Posted: December 3rd, 2022
Care and disaster management plan
Nursing care plan
The project has identified the aggregate as RISE program participants from Albany in Georgia. This population of interest comprises of opiate addicts who are seeking treatment for the addiction. Opiates are identified to include Oxycodone, Morphine, Methadone, Codeine, and Heroin. The first step in the care plan is the patient diagnosis. In this case, opiate addiction would be defined as the constant and unending need for opiates even when it causes the patient to have serious economic, social, psychological and/or physical harm and consequences that include a loss of control over the opiate use and abuse. It is important to note that a diagnosis for opiate addiction can occur with or without physical dependence. Also, the patient would be subjected to standardized tests to assess addiction and recovery. These tests include CAGE-AID Test, Recovery Attitude and Treatment Evaluation, Addiction Severity Index, and Drug Abuse Screening Test (Sperry, 2016; Wheeler, 2014).
Notable features in the diagnosis are psychological dependence and physical dependence. Psychological dependence refers to the continued use of opiates to avoid unpleasant experiences and occur that could occur if the opiate is not taken. Physical dependence ensues if ceasing to use the opiate causes adverse physical effects that could be heightened if the cessation is abrupt and rapid. As previously indicated, physical dependence is not necessarily an indication of opiate addiction; since addiction could be present with or without any physical dependence (Sperry, 2016).
An important aspect of the patient diagnosis is the client assessment for opiate dependencies, toxicities, withdrawal, and other related risk factors. Some of the notable risk factors include a vulnerability to peer pressure, present of a psychiatric disorder, proneness to self-medication, risk-taking tendencies, unsuccessful life, poor pain tolerance, and low self-esteem. The general physical symptoms and signs identified during diagnosis include poor health state, cool and moist hands, shakiness, poor hygiene, and hyperactivity. The general behavioral symptoms and signs include poor attention span, drug seeking behaviors, possession of opiates and associated paraphernalia, problems with law enforcement, school and other social institutions, poor work performance, forgetfulness, low tolerance for frustration, and irritability (Sperry, 2016).
The symptoms and signs of opiate addiction, use and abuse that the nurse would be keen on include piloerection (goose bumps), diarrhea, spasms, muscular pain, tremors, diaphoresis, poor attention span, memory loss, slurred speech, sedation, euphoria, confusion, impaired gait and coordination, and pupil constriction. The withdrawal symptoms and signs for opiates include dilated pupils, weakness, muscular spasms, dysphoria, perspiration, loss of appetite, vomiting, nausea, fever, insomnia, and piloerection (Sperry, 2016).
Once the patient has been diagnosed with opiate abuse and/or addiction condition, the next step is to conduct treatment. The first treatment approach is pharmacotherapy whereby antipsychotic medication are prescribed to manage the symptoms. These medication restore the brains natural chemical balance to eliminate or reduce the psychotic symptoms. The second treatment approach is supportive psychosocial interventions that are used as adjuncts to the psycho-education programs and pharmacotherapy. They are intended to reduce relapse, improve medication adherence, quality of life and social functioning, and alleviate residual symptoms. They include individual and group approaches (Sperry, 2016).
An important consideration when offering nursing treatment for opiate addiction is the presentation of opioid withdrawal syndrome, an uncomfortable and distressing but typically not life-threatening experience for the patient. It occurs when opiates intake is stopped or markedly decreased. The symptoms for syndrome typically include nausea, muscle cramps, joint aches, irritability, gooseflesh, pupillary dilation, feeling tired, poor sleep, depression (dysphoria), perspiration, diarrhea, yawning, vomiting, runny nose, runny eyes, and restlessness. Three of medication can be prescribed for the syndrome. Firstly, Methadone that is prescribed to prevent the withdrawal symptoms through decreasing opioid craving, relieving pain, and blocking ‘highs’ if the opioid is substituted. It helps in detoxification and maintenance of abstinence. Secondly, Buprenorphine that is prescribed to prevent the withdrawal symptoms. It blocks ‘highs’ if opioid is substituted. It acts as a pain medication and reduces opioid craving. Thirdly, Naltrexone that is prescribed after the patient has completely withdrawn from the opiate since taking it alongside opiates could precipitate the withdrawal syndrome. It helps with detoxification and maintaining abstinence. The three medication are supplemented by counseling to improve outcomes (Sperry, 2016; Wheeler, 2014).
In addition, nursing diagnoses will be conducted for anxiety, sleep deprivation, and imbalanced nutrition as existing concerns. The nursing diagnosis for anxiety would identify feelings of apprehension caused by anticipation of danger among the patients. The nursing assessment would be conducted for presence of culture-bound anxiety states, level of anxiety, influence of cultural values and beliefs, coping techniques, and physical reactions. Nursing interventions would focus on awareness, supportive environments, interactions, conversations, and reducing sensory stimuli (Wayne, 2019a). The nursing diagnosis for sleep deprivation would identify disruptions in the quality and amount of sleep. Nursing assessment would note sleep patterns and circumstances hindering sleep. Nursing interventions would focus on helping patients to obtain optimal amounts of sleep as evidenced by improved sleep patterns, and rested appearance (Wayne, 2019c). The nursing diagnosis for imbalanced nutrition would identify the patient’s nutritional status and if nutrient intake is less than the body requirements. Nursing assessment would note the patient’s weight, nutritional history, relevant etiological factors, review laboratory values, and check physical signs. The nursing intervention would offer nutritional support (Wayne, 2019b).
Disaster management plan
The geographical location of the aggregate is Albany, Georgia. A review of the natural disasters that have occurred in the location reveal that it has a high probability of experiencing tornadoes. In fact, its tornado index is reported at 221.78, a figure that is higher than the Georgia State average at 179.92 and the US national average at 136.45. This implies that the risk of tornado damage is higher in Albany when compared to the state average and national average. In fact, the location has experienced 82 tornado events with magnitude of 2 or higher in the period between 1951 and 2007. These events have resulted in 42 fatalities and property damage approximated at $250 million. Other natural disasters of significance to the area are thunderstorm winds, hail and floods of which 1,174, 368 and 96 events (respectively) were recorded from 1950 to 2010 within 50 miles of Albany (World Media Group, 2020).
It is evident that Albany has a higher risk of experiencing tornadoes and hail than any other natural disaster since they have occurred with the highest frequency from 1950. Strategies for handling these disasters would be presents from two perspectives. The first perspective is preparedness involving continuously planning, equipping, training and exercises. Planning for the two disasters entails identifying places in which to take shelter, familiarizing with and monitoring the warning system systems, and establishing procedures to account for individuals in case the disasters occur. Underground locations are preferred for sheltering (such as storm cellars and basements) since they offer the best protection. In addition, there is a need to implement accountability procedures presented as warning systems to ensure that aggregate remains safe in case the disasters occur. Two warning systems are typically used. Firstly, a watch system that requires the aggregate to closely monitor media stations (television and radio) for information on the disaster progress so that they are able to take shelter prior to occurrence, and can check for supply kits. Secondly, a warning system that offers information on an imminent threat if the disaster has been sighted or indicated through radar with the aggregate expected to immediately take shelter (Occupational Safety and Health Administration, 2020).
Equipping activities involve getting emergency supplies kits and keeping them in shelter locations. The recommended items for the kit include cellphones with chargers and backup batteries, local maps, manual can opener, wrench for utilities, personal sanitation items, dust masks, signal whistle, first aid kit, flashlight, battery powered radio, food and water. In addition, prescription and non-prescription medication should be stocked to include laxatives, antidiarrheal medication, and pain relievers (Occupational Safety and Health Administration, 2020).
Training and exercises activities involve ensure that the aggregate know what to do in case of an emergency. In addition, it requires regularly practicing for shelter-in-place plans, and updating procedures and plans based on lessons learned from the exercises (Occupational Safety and Health Administration, 2020).
Occupational Safety and Health Administration (2020). OSHA: Tornado preparedness and response. References https://www.osha.gov/dts/weather/tornado/preparedness.html
Sperry, L. (2016). Handbook of diagnosis and treatment of DSM-5 personality disorders: assessment, case conceptualization, and treatment (3rd ed.). New York, NY: Routledge.
Wayne, G. (2019a). Anxiety. Retrieved from https://nurseslabs.com/anxiety/
Wayne, G. (2019b). Imbalanced nutrition: less than body requirements. Retrieved from https://nurseslabs.com/imbalanced-nutrition-less-body-requirements/
Wayne, G. (2019c). Insomnia. Retrieved from https://nurseslabs.com/insomnia/
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: a how-to-guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company, LLC.
World Media Group (2020). Albany, GA natural disasters and weather extremes. Retrieved from http://www.usa.com/albany-ga-natural-disasters-extremes.htm
Instructions Developing a Care Plan Last week, you conducted a risk assessment to identify the health risks faced by the aggregate you selected. This week, begin working on a comprehensive care plan for the aggregate. The care plan should propose a nursing diagnosis for the aggregate and include strategies to tackle the major health risks identified during the risk assessment. In addition, it should include a disaster management plan with the following components: List of disasters that might affect your aggregate (take into consideration the geographical location of the aggregate, past history, etc.) Strategies for handling at least two disasters from the list. Recommendation for a disaster supplies kit. (Project Recap: Propose a nursing diagnosis and suggest interventions that address the major health risks identified from the risk assessment. In your care plan, include a list of disasters that may affect the aggregate and a disaster management plan.) Submission Details: Your comprehensive care plan should be in a 4- to 5-page Microsoft Word document and name your document. SU_NSG4076_W6_Project_LastName_FirstInitial.doc. Submit your document to the Submissions Area by the due date assigned. Support your responses with examples. Cite all sources in APA. (I have attached a copy of last weeks Risk Assessment and any other documentation you may need. Please let me know if you have any questions.)
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