Scenario B – Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five.

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Scenario B – Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five.

Scenario B – Tracey is a 35 year old woman who presents for assessment to the Emergency Mental Health Community Team. She is six months pregnant with her third child. Her other children, to her ex-partner, are aged three and five. Tracey is in a heterosexual relationship with her partner of one year, Peter. Peter moved in to live with Tracey and her children eight months ago. The children’s father is distressed about Peter moving in to live with his children. There is verbal hostility between Tracey and her ex- partner each time he visits to collect the children for a weekend visit. Her expartner frequently states he is making arrangements for court to have full time care of the children. Tracey and her current partner, Peter, are in $35,000 uncontrolled debt after a recent new joint business venture failed. A finance company calls weekly requesting payment. Tracey and her partner stopped making the mortgage repayments three months ago, with the belief that dealing with the uncontrolled debt would be a better option. Her parents are supportive but live in Queensland. Tracey is able to have face to face contact with them once a year. She does chat with her parents over telephone every week if possible. Tracey states she is worried about how she will cope with her two children and new baby. She reports low mood, weekly panic attacks and fleeting thoughts of suicide. During your meeting with Tracey, you note she is fidgety and restless, breathing rapidly, shaking slightly, sweating and tearful. She is not wishing to actively engage with the mental health services, for fear it will impact on her having care of her children, stating she will visit her General Practitioner (GP).

1) Investigate and outline the prevalence/incidence of anxiety (depending on the scenario you have chosen) in Australia – Your answer needs to cover: gender, age groups, specific risk groups, hospitalisations. 225 words

? Please refer to ABS Australia 2007. ( Only Australia statistics)

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2) Using current literature discuss TWO (2) factors that may have contributed to the development of the client’s presentation and mental health concerns. 225 words

? Contributed factors: Child custody issues, financial stress, Verbal hostility with ex husband
3) Using current literature discuss TWO (2) ethico-legal issues related to your scenario.225 words
The Mental Health Act (2007) is the legal construct used predominately for clinical care in the mental health services. Please ensure if you are using the Mental Health Act, you refer to the latest NSW version. However you may also wish to consider legal frameworks around access to health records, storage of health records or privacy. Professional nursing standards or ethics literature may also help guide your thinking.

For example you may wish to consider:

• the professional boundaries around confidentiality
• the use of the mental health act for when safety concerns are noted
• a nurse’s role in assessment and engagement with a client knowing that they may have to activate resources to possibly schedule a person and detain them ( ie remove their freedom) due to concerns about their safety
• You may also consider a person’s right to engage with mental health services when there are actual risks or potential risks to their safety or the safety of others
• The ethics of a nurse taking no action if risks to self are identified or potential risks are noted
• a person’s autonomy and right to choose
• a nurse’s discussion with other health professionals ie. GP
• a nurse’s involvement with family members when risks are noted versus a person’s right to choose no family involvement
• a nurse’s professional and ethical role in child protection matters for risks or potential risks
• non-maleficence; a principle to avoid harm. However assessment and interventions may cause distress to the person and their family
4) Identify TWO (2) nursing/midwifery concerns / problems with evidence from your chosen scenario- Your risk identification should be focused on the next 1-5 days of nursing/midwifery care for your client.100-150 words(USE TABLE)
? Symptoms of anxiety
? Inability to cope
? Fleeting thoughts to suicide
? Reducing engagement in services
? For each nursing / midwifery concern / problem you have identified in Question 4, outline and describe TWO (2) evidence based nursing / midwifery interventions (ie; what you would actually do as a nurse / midwife to support the person and how you would do it). Your interventions should be focused on nursing / midwifery care for your client over the next 1-5 days. They must be interventions which you would actually undertake directly with your client within your role as a nurse. You are also required to provide a clear rationale for each nursing intervention (ie. Why have you chosen the particular nursing interventions? How will the interventions support the person or contribute positively to their current presentation or concern?) Each intervention and rationale must be supported by current literature. 225 words (USE TABLE)


 

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