XvSim StandaloneXTime: 1000oint.lww.com/titles/9781975 198183/classes/687f62f6-68e7-4b65-aba0-460a00fb0baf/assignmentsLocation: Medical area (infirmary) in a jail+Report from intake coordinator:Situation: The patient, Sandra Littlefield, is a 36-year-old female who has been in jail for the past week on prostitutioncharges. She has a history of back pain and being given acetaminophen and ibuprofen. She is complaining of unrelievedpain and has put in a request to see the nurse.Background: Sandra Littlefield has a diagnosis of borderline personality disorder. She has been compliant during thisincarceration but has a history of aggressive behavior during past incarcerations. She was sexually abused as a child andhas been hospitalized for suicide attempts in the past, as well as for complications from her struggles with at-risksubstance use. Her history of back pain has resulted in frequent emergency room visits. During her prior two visits to thenurse at the jail, she was given acetaminophen and ibuprofen for pain.Assessment: Sandra was examined by the provider 3 days ago. She was alert and oriented, and her vital signs were asfollows: temperature 37°C (98.6°F), heart rate 84 beats/min, respiratory rate 16 breaths/min, blood pressure 132/80mmHg, and SpO2 98%. A physical examination of her back revealed no physical problems, and an MRI of her back,included in the patient chart, was negative. She receives ibuprofen 600 mg every 8 hours and was given both ibuprofen600 mg and acetaminophen 1000 mg at 8 a.m.Recommendation: The provider has asked us to avoid focusing too much on the physical complaints and instead try tohelp her with coping strategies for pain management, and to complete a mental status examination. Also, she wouldbenefit from boundaries and limit setting.A ☆ana▲▲WW30DownloadsvSim2.0 MentarOpen fileName.docxOpen fileName collette CenOpen fileOpen fileStep 1 IntroductionOpen fileName of patient.docxOpen filevSim2.0 Mental Health COpen filevSim2.0 Mental Health DaOpen filevSim2.0 Mental Health DavieOpen filevSim2.0 MentalHealth_DavidCOpen fileStep 1 Therapeutic Class for TemOpen file72331959869_1991839A-367F-4 -) Protected View - Saved VW View Helpyou need to edit, it's safer to stay in Protected View. Enable Editinge disabled.ReactivateSearchMental Health Case: Sandra LittlefieldDocumentation Assignments1. Document your findings related to the focused assessment of Sandra Littlefield's coping strategies. Include herresponses to your assessment.2. Document all patient teaching regarding coping strategies and cognitive restructuring techniques provided to SandraLittlefield. Include her response to the teaching.3. Referring to your feedback log, document all nursing care provided and Sandra Littlefield's response to this care.Document all interventions associated with boundary and limit setting directed toward managing Sandra Littlefield'smanipulative behavior.4.5. Document examples of Sandra Littlefield's statements that shows she views the world in a polarized, extreme way(i.e., individuals are either all good or all bad), and include interventions implemented to respond appropriately.6. Document your handoff report in the SBAR format to communicate Sandra Littlefield's future needs.LQ Search

The documentation assignments focus on assessing and documenting Sandra’s coping strategies, teaching her about these strategies and cognitive restructuring techniques, documenting the nursing care provided and her response to it, documenting interventions related to boundary and limit setting, documenting examples of Sandra’s polarized worldview and the interventions implemented in response, and finally, documenting a handoff report in the SBAR format to communicate Sandra’s future needs.Answer 1: Focused assessment of Sandra’s coping strategies: Sandra reported using distraction techniques such as reading and deep breathing exercises to manage her pain. In any case, she communicated frustration with the persistent nature of her back torment and expressed that these procedures were not continuously effective.Answer 2: Patient teaching regarding coping strategies and cognitive restructuring techniques: Sandra was educated on additional coping strategies such as progressive muscle relaxation and guided imagery. She was also introduced to cognitive restructuring techniques to help her manage negative thoughts. Sandra was receptive to learning these new strategies and techniques and expressed a willingness to try them.Answer 3: Nursing care provided and Sandra’s response: Sandra was provided with regular nursing care, including medication administration and monitoring of her vital signs. She was cooperative during these interactions and reported a slight improvement in her pain after taking her medication.Answer 4: Interventions associated with boundary and limit setting: Given Sandra’s history of manipulative behavior, clear boundaries and limits were set regarding acceptable behavior and the use of the call light. Sandra was informed of these boundaries and the consequences of not adhering to them.Answer 5: Examples of Sandra’s polarized worldview and interventions implemented: Sandra made several statements indicating a polarized worldview, such as “All the officers here are out to get me.” In response, therapeutic communication techniques were used to challenge these beliefs and encourage a more balanced perspective.Answer 6: Handoff report in SBAR format: The handoff report would include Sandra’s situation (current complaints and diagnoses), background (medical history and recent changes), Assessment (current condition and any recent changes), and Recommendation (suggested actions or needs moving forward).In summary, the nursing care for Sandra Littlefield involved assessing and teaching coping strategies, providing routine care, setting boundaries, addressing her polarized worldview, and communicating her status and needs in a handoff report. Sandra was responsive to these mediations, which were aimed at managing her torment, tending to her mental health needs, and guaranteeing a secure and helpful environment.