Assessment
What subjective cues from Kyle story indicates concern?
"Feels safer in his room”
“Does not need friends”
“What’s the point of being alive?”
Reports fatigue and shortness of breath with mild exertion
Feels angry, rejected, and embarrassed
From your assessment what are some of the potential nursing diagnosis that can apply to Kyle ?
risk of self harm, ineffective coping, risk for imbalanced nutrition, social isolation, low self-esteem, activity intolerance
What are the immediate priorities for kyle?
Kyle’s safety, emotional support and active listening, notify mother and collaborate with her about mental health care
What nursing interventions can be put in place immediately to ensure Kyle safety and wellbeing
suicide risk assessment, nonjudgmental environment to express feelings, encourage physical activity, monitor diet and educate better nutrition choice, educate mother about signs of depression
How would you evaluate if the short and long term goals are met?
Short-term: attends school more often, eats healthier, fewer negative thoughts, exercise regularly, connects with peers
Long-term: happier mood, no suicidal thoughts, healthier BMI, better social relationships.
What objective data can be collected by the nurse?
Age, BMI, Diet, Physical activity, Behaviours, School performance, Vital signs
Which of these diagnosis would be top priority and why?
risk for self harm, SAFETY!
What are some short term goals that can help address kyle physical and emotional health needs?
express his feelings, talk to one trusted adult, attend school regularly for a week, one balanced meal per day, exercise/walk for 10–15 minutes of physical activity daily.
How can nurses promote mental health and build coping strategies for kyle
stress-reduction techniques, identify supportive adults and positive outlets, build self-esteem through achievable goals, active listening, therapeautic communication
What would indicate an improvement in his physical health
lower BMI, more physical exercise, better diet, better lab results
What factors in Kyle environment and personal life might be contributing to his current behaviours ?
Parental absence, Bullying at school, Community resources, Diet, Sedentary lifestyle, family stress, lack of peer support
How is mental and physical health diagnosis interconnected to Kyle case?
Obesity and social isolation/sadness, go hand in hand because emotional distress can cause overeating and inacitivity and obesity causes decreased self-esteem and social isolation. Poor eating causes reduced energy, mood
What are some long term goals that can support sustainable change ?
Develop healthy coping strategies for managing stress and bullying, achieve a healthy weight and improved exercise, one strong positive social connection, no suicidal thoughts for 6 months.
What community resources or programs can help
Youth mental health programs, school counselor, nutrition programs, physical activity programs
What would indicate improvement in his emotional and social status
Positive mood, higher self-esteem, participates in activities, makes friends, less negative ways of expressing emotions
What other assessments should be considered?
Mental health assessment, physical exam, nutrition assessment, sleep patterns, family dynamics
How does the bullying and social isolation influence his emotional and physical outcomes
Leads to low self-worth, depression, and anger, triggers stress hormones, promotes avoidance of physical and social activities,
How can nurses collaborate with others to create multidisciplinary plan of care?
nurse, psychologist or counselor, dietitian, physician, school staff, social worker
How can nurses help with educate the mother about healthy lifestyle changes while also taking into consideration of her constraints
simple nutrition meal ideas, meal prepping, open communication with Kyle, connect with support groups for single parents, social work
If Kyle condition does not improve, what might disrupt the professm and how can the plan be reviewed and changed
Reassess for new stressors or barriers, review care plan and modify, adjust goals and look for better indivdualized support ways
What social determinants of health affect Kyle wellbeing?
economic stability, access to healthy food, education environment, social support, neighbourhood safety, healthcare access
How would describe a patient diagnosis without being judgemental and negative? (ex. Focus on pt, strengths, instead of sounding blaming)
Instead of saying “obese, lazy, or noncompliant,” say:
How can the plan incorporate kyle interests to promote his engagement?
What strategies can the nurse use to communicate with kyle
calm, empathetic tone, active listening, no judging, open-ended questions, validate emotions
How can nurses reflect on their own approach to make sure of culturally component, compassionate, non-judgmental care
practice cultural sensitivity, understanding Kyle’s family situation and stressors, nonjudgmental, compassionate communication, reflect on personal biases, focus on empathy and empowerment, not blame.