
HONOs Scoring:
Domain
Overactive, aggressive,
disruptive behaviour.
0
2. Non‐accidental self‐injury 2
3. Substance use and misuse. 0
4. Cognitive problems 3
4. Physical illness or disability
problems
1
6. Hallucinations or delusions 0
7. Depressed mood 4
8. Other mental health issues 3
9. Activities of daily living 4
10. Relationships 2
11. Problems with living
conditions
1
12. Problems with occupation
and activities
4
Consume
rs
Priority
Identified
Goals/Issues
The
consumer’s
strengths to
address these
issues
Consumer and
Nursing
Interventions
Person/s
Responsible
Timeframe
Rachelle Issue 1: Strengths 1 Interventions 1 Responsibili Timeframe

3PUBLIC HEALTH
is
suffering
from
post-
traumatic
disorder
for the
death of
her
brother
and
cancer
diagnosis
of her
sister
(Yehuda t
al.,
2015).
She has
low self-
esteem,
including
dysphoria
and
depressiv
Severe
depression,
which
triggers by
her feeling
that she
lacks her
daughter's
adequate
maternal and
care abilities
and poor
self-
perception
has skewed
her self-
image and
contributed
to
anhedonia,
and the loss
of self-
esteem plus
self-
culpation
Rachel is able
to understand
that she is not
taking proper
care of her
baby and
herself as well.
Realisation is
a strength of
the recovery.
Her condition
of maternal
care for her
child
diagnosed
quickly. The
time gap is not
huge and can
be filled by
proper
maternal
caregiving.
Rachelle is a
Schema and
dialectical
behavioural
counseling
should be
provided for her
self-harming
thoughts
including
keeping the self-
harming objects
out of her reach
(Fassbinder et
al., 2016).
Cognitive
behaviour
therapy need to
start as soon as
possible with the
proper assistance
of a mental
health nurse and
psychologist
ty 1
Rachelle's
husband,
mother, the
mental
health nurse
who guides
her and the
other
representati
ves of the
multidiscipl
inary team,
must share
responsibilit
y
1
Regular
assessments
are indeed
necessary
to help the
person
to get out of
despair and
reconnect
with its
healthy
environmen
t and the
ideations of
self-harm
can be kept
in control.

4PUBLIC HEALTH
e
disorder.
She is
also
failing to
take care
of her
newborn.
Consume
r priority
1#
has led to
the patient's
feelings of
greater
distress and
anxiety
(Pizzagalli,
2014). The
death of her
sister, six
months
back, and
sister's
cancer add
on with the
problem
enhancing
the
reduction of
low self-
esteem,
increasing
self-harm
probability
as well as
middle-aged
woman, aging
thirty one
only. Age is a
significant
factor in
recovery. It is
expected that
Rachelle will
recover soon
and self-
recovery is
also possible
for her as the
age plays as
strength of the
recovery in her
part.
(Curwen, Palmer
& Ruddell,
2018).
She should be
demonstrated
self-relaxing
techniques like
yoga, meditation
and music
therapy (Klainin-
Yobas et al.,
2015).
Proper
medication
should be
applicable to
control her
condition
(safetyandquality
.gov.au, 2020).

5PUBLIC HEALTH
suicidal
tendencies
(Sandica &
Pop, 2014).
Goal 1:
Rachelle
will be out
of
depression,
bond with
her child,
good self-
esteem, and
eliminate
suicidal
thoughts.
HONOs
score - 4

6PUBLIC HEALTH
Rachelle
feels unc
ertain
towards
their own
selves
which
has
contribut
ed to
serious
self-care
deficits in
her.
Consume
r priority
2#
Issue 2:
Incapability
to do daily
work almost
at the
everyday
leading
Rachel to
get
in trouble
with usual
tasks
like sleeping
, taking care
of the baby
and home.
She can not
adequately
Strengths 2
Her family
support is the
primary factor
of self-healing.
She can rebuilt
her working
efficiency by
the support,
love and care
of the family.
The working
environment
for the patient
is the home,
which is the
most
Interventions 2
As the family
plays a
important part in
Rachelle's
recovery, family
counselling is
important
intervention
(Diamond et al,.
2014).
Along with the
CBT therapy, the
patient need a
skill
developmental
therapies and a
Responsibili
ty
2
The
responsibilit
y will be
shared by
the family
member,
patient and
the skill
developmen
t counsellor
(Page &
Wosket,
2014).
Timeframe
2
The
counselling
classes can
be taken
twice a
week to get
effective
result.

7PUBLIC HEALTH
perform the
house's day-
to-day tasks
because she
has serious
self-care
problems as
well as
complicated
skills
development
problems.
She has a
problem of
feeling
worthlessnes
s and
dysphoria
(Zahn et al.,
2016).
Goal 2 :
The patient
will be able
to
comfortable
place of
recovery and
polishing the
working skill
for an
individual.
This part also
play as a
strength.
counsellor to
boost her skills
and confidence
(Radkovsky et
al., 2014,
healthdirect.gov.
au, 2020).

8PUBLIC HEALTH
participate
in daily life
task and not
doubt her
existence.
HONOS
score
4
The
patient is
not
ready to
return to
the job
she once
cherished
and her
condition
of anhedo
nia
that adver
sely
Issue 3:
The woman
has
anhedonia
and social
isolation has
left her very
distant from
the
surrounding
world
(Winer et
al.,
2014). Rach
elle also
Strengths 3
According to
Erik Erikson
stages of
psychosocial
development,
she is in the
stage of
connection and
loneliness,
with an
invigilation
of strong
supportive
Interventions 3
The nurse, in
collaboration
with the clinical
psychologist,
can give
interpersonal
therapy to treat
her social
distance and
social isolation
problem 9
Barkham et al.,
2016).
Responsibili
ty 3
The mental
health
worker,
licensed
counsellor,
her
relatives,
physical
therapist, co
lleagues
play as the
primary
stakeholder
Timeframe
3
The
Interperson
al therapy is
given in
every
alternative
days to
analyse the
social skill
improveme
nt in
patients

9PUBLIC HEALTH
influenci
ng her
social life
and
depressio
n.
Consume
r priority
3#
shown social
isolation
from her
loved ones,
as well as
from
colleagues
and
associates. .
She is not
well
equipped to
return to her
career
concerning h
er
complicated
health issue
and concentr
ation proble
m in job.
Goal 3 :
family which
will serve as a
weapon
(Knight, 2017,
Morgan et
al.,2017).
Programs in
which primary
care
professionals
and clinicians in
behavioural
health work
together use
measurement-
based phased
diagnosis and
recovery criteria
to achieve will
dramatically
enhance the
safety and
wellness of
patients while
lowering total
health care costs.
Application of
these specific
type service can
help Rachelle's
in this part
(O’Hara &
O’Hara,
2015).
(Dimaggio
et al.,
2015).

10PUBLIC HEALTH
Rachelle
will be able
to
concentrate
in her work,
participate
in social
networking
and join her
job.
HONOS
score - 4
overall
wellbeing
improving her
behavioural
disorder
(Unützer, &
Park, 2012).

11PUBLIC HEALTH
References:
Barkham, M., Guthrie, E., Hardy, G. E., & Margison, F. (2016). Psychodynamic-
interpersonal therapy: A conversational model. Sage.
Curwen, B., Palmer, S., & Ruddell, P. (2018). Brief cognitive behaviour therapy. Sage.
Diamond, G. S., Diamond, G. M., Levy, S. A., & Siqueland, L. (2014). Attachment-based
family therapy for depressed adolescents. Washington DC.
Dimaggio, G., Montano, A., Popolo, R., & Salvatore, G. (2015). Metacognitive interpersonal
therapy for personality disorders: A treatment manual. Routledge.
Fassbinder, E., Schweiger, U., Martius, D., Brand-de Wilde, O., & Arntz, A. (2016). Emotion
regulation in schema therapy and dialectical behavior therapy. Frontiers in
psychology, 7, 1373.
healthdirect.gov.au. (2020). Cognitive behaviour therapy (CBT). Retrieved 5 April 2020,
from https://www.healthdirect.gov.au/cognitive-behaviour-therapy-cbt
Klainin-Yobas, P., Oo, W. N., Suzanne Yew, P. Y., & Lau, Y. (2015). Effects of relaxation
interventions on depression and anxiety among older adults: a systematic
review. Aging & mental health, 19(12), 1043-1055.
Knight, Z. G. (2017). A proposed model of psychodynamic psychotherapy linked to Erik
Erikson's eight stages of psychosocial development. Clinical psychology &
psychotherapy, 24(5), 1047-1058.
Morgan, A. J., Reavley, N. J., Jorm, A. F., & Beatson, R. (2017). Discrimination and support
from friends and family members experienced by people with mental health
problems: findings from an Australian national survey. Social psychiatry and
psychiatric epidemiology, 52(11), 1395-1403.

12PUBLIC HEALTH
O’Hara, D. J., & O’Hara, E. F. (2015). Counselling and psychotherapy: Professionalisation in
the Australian context. Psychotherapy and Counselling Journal of Australia, 3(1).
Page, S., & Wosket, V. (2014). Supervising the counsellor and psychotherapist: A cyclical
model. Routledge.
Pizzagalli, D. A. (2014). Depression, stress, and anhedonia: toward a synthesis and integrated
model. Annual review of clinical psychology, 10, 393-423.
Radkovsky, A., McArdle, J. J., Bockting, C. L., & Berking, M. (2014). Successful emotion
regulation skills application predicts subsequent reduction of symptom severity during
treatment of major depressive disorder. Journal of Consulting and Clinical
Psychology, 82(2), 248.
safetyandquality.gov.au. (2020). Retrieved 5 April 2020, from
https://www.safetyandquality.gov.au/sites/default/files/migrated/Medication-Safety-
in-Mental-Health-final-report-2017.pdf
Sandica, B. A., & Pop, B. (2014). Risk factors for PTSD. J Trauma Treat S, 4, 2167-1222.
Unützer, J., & Park, M. (2012). Strategies to improve the management of depression in
primary care. Primary care, 39(2), 415–431.
https://doi.org/10.1016/j.pop.2012.03.010
Winer, E. S., Nadorff, M. R., Ellis, T. E., Allen, J. G., Herrera, S., & Salem, T. (2014).
Anhedonia predicts suicidal ideation in a large psychiatric inpatient
sample. Psychiatry research, 218(1-2), 124-128.
Yehuda, R., Hoge, C. W., McFarlane, A. C., Vermetten, E., Lanius, R. A., Nievergelt, C.
M., ... & Hyman, S. E. (2015). Post-traumatic stress disorder. Nature Reviews Disease
Primers, 1(1), 1-22.

13PUBLIC HEALTH
Zahn, R., Lythe, K. E., Gethin, J. A., Green, S., Deakin, J. F. W., Young, A. H., & Moll, J.
(2015). The role of self-blame and worthlessness in the psychopathology of major
depressive disorder. Journal of Affective Disorders, 186, 337-341.