Critical Care Unit

Mr. Jackson has just arrived in the Critical Care Unit at the hospital where you work. He was in a bad car accident in which a family member and a close friend were both killed. Mr. Jackson is aware that the other two people in the car did not survive. He has rib and femoral fractures and numerous contusions. He is sedated. In the morning, he asks you how the other driver is. He tells you that in two days it will be his sister’s birthday. You understand that his sister was one of the passengers. Mr. Jackson is able to talk to his kids on the phone and tells you, with tears in his eyes, “It’s really hard to be far away from them and helpless at a time like this.”

-You appraise Mr. Jackson’s stressor, a process that evaluates ___ in relation to his well-being.

-Part of your appraisal includes assessing Mr. Jackson’s cognitive responses to his situation. Which type of response best describes Mr. Jackson’s current state when he hangs up the phone and speaks to you in the scene above?

-Initially Mr. Jackson is, understandably, enormously depressed. He eats very little the first eight days of hospitalization, consuming, on average, half of a small yogurt smoothie twice a day, but only because he is pressed to do so. You also note that he is gentle and passive with everyone, even quietly teasing or joking a little, but he does not cry or grieve overtly, although several times when you have entered his room unexpectedly, you see signs that he has been weeping in silence. What is your primary nursing goal these first few days after the accident?

-One year later, Mr. Jackson comes by with his daughter, bringing flowers and a letter of appreciation for all who helped him recover after his accident. He tells you he is seeing a specialist who works with him to reinforce adaptive coping resources. “I’m not over what happened, of course,” he says, “but I’m functioning well, and therapy has helped me get some solid adaptive coping mechanisms. I’ve worked hard to get to this point, especially for my daughter’s sake. My nurse practitioner says it’s all about building to my ‘optimal level of wellness’ now.” What is likely the focus of Mr. Jackson’s psychiatric nurse practitioner’s patient assessment? Original posts must be at least 350 words.

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