How would you use therapeutic communication and principles of cognitive behavioral therapy with the client?
Describe your assessment process. What are some likely co-morbid conditions? List one nursing diagnosis and an appropriate nursing intervention.
What interdisciplinary referrals might be appropriate?
Please make an initial post by midweek, and respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation.
NUR2488
Module 07 Borderline Personality Disorder Case Study
S.is a 48-year-old
divorced woman with one adult daughter and three grandchildren. She is
currently working as an LPN part-time in a nursing home and works at a
convenience store one or two days per week. She has had many jobs over the last
22 years, usually changing every one or two years to a new job. S notes that
she has been called less often to work in the convenience store and worries
that they don’t like her anymore. She reports being written up several times
for arguing with customers. She also reports that she liked her supervisor at;
first; she says, “Now I hate her; she’s trying to get me fired.” S. reports
that she has tried to get full-time jobs five times in the last four years was
hired for three but only lasted one or two weeks at each one.
S. reports
that she is currently not talking to her daughter because “she is mean to me
and she needs to apologize, or I won’t talk to her again.” She is upset that
she hasn’t seen her three small grandchildren in about a year. She sends them
presents and cards frequently that say “I still love you! Grandma” but hasn’t
called them since she stopped talking to her daughter. She is considering
reporting to the county that her daughter is keeping her grandchildren from
her.
S. is very
unhappy that she isn’t in a relationship. She was abused by her ex-husband and
had a pattern of meeting and dating men who eventually abused her. She states
that her last relationship was very good; the man was not abusive, and “I loved
him very much.” The relationship ended for reasons that S. doesn’t understand.
However, she does report many arguments that ended in “scenes,” such as her
throwing chairs, stomping out of the house, making crank phone calls to his
family, and calling the police with false reports. But S. also reports that she
“couldn’t have loved him more, and I showed it.” She gives examples of going to
her boyfriend’s place of work with flowers, buying him expensive presents,
surprising him with tickets to Mexico at the last minute – she was very upset
that he wasn’t willing to drop everything and go with her. S. reports asking
him why he didn’t love her and what she was doing wrong regularly. When the
boyfriend asked to break up, S. reported sitting outside his house for weeks,
crying; she called his mother, called his boss, and called and texted him until
he filed a restraining order. This occurred about four months ago.
S. admitted herself to the mental health unit when she felt
suicidal. She reports that she had stopped her psychotherapy three months ago
and stopped going to DBT. She also stopped her anti-depressant at that time, as
she felt it wasn’t working, and missed her last two psychiatrist appointments.
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