Case study Mr C
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the
Health History
and Medical Information
for Mr. C., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the
Critical Thinking Essay
assignment, as instructed below.
Health History and Medical Information
Health History
Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.
Objective Data:
1. Height: 68 inches; weight 134.5 kg
2. BP: 172/98, HR 88, RR 26
3. 3+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:
1. Describe the clinical manifestations present in Mr. C.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite.
References
Whitney, S. GCU. (, 2020). Elimination Complexities.
https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/
#/chapter/3
Whitey, S. (2018). Elimination Complexities. In Pathophysiology: Clinical Applications for Client Health. Grand Canyon University (Ed.). https://lc.gcumedia.com/nrs410v/pathophysiology-clinical-applications-for-client-health/v1.1/
Read “Estimated Glomerular Filtration Rate Decline and Risk of End-Stage Renal Disease in Type 2 Diabetes,” by Megumi et al., from PLOS ONE (2018).
URL:
https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=131037700&site=eds-live&scope=site
Read “Facts About Chronic Kidney Disease,” from the A to Z Health Guide (2017), located on the National Kidney Foundation website.
URL:
https://www.kidney.org/atoz/content/about-chronic-kidney-disease
Read “Acute Kidney Failure,” located on the Mayo Clinic website.
URL:
https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048
Read “Kidney Failure (Symptoms, Signs, Stages, Causes, Treatment, and Life Expectancy),” by Wedro, located on the MedicineNet website.
URL:
https://www.medicinenet.com/kidney_failure/article.htm
Rubic_Print_Format
| Course Code | Class Code | Assignment Title | Total Points | |||||||
| NRS-410V | NRS-410V-O500 | Case Study: Mr. C. | 120.0 | |||||||
| Criteria | Percentage | Unsatisfactory (0.00%) | Less Than Satisfactory (75.00%) | Satisfactory (79.00%) | Good (89.00%) | Excellent (100.00%) | Comments | Points Earned | ||
| Content | 80.0% | |||||||||
| Clinical Manifestations of Mr. C. | 10.0% | Clinical manifestations are omitted. | Clinical manifestations are partially presented. There are major omissions and inaccuracies. | Clinical manifestations are summarized. An overview of the general symptoms is presented. Some findings are incomplete. | Subjective and objective clinical manifestations are described. Overall, the clinical manifestations are accurate and reflect observed and perceived signs and symptoms. | Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms. | ||||
| Potential Health Risks for Obesity and Bariatric Surgery | Potential health risks for obesity and whether bariatric surgery is an appropriate intervention are not discussed. | A partial summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are major inaccuracies. More information is needed. No evidence or rationale is provided to support discussion. | A summary on the potential health risks for obesity and whether bariatric surgery is an appropriate intervention is presented. There are some inaccuracies. More evidence or rationale is needed to support discussion. | A discussion on the potential health risks for obesity is presented. A discussion on whether bariatric surgery is an appropriate intervention is presented but needs some evidence or rationale for support. | A detailed discussion of the potential health risks for obesity is presented. A through and compelling discussion on whether bariatric surgery is an appropriate intervention is presented. The discussion is well-developed and supported by evidence and additional rationale. | |||||
| Functional Health Patterns | 1 | 5.0% | Actual or potential problems based on the assessment of functional health patterns of the patient are omitted or are irrelevant for the patient and his condition. The overall criteria for this assignment are not met. | At least four actual or potential problems identified from the functional health patterns are presented. The identified problems are not entirely relevant for the patient and his condition. Rationale or evidence is required for support. | At least five actual or potential problems identified from the functional health patterns are summarized. The identified problems are generally relevant for the patient and his condition. Some rationale and evidence is required for support. | Five or more actual or potential problems identified from the functional health patterns are discussed. The identified problems are relevant for the patient and his condition. Overall, the discussion is supported by rationale and evidence. Some detail is needed for clarity or accuracy. | Five or more actual or potential problems identified from the functional health patterns are discussed. The discussion is insightful, and the identified problems are highly relevant for the patient and his condition. The discussion is well-supported by rationale and evidence. | |||
| Staging and Contributing Factors of End-Stage Renal Disease (ESRD) | Staging and contributing factors for ESRD are omitted or inaccurate. | Staging of ESRD is partially summarized. The contributing factors for ESRD are vague. There are inaccuracies. | The staging of ESRD and the contributing factors for ESRD are generally explained. Some information is required; there are minor inaccuracies. | The staging of ESRD and the contributing factors for ESRD are explained. Some information or detail is needed for clarity or detail. | The staging of ESRD and the contributing factors for ESRD are explained. The information is accurate and reflects contemporary practice and research. | |||||
| Health Promotion and Prevention for ESRD | 20.0% | Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is omitted. | Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is partially summarized. There are inaccuracies. Some aspects are not relevant for the patient and his health status. | Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is generally described. There are minor inaccuracies. Overall, the proposed items are relevant for the patient and his health status. Some evidence and rationale are needed to support the discussion. | Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is described. The proposed items are relevant and appropriate for the patient and his health status. Evidence and rationale generally support the discussion. | Patient education for the prevention of future events, health restoration, and avoidance of deterioration of renal status is thoroughly described. The proposed items are clearly presented and highly relevant and supportive of patient and his health status. Strong evidence and rationale generally support the discussion. | ||||
