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Nursing 265 (Sexuality)- Hesi Case Study Answered Perfectly!!

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NURSING 265 (SEXUALITY)- HESI CASE STUDY ANSWERED PERFECTLY!!

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NURSING 265 (SEXUALITY)- HESI CASE STUDY ANSWERED
PERFECTLY!!
It is 8:30 AM. You are a nurse working first shift on a Chemical Dependency Unit.
Twenty-two-year-old Delena Johnson is one of your patients today. Delena was
admitted at 7:30 AM, accompanied by a social worker. She has a two year history
of heavy cocaine use.


Delena is separated from her husband, but has custody of three young children,
who are now in foster care. Her youngest child (age six months) was treated as a
crack baby.Delena is unemployed. She reports no family in the area and has no
support system, noting "all my friends are drug users." She has attempted
outpatient treatment twice previously.Delena is acting angry, although she initiated
her own admission.


After introducing yourself, you collect the following initial assessment data:-
weight 54.5 kg (120 pounds), height 170 cm (5 feet 7 inches), BP 120/70, heart
rate 70, R 18- states has not eaten in two days- states has not slept in three days-
smokes


Answers :"Have you been using any other drugs?"


Delena will experience withdrawal symptoms. It is important to know about any
and all drugs that she has been using, including alcohol, so that related withdrawal
symptoms can be anticipated. Assessments and interventions related to anticipated
withdrawal symptoms should be integrated in Delena's care plan.
Delena denies having used any other drugs recently, including alcohol. She reports
that she last used cocaine early this morning, prior to her admission.


What physical signs and symptoms might you expect Delena to exhibit, knowing
that she used crack cocaine a few hours ago?

, Answers :-Dyspnea
-Nausea and vomiting


Dyspnea is a common finding in people who smoke crack. Shortness of breath may
be apparent even during withdrawal from the drug, a result of nasal irritation and
lung damage.
Delena looks fatigued. Cocaine is a stimulant, and Delena has not slept or
eaten.Delena has multiple puncture marks and scarring at both antecubital fossa
and forearms (track marks), a result of injecting cocaine in the past.


After a thorough physical assessment, you document the following:"Pupils equal
and react to light; breathes through mouth but does not have respiratory distress;
coughs frequently; eyes close often; complains of being very tired although
continues to exhibit physically restlessness, observed as frequent leg movement;
bowel sounds normal after ingestion of water; no evidence of nystagmus or
vomiting; denies feeling nauseated."


Delena has been using crack cocaine. Both cocaine and crack cocaine are derived
from the cocoa plant, although they are refined differently. Crack cocaine is faster-
acting and more potent than cocaine. Both cause a brief intense rush that is
followed by 15-20 minutes of e


Answers :-Lethargy
Cocaine is a stimulant. During a cocaine "high," increased alertness occurs.
Lethargy, lack of energy, and apathy typically occur with cocaine withdrawal.
Depression, anxiety, and anger may also be noted as the stimulating effects of
cocaine wear off. You can anticipate that Delena will be depressed, lethargic, and
apathetic during cocaine withdrawal.
-Disturbed sleep
Cocaine is a stimulant. During a cocaine "high," insomnia is common. Withdrawal
is often characterized by a generalized fatigue and need for sleep ("crash"),

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