What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications?

QUESTION

Case Study, Mohr

CHAPTER 39, Clients with Medical Illnesses

In completing the case study, students will be addressing the following learning objectives:

Identify common medical conditions that can have accompanying psychiatric complications or symptoms. Describe general nursing implications for clients experiencing psychiatric disorders that are intertwined with other nonpsychiatric illnesses.

1. Carla, a 27-year-old white single mother of two preschool-age children, is in the psychiatric hospital for treatment of anxiety and depression. Carla has a cardiac condition that requires surgery. Carla is concerned over the financial cost of the surgery and caretakers for her children while she is in the hospital and undergoing rehabilitation. Carla is also worried that she may be unable to continue in her present employment as a salesperson due to the physical demands of this position. Carla’s case is representative of many patients with medical conditions who develop psychiatric symptoms.

(Learning Objectives: 1, 2)

a. What are some prevalent medical conditions that can also be accompanied by psychiatric symptoms or complications?

b.What are some nursing implications for Carla that address both the psychiatric and nonpsychiatric illnesses?

ANSWER

Psychiatric Complications in Patients with Medical Illnesses: A Case Study Analysis

Introduction

In this case study, we examine the story of Carla, a 27-year-old single mother of two preschool-age children, who is currently receiving treatment for anxiety and depression in a psychiatric hospital. Carla’s situation is complicated by a cardiac condition that necessitates surgery. This scenario is representative of many patients who experience psychiatric symptoms in conjunction with their medical conditions. This essay will address two key learning objectives: (1) identifying prevalent medical conditions that can be accompanied by psychiatric symptoms or complications, and (2) outlining nursing implications that encompass both psychiatric and nonpsychiatric illnesses for Carla.

Prevalent Medical Conditions with Psychiatric Symptoms or Complications

Cardiovascular Diseases: Cardiovascular diseases, such as coronary artery disease, heart failure, and arrhythmias, can manifest psychiatric symptoms (De Hert & Vancampfort, 2018). Patients may experience anxiety and depression due to the emotional and physical stress associated with their cardiac condition. Additionally, the fear of potential complications or mortality can further contribute to these psychiatric symptoms.

Endocrine Disorders: Conditions like diabetes, thyroid disorders, and adrenal insufficiency are known to impact mental health. Fluctuating hormone levels and the challenges of managing these chronic illnesses can contribute to psychiatric complications (Mishra et al., 2022). Patients may experience mood swings, anxiety, and depressive symptoms due to the physiological and psychological burden of their endocrine disorder.

Neurological Conditions: Neurological disorders, such as multiple sclerosis, Parkinson’s disease, and stroke, can be accompanied by psychiatric symptoms. The disruption of neural pathways and the impact on daily functioning can lead to anxiety, depression, cognitive impairment, and even psychosis. Furthermore, the fear of progressive disability or cognitive decline may worsen psychiatric symptoms in these patients.

Nursing Implications Addressing Psychiatric and Nonpsychiatric Illnesses for Carla

As Carla’s nurse, it is crucial to approach her care holistically, addressing both her psychiatric and nonpsychiatric illnesses. Here are some nursing implications to consider:

Collaborative Care: Foster collaboration between the psychiatric and medical teams to ensure comprehensive care for Carla. Regular interdisciplinary meetings can facilitate communication, allowing the coordination of treatment plans that address her psychiatric symptoms and cardiac condition simultaneously.

Emotional Support and Education: Provide Carla with emotional support by actively listening to her concerns regarding the financial cost of surgery and childcare arrangements. Offer reassurance and empathetic understanding to alleviate her anxiety (Tomás et al., 2016). Additionally, educate Carla about her cardiac condition, the planned surgery, and the rehabilitation process. Clear and concise information will empower her to make informed decisions regarding her treatment and employment.

Referral to Social Services: Connect Carla with social services or community resources that can assist with financial concerns and childcare options during her hospitalization and rehabilitation period. Collaborating with social workers and case managers can help alleviate the burden and enhance Carla’s ability to focus on her recovery.

Encourage a Support System: Emphasize the importance of building a support system for Carla. Engage her family, friends, or community resources to provide emotional and practical support during her hospitalization and post-surgery period. Having a reliable support network can reduce feelings of isolation and enhance her overall well-being.

Conclusion

Patients like Carla, who face psychiatric symptoms alongside their medical conditions, require a comprehensive approach to their care. By identifying prevalent medical conditions that can be accompanied by psychiatric symptoms and complications, nurses can implement appropriate interventions. The nursing implications discussed in this case study provide a framework for addressing Carla’s psychiatric and nonpsychiatric illnesses simultaneously, optimizing her chances for a successful recovery. By adopting a holistic approach, healthcare professionals can improve patient outcomes and enhance their overall well-being.

References

De Hert, M., & Vancampfort, D. (2018). The intriguing relationship between coronary heart disease and mental disorders. Dialogues in Clinical Neuroscience, 20(1), 31–40. https://doi.org/10.31887/dcns.2018.20.1/mdehert 

Mishra, K., Sawant, N. S., & Garg, S. (2022). Management of psychiatric disorders in patients with endocrine disorders. Indian Journal of Psychiatry, 64(8), 402. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_30_22 

Tomás, C., De Oliveira, E. N. A., Sousa, D., Uba-Chupel, M., Furtado, G., Rocha, C. F. D., Teixeira, A. L., Ferreira, P. G., Alves, C., Gisin, S., Catarino, E. A., Carvalho, N., Coucelo, T., Bonfim, L. F. B., Silva, C., Franco, D. V., González, J., Jardim, H. G., Silva, R. R., . . . Moreira, L. O. (2016). Proceedings of the 3rd IPLeiria’s International Health Congress. BMC Health Services Research, 16(S3). https://doi.org/10.1186/s12913-016-1423-5