| Resources for ESRD Patients for Nonacute Care and Multidisciplinary Approach | Types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, are not discussed. | An incomplete explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are major inaccuracies. | A general explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. There are minor inaccuracies. Some additional information is required. | An explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. Some detail is required for clarity. | A clear and detailed explanation on the types of resources available for ESRD patients for nonacute care, and the beneficial types of multidisciplinary approaches, is presented. The explanation demonstrates insight into both resources and multidisciplinary approaches for nonacute care for ESRD patients. | |||||
| Organization, Effectiveness, and Format | ||||||||||
| Thesis Development and Purpose | Paper lacks any discernible overall purpose or organizing claim. | Thesis is insufficiently developed or vague. Purpose is not clear. | Thesis is apparent and appropriate to purpose. | Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. | Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. | |||||
| Argument Logic and Construction | Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. | Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. | Argument is orderly but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. | Argument shows logical progression. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. | Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. | |||||
| Mechanics of Writing (includes spelling, punctuation, grammar, language use) | Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. | Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. | Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. | Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. | Writer is clearly in command of standard, written, academic English. | |||||
| Paper Format (use of appropriate style for the major and assignment) | 2.0% | Template is not used appropriately, or documentation format is rarely followed correctly. | Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. | Appropriate template is used. Formatting is correct, although some minor errors may be present. | Appropriate template is fully used. There are virtually no errors in formatting style. | All format elements are correct. | ||||
| Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) | 3.0% | Sources are not documented. | Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. | Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. | Sources are documented, as appropriate to assignment and style, and format is mostly correct. | Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. | ||||
| Total Weightage | 100% |
Running head: GUIDED IMAGERY AND PROGRESSIVE MUSCLE RELAXATION
2
12
Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy
Hannah K. Greenbaum
Department of Psychology, The George Washington University
PSYC 3170: Clinical Psychology
Dr. Tia M. Benedetto
October 1, 2019
Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy
A majority of Americans experience stress in their daily lives (American Psychological Association, 2017). Thus, an important goal of psychological research is to evaluate techniques that promote stress reduction and relaxation. Two techniques that have been associated with reduced stress and increased relaxation in psychotherapy contexts are guided imagery and progressive muscle relaxation (McGuigan & Lehrer, 2007). Guided imagery aids individuals in connecting their internal and external experiences, allowing them, for example, to feel calmer externally because they practice thinking about calming imagery. Progressive muscle relaxation involves diaphragmatic breathing and the tensing and releasing of 16 major muscle groups; together these behaviors lead individuals to a more relaxed state (Jacobson, 1938; Trakhtenberg, 2008). Guided imagery and progressive muscle relaxation are both cognitive behavioral techniques (Yalom & Leszcz, 2005) in which individuals focus on the relationship among thoughts, emotions, and behaviors (White, 2000).
Group psychotherapy effectively promotes positive treatment outcomes in patients in a cost-effective way. Its efficacy is in part attributable to variables unique to the group experience of therapy as compared with individual psychotherapy (Bottomley, 1996; Yalom & Leszcz, 2005). That is, the group format helps participants feel accepted and better understand their common struggles; at the same time, interactions with group members provide social support and models of positive behavior (Yalom & Leszcz, 2005). Thus, it is useful to examine how stress reduction and relaxation can be enhanced in a group context.
The purpose of this literature review is to examine the research base on guided imagery and progressive muscle relaxation in group psychotherapy contexts. I provide overviews of both guided imagery and progressive muscle relaxation, including theoretical foundations and historical context. Then I examine guided imagery and progressive muscle relaxation as used on their own as well as in combination as part of group psychotherapy (see Baider et al., 1994, for more). Throughout the review, I highlight themes in the research. Finally, I end by pointing out limitations in the existing literature and exploring potential directions for future research.
Guided Imagery
Features of Guided Imagery
Guided imagery involves a person visualizing a mental image and engaging each sense (e.g., sight, smell, touch) in the process. Guided imagery was first examined in a psychological context in the 1960s, when the behavior theorist Joseph Wolpe helped pioneer the use of relaxation techniques such as aversive imagery, exposure, and imaginal flooding in behavior therapy (Achterberg, 1985; Utay & Miller, 2006). Patients learn to relax their bodies in the presence of stimuli that previously distressed them, to the point where further exposure to the stimuli no longer provokes a negative response (Achterberg, 1985).
