Question

Mr Smith a 52 year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. The patient has a history of smoking two packs of cigarettes for 35 years, and he drinks a six pack of beer on weekend nights, but does not drink the rest of the week. He is the sole financial support for his family. He is a consultant for a company and is out of town during the week days. Mr Smith has gained 20 pounds. He is 5 foot, 6 inches, weighing 200 pounds. His diet consists mostly of fast foods. He rarely exercise. His wife care for their three teenage children. The eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. Mr Smith developed chest pains and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. The wife is in the waiting room while the nurses settle Mr Smith into his room. The youngest son, 13 years of age, is at a friends house. The teenage daughter is staying at the bedside of the criticall I’ll eldest son. The wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son I’ll.

a. What maladaptive response to stress may have contributed to Mr Smith’s development of an illness

b. Based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family.

C. What nursing interventions should be used to promote effective coping for the patient and his family?

Answer 1

a)Maladaptation means the person is not able to get adjusted to a stressful event and cope.He was not able to discontinue the behavior of smoking or taking alcohol. The biggest maladaptation being his son in critical care and daughter wanting a contraceptive pill at this age,wife's anger on son,guiding daughter in wrong way,and wrong thinking.,trampled car

b)Assess the family history of any medical condition

The family is in a state of denial and not accepting the current situation.How they overcome critical situation. Gathering information on who is there for caring the son admitted in ICU .what the mother done when the daughter wanted a birth control pill.

c) The following intervention has to be done

• Health educate Mr.Smith about the harmful effects of smoking and alcohol
• Healthy food habits to control his overweight
• Encouraging for regular exercise
• Psychological support to him
• Educating the mother about the ill effects of encouraging birth control pill
• Making her aware her son is not the reason for her husband's situation
• She should be encouraged to give a mothers support to her son on priority basis
• The daughter had to be given teen health education