Nursing Care Plan

This assignment analyzes two case studies, Lucy and Raj, focusing on their individual circumstances, mental health, and potential risks. It examines the role of healthcare policy, interventions, and the impact of prejudice, discrimination, and exclusion on patient care. It also includes a detailed nursing care plan for Lucy, outlining objectives, interventions, rationale, and evaluation.

Patient Profile
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Patient details and history:
24-Year-old lady Lucy who have been presented in hospital for overdose of painkillers. As per past
medical records it is outlined that she is recently been diagnosed with depression and smokes and
drinks regularly. She is singly parent and vulnerable to people in surroundings. She denies inclusion
in therapies and recently visited general practitioner who prescribed her antidepressants. Thus,
because of negligence and vulnerable habits she started developing symptoms of Asthma.
Patient details and history
How can sociological and psychological concepts help us to develop a better
understanding of the service users in both case studies? Provide an example from your
work setting.
Sociological concept of nursing is based on human interaction that is nurse and
patient communication. However, psychological concept of nursing is based on developing
understating over mental process of patient which helps in gaining deeper understanding over
patient situation and ability to react to certain situations (Winnicott, 2018). For example, in
accordance with medical condition of Lucy it can be said that it is important for the nurse to
make use of cognitive behavioural therapy psycho-social intervention as it aims at improving
mental health. With the help of this approach heath care provider can change thinking pattern
of patient which can assist in reducing stress, complicated relationships, grief and cope with
challenges of life.
The relationship between culture and concepts of health and disease relating to both
case studies.
The patients’ health is being deteriorating as the service user is been engaged in
excessive drinking, and smoking of cigars. Also, one of the major reasons of suffering from
depression is being a single parent and living in a deprived area. The health is deteriorating as
there are no family members that can support the patient (Liu and et.al., 2014). Also, anxiety
and depression can be caused as the patient is not engaged in any physical activity and is
consuming excessive amount of alcohol. She has no one to support and take care of her
which is the main reason of her disease.
Observational Record
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Sociological and
psychological
concepts to
consider in care
planning
Raj Lucy
Income
Social class Lucy is ill because of ger living
condition like she is a single
parent living in deprived area.
Further, she is dependent on
substance use like she consumes
alcohol daily and also is a regular
smoker and now been presented
in hospital for overdose of pain
killer.
Education
Ethnicity She is suffering from depression
and started developing symptoms
of Asthma
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Gender Female
At risks of developing Asthma
Job roles Part time carer and a single
parent
Cultural
influences
Single parent, reluctant to seek
helps from mother and live in
deprived area of Blackpool
Mental health Diagnosed with depression
Vulnerable, dependent on pain
killers
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Stages of
development
Developing symptoms of Asthma
Personality Reluctant seek for help
She finds difficult to manage
responsibility of parent and job
She needs to be rewarded or
motivated for participating in
therapy
Raj
Assessment of Need Treatment/Who would be involved and their role
Medical treatment
required for mental and
physical health, including
medication and therapy
Potential risks to own
wellbeing and safety and
to the safety of others
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Support required if
service user finds
themselves in crisis
Any needs service user
may have as a result of
problems with alcohol or
drugs (medication,
treatment, support)
Personal circumstances
including family and
carers
Financial
circumstances/needs
Housing circumstances/
needs
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Employment and
education needs
Support services involved
Lucy
Assessment of Need Treatment/Who would be involved and their role
Medical treatment
required for mental and
physical health, including
medication and therapy
Atypical antidepressants and monoamine oxidase inhibitors
Further, it is important for the nurse to conceptualize goals of
recovery by focusing on patient centred care. In addition, for
mental growth care workers will focus on making use of
cognitive behaviour therapy which supports psycho and
mental growth.
Potential risks to own
wellbeing and safety and
to the safety of others
Increased aggression and vulnerable behaviour towards
therapies can be a risk to wellbeing and safety of patient as
well as to nursing care plan.
Support required if
service user finds
themselves in crisis
It is important for the hospital setting to assist Lucy with
community care nurse who can assist her all the time.
Primary role of community care workers is to assist patient in
regular treatment and health literacy.
Any needs service user
may have as a result of
Withdrawal from alcohol and smoke is the critical situation
for the patient which requires major attention and
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problems with alcohol or
drugs (medication,
treatment, support)
administration. In accordance with condition of Lucy, it is
important for the heath care provider to focus on intake of
medication and changes in her behaviour.
This can be managed by nurse by using assessment tool that
is AUDIT which is alcohol use disorders identification test
with normal CAGE questions.
Personal circumstances
including family and
carers
In this mother of Lucy and Community care nurse will be
involved.
Financial
circumstances/needs
The patient can seek treatment from public hospital setting
like National health services.
Housing circumstances/
needs
It is important for Lucy to move from deprived setting
because it is another cause of her social status and vulnerable
behaviour.