Contemporary research supports the efficacy of guided imagery interventions for treating medical, psychiatric, and psychological disorders (Utay & Miller, 2006). Guided imagery is typically used to pursue treatment goals such as improved relaxation, sports achievement, and pain reduction. Guided imagery techniques are often paired with breathing techniques and other forms of relaxation, such as mindfulness (see Freebird Meditations, 2012). The evidence is sufficient to call guided imagery an effective, evidence-based treatment for a variety of stress-related psychological concerns (Utay & Miller, 2006).
Guided Imagery in Group Psychotherapy
Guided imagery exercises improve treatment outcomes and prognosis in group psychotherapy contexts (Skovholt & Thoen, 1987). Lange (1982) underscored two such benefits by showing (a) the role of the group psychotherapy leader in facilitating reflection on the guided imagery experience, including difficulties and stuck points, and (b) the benefits achieved by social comparison of guided imagery experiences between group members. Teaching techniques and reflecting on the group process are unique components of guided imagery received in a group context (Yalom & Leszcz, 2005).
Empirical research focused on guided imagery interventions supports the efficacy of the technique with a variety of populations within hospital settings, with positive outcomes for individuals diagnosed with depression, anxiety, and eating disorders (Utay & Miller, 2006). Guided imagery and relaxation techniques have even been found to “reduce distress and allow the immune system to function more effectively” (Trakhtenberg, 2008, p. 850). For example, Holden-Lund (1988) examined effects of a guided imagery intervention on surgical stress and wound healing in a group of 24 patients. Patients listened to guided imagery recordings and reported reduced state anxiety, lower cortisol levels following surgery, and less irritation in wound healing compared with a control group. Holden-Lund concluded that the guided imagery recordings contributed to improved surgical recovery. It would be interesting to see how the results might differ if guided imagery was practiced continually in a group context.
Guided imagery has also been shown to reduce stress, length of hospital stay, and symptoms related to medical and psychological conditions (Scherwitz et al., 2005). For example, Ball et al. (2003) conducted guided imagery in a group psychotherapy format with 11 children (ages 5–18) experiencing recurrent abdominal pain. Children in the treatment group (n = 5) participated in four weekly group psychotherapy sessions where guided imagery techniques were implemented. Data collected via pain diaries and parent and child psychological surveys showed that patients reported a 67% decrease in pain. Despite a small sample size, which contributed to low statistical power, the researchers concluded that guided imagery in a group psychotherapy format was effective in reducing pediatric recurrent abdominal pain.
However, in the majority of guided imagery studies, researchers have not evaluated the technique in the context of traditional group psychotherapy. Rather, in these studies participants usually met once in a group to learn guided imagery and then practiced guided imagery individually on their own (see Menzies et al., 2014, for more). Thus, it is unknown whether guided imagery would have different effects if implemented on an ongoing basis in group psychotherapy.
Progressive Muscle Relaxation
Features of Progressive Muscle Relaxation
Progressive muscle relaxation involves diaphragmatic or deep breathing and the tensing and releasing of muscles in the body (Jacobson, 1938). Edmund Jacobson developed progressive muscle relaxation in 1929 (as cited in Peterson et al., 2011) and directed participants to practice progressive muscle relaxation several times a week for a year. After examining progressive muscle relaxation as an intervention for stress or anxiety, Joseph Wolpe (1960; as cited in Peterson et al., 2011) theorized that relaxation was a promising treatment. In 1973, Bernstein and Borkovec created a manual for helping professionals to teach their clients progressive muscle relaxation, thereby bringing progressive muscle relaxation into the fold of interventions used in cognitive behavior therapy. In its current state, progressive muscle relaxation is often paired with relaxation training and described within a relaxation framework (see Freebird Meditations, 2012, for more).
Research on the use of progressive muscle relaxation for stress reduction has demonstrated the efficacy of the method (McGuigan & Lehrer, 2007). As clients learn how to tense and release different muscle groups, the physical relaxation achieved then influences psychological processes (McCallie et al., 2006). For example, progressive muscle relaxation can help alleviate tension headaches, insomnia, pain, and irritable bowel syndrome. This research demonstrates that relaxing the body can also help relax the mind and lead to physical benefits.
Progressive Muscle Relaxation in Group Psychotherapy
Limited, but compelling, research has examined progressive muscle relaxation within group psychotherapy. Progressive muscle relaxation has been used in outpatient and inpatient hospital settings to reduce stress and physical symptoms (Peterson et al., 2011). For example, the U.S. Department of Veterans Affairs integrates progressive muscle relaxation into therapy skills groups (Hardy, 2017). The goal is for group members to practice progressive muscle relaxation throughout their inpatient stay and then continue the practice at home to promote ongoing relief of symptoms (Yalom & Leszcz, 2005).
Yu (2004) examined the effects of multimodal progressive muscle relaxation on psychological distress in 121 elderly patients with heart failure. Participants were randomized into experimental and control groups. The experimental group received biweekly group sessions on progressive muscle relaxation, as well as tape-directed self-practice and a revision workshop. The control group received follow-up phone calls as a placebo. Results indicated that the experimental group exhibited significant improvement in reports of psychological distress compared with the control group. Although this study incorporated a multimodal form of progressive muscle relaxation, the experimental group met biweekly in a group format; thus, the results may be applicable to group psychotherapy.
Progressive muscle relaxation has also been examined as a stress-reduction intervention with large groups, albeit not therapy groups. Rausch et al. (2006) exposed a group of 387 college students to 20 min of either meditation, progressive muscle relaxation, or waiting as a control condition. Students exposed to meditation and progressive muscle relaxation recovered more quickly from subsequent stressors than did students in the control condition. Rausch et al. (2006) concluded the following:
A mere 20 min of these group interventions was effective in reducing anxiety to normal levels
. . . merely 10 min of the interventions allowed [the high-anxiety group] to recover from the stressor. Thus, brief interventions of meditation and progressive muscle relaxation may be effective for those with clinical levels of anxiety and for stress recovery when exposed to brief, transitory stressors. (p. 287)
Thus, even small amounts of progressive muscle relaxation can be beneficial for people experiencing anxiety.
Guided Imagery and Progressive Muscle Relaxation in Group Psychotherapy
Combinations of relaxation training techniques, including guided imagery and progressive muscle relaxation, have been shown to improve psychiatric and medical symptoms when delivered in a group psychotherapy context (Bottomley, 1996; Cunningham & Tocco, 1989). The research supports the existence of immediate and long-term positive effects of guided imagery and progressive muscle relaxation delivered in group psychotherapy (Baider et al., 1994). For example, Cohen and Fried (2007) examined the effect of group psychotherapy on 114 women diagnosed with breast cancer. The researchers randomly assigned participants to three groups: (a) a control group, (b) a relaxation psychotherapy group that received guided imagery and progressive muscle relaxation interventions, or (c) a cognitive behavioral therapy group. Participants reported less psychological distress in both intervention groups compared with the control group, and participants in the relaxation psychotherapy group reported reduced symptoms related to sleep and fatigue. The researchers concluded that relaxation training using guided imagery and progressive muscle relaxation in group psychotherapy is effective for relieving distress in women diagnosed with breast cancer. These results further support the utility of guided imagery and progressive muscle relaxation within the group psychotherapy modality.
Conclusion
Limitations of Existing Research
Research on the use of guided imagery and progressive muscle relaxation to achieve stress reduction and relaxation is compelling but has significant limitations. Psychotherapy groups that implement guided imagery and progressive muscle relaxation are typically homogeneous, time limited, and brief (Yalom & Leszcz, 2005). Relaxation training in group psychotherapy typically includes only one or two group meetings focused on these techniques (Yalom & Leszcz, 2005); thereafter, participants are usually expected to practice the techniques by themselves (see Menzies et al., 2014). Future research should address how these relaxation techniques can assist people in diverse groups and how the impact of relaxation techniques may be amplified if treatments are delivered in the group setting over time.
Future research should also examine differences in inpatient versus outpatient psychotherapy groups as well as structured versus unstructured groups. The majority of research on the use of guided imagery and progressive muscle relaxation with psychotherapy groups has used unstructured inpatient groups (e.g., groups in a hospital setting). However, inpatient and outpatient groups are distinct, as are structured versus unstructured groups, and each format offers potential advantages and limitations (Yalom & Leszcz, 2005). For example, an advantage of an unstructured group is that the group leader can reflect the group process and focus on the “here and now,” which may improve the efficacy of the relaxation techniques (Yalom & Leszcz, 2005). However, research also has supported the efficacy of structured psychotherapy groups for patients with a variety of medical, psychiatric, and psychological disorders (Hashim & Zainol, 2015; see also Baider et al., 1994; Cohen & Fried, 2007). Empirical research assessing these interventions is limited, and further research is recommended.
Directions for Future Research
There are additional considerations when interpreting the results of previous studies and planning for future studies of these techniques. For example, a lack of control groups and small sample sizes have contributed to low statistical power and limited the generalizability of findings. Although the current data support the efficacy of psychotherapy groups that integrate guided imagery and progressive muscle relaxation, further research with control groups and larger samples would bolster confidence in the efficacy of these interventions. In order to recruit larger samples and to study participants over time, researