In: Nursing
Client Profile
Betty, a 50-year-old woman, came to this country with
her parents when she was 7 years old. The family members worked as
migrant farmworkers until they
had enough money to open a restaurant. Betty married young. She and
her husband worked in the family restaurant and eventually bought
it from the parents.
They raised seven children, all grown and living on their own.
Betty and her husband live in a mobile home close to the
restaurant. She does not work in the family
restaurant anymore because she worries excessively about doing a
poor job. Betty no longer goes out if she can help it. She stays at
home worrying about how she
looks, what people think or say, the weather or road conditions,
and many other things. Betty is not sleeping at night and keeps her
husband awake when she roams
the house. She keeps her clothing and belongings in perfect order
while claiming she is doing a poor job of it. She does not prepare
large family dinners anymore,
though she still cooks the daily meals; one daughter has taken over
the family dinners. This daughter has become concerned about Betty
being isolated at home and
worrying excessively and calls the community mental health center
for an appointment for Betty.
Case Study
Betty presents at the community mental health center
accompanied by her husband, her children and their spouses, several
grandchildren, and a few cousins.
When Betty's name is called and she is told that the nurse is ready
to see her, she frowns and says: "What will I say? I don't know
what to say. I think my slip is showing. My hem isn 't straight."
Betty says she wants her whole family to go in to see the nurse
with her. The nurse notices that Betty is extremely well-groomed
and dressed in spite of concerns she has been voicing about her
appearance. Before the psychiatric nurse interviews Betty alone,
she hears from the daughter that Betty "worries all the time" and
although she has always been known to be a worrier, the worrying
has become worse over the past six or eight months. The husband
shares that his wife is keeping him awake at night with her
inability to get to sleep or stay asleep. The nurse interviews
Betty alone. The nurse notices that Betty casts her eyes downward,
speaks in a soft voice, does not smile, and seems restless as she
taps her foot on the floor, drums her fingers on the table, and
seems on the verge of getting out of her chair. Themes in tl1e
interview include: being tired, getting tired easily, not being
able to concentrate, not getting work done, trouble sleeping,
worrying about whether her husband loves her anymore and whether
she and her husband have enough money, and not having the energy to
attend to the housework or her clothing. The nurse has the
impression that Betty's anxiety floats from one worry to another.
There is no convincing Betty that she looks all right. Any attempt
to convince her that she need not worry about something, in
particular, leads to a different worry before coming back to tl1e
earlier worry. The community mental health psychiatrist examines
Betty and, after a thorough physical examination and lab studies,
finds nothing to explain her fatigue and difficulty sleeping other
than anxiety. Betty produces her medicine bottles and says she is
currently taking only vitamins, hormone replacement, and calcium.
The psychiatrist asks the nurse to contact Betty's family health
care provider to get information on any medical or psychiatric
conditions he is treating her for; the report comes back that she
has no medical diagnoses and the family health care provider thinks
she suffers from anxiety. The psychiatrist prescribes buspirone
(BuSpar) for Betty. Two weeks later, during a home visit to Belly,
the nurse learns, with some probing, that Betty is upset with her
husband for loaning all their savings to the daughter and her
husband to build a new home, while they continue to live in an
older mobile home. At the end of the n nurse's home visit, Betty's
daughter arrives and tells the nurse that she wonders iI Betty is
making any progress. Betty also worries she is not getting better
and asks the nurse about taking some herbal medicines containing
Kava and Passaflora that her sister got from a curandara (folk
healer); her sister wants to take her to see the curandara and have
her do a ritual to cure the evil eye
that was placed on Betty and made her sick.
Can You help me write an SBAR for this case study Thank You
We have tried to explain you SBAR format for the given case in the above image.
S stands for situation, B for background, A for assessment and R for recommended treatment.
I hope our explanations are easy to understand. If you like them, encourage us by giving thumbs up.