Employment and
education needs
Heathy literacy by community care provider
Support services involved Health professional view son welling of patient and family
Psychological theories and approaches that can be used when caring for service users to
enable positive behaviour change.
Interventions/approaches Lucy - Rationale
Personal interaction with
Lucy in low firm tone
(Cognitive behaviour
therapy)
This will assist in developing trust and positive
environment for Lucy which will help in identifying gaps
which needs to be addressed to manage mental growth.
Assessment of contributing
factors like relationships,
educational failure es,
This will target emotional outburst of Lucy which will
helps in relieving her with stress and deprived mental
condition.
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availability of support system
and family.
Outcomes/Review Participation of Lucy in daily activities, eagerness to seek
help and involve with family.
Interventions/approaches Raj - Rationale
How does this encourage positive behaviour change?
How does this encourage positive behaviour change?
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Outcomes/Review
Role of healthcare policy and influencing factors
LUCY
Health care policy helps in closing the gap and prioritising health needs of patient.
Mental Health Act 1983 was enforced by UK government to control certain circumstances by
focusing on assessing and treating needs of people suffering from mental disorders. The act
will be supportive in case of Lucy because it is possible that at the time of alcohol withdrawal
Lucy become vulnerable and can be aggressive towards health care worker. In this situation
implication of Mental health Act and health care ethical code of conduct will assist in
managing proper care of patient.
RAJ
Illness and the impact on healthcare provision
LUCY
Community based approach is effective for managing risk of relapse in case of Lucy
because this technique is focused patient centred care which helps in focusing in
psychological health outcome of patient. In addition, inclusion approach is another way of
mitigating risk because in this community care nurse will be focusing on changes in social
life of Lucy which is the major cause of her alcohol abuse and growing depression.
RAJ
Evaluation of interventions/approaches
LUCY
CBT is effective intervention as it aims at growing psychological and social wellbeing of
person but on the other hand, assessing contributing factors like relationships, educational
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failure will help in managing emotional outburst of Lucy. Managing emotional condition of
patient on the basis of past medical condition is bets approach for mitigating risk of relapse
and gaining positive health outcome.
RAJ
How have these interventions improved the health and wellbeing of both service users
(case study 1 and 2) from different cultural backgrounds?
LUCY
Assessment of contribution factors in case of Lucy helped the nurse in drawing
outline over the circumstances which lads to alcohol abuse and consumption of pain killers. It
is the mental stress which make people vulnerable to surroundings and therefore support form
health care provider was the benefice approach of managing patient centred care. For
example, Noah a 45-year-old lady suffering from Dementia was suffering from severe mental
disorders. She was aggressive and addictive if antidepressants. Assessment of contributing
factors and inclusion therapies with her was the approach which helped in managing
improvement in her health condition like Lucy. Thus, it can be said that when managing
care for patient suffering from mental illness it is important for service provider to focus on
social and psychological wellbeing of person which can be done by involving with, changing
surroundings, understanding, etc.
RAJ
Take into consideration the impact of prejudice, discrimination and exclusion on both
service users. How effective have these interventions been for both?
Prejudice: Gaining opinion of Lucy over her actual experiences was the best intervention
which helped in gaining insight over the factor which caused her mentally sick.
Discrimination: Managing person centred care in case of Lucy wan not discriminative
practice instead the approach helped in focusing on her condition individually.
Exclusion: Exclusion of Lucy from people of Blackpool was another strategy of managing
appropriate care for depression as well as for asthma. According to Gu and et.al., 2015, nurse
and physicians exclude patients from indicators that were related to providing treatments and
achieving target levels of intermediate outcomes.
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Provide an evaluation of own care planning of both service users compared to an
existing plan and the specific healthcare interventions used and processes (from
planning, through to review).
LUCY
Existing plan of care is only limited to anti-depressants and therapies where Lucy take
medication and deny participation in therapies and therefore own care planning is focused on
understanding condition of Lucy but managing Personal centred car an CBT which will
support her social and Psycho growth. The own care planning will help in managing her
surroundings, participation and withdrawal from social interactions of deprived area which
are restricting her metal growth and health outcome.
Nursing
Diagnosis
Objectives Nursing
intervention
Rationale Evaluatio
n
 Dysfunctio
nal family
system
(Martin
and BSN,
(2016)
 Single
parent
 Alcoholic
and
smoker
 Lives in
deprived
area
 Social
interaction
s
Short term
Goal
 Nursing
interactio
n to
develop
positivity
Long term Goal
 After
nursing
care Lucy
will be
able to
express
herself
and
involvem
ent in
therapy
sessions.
 Interactio
n in Low
firm tone
 CBT
 Assessm
ent of
contributi
ng
factors
 Build
trust
 Develop
positive
and
trusting
environm
ent
 Managem
ent of
emotional
outburst
Increased
participati
on in daily
routine
activities
and
therapies
to control
her
depression
and
developin
g
symptom
of
depression
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RAJ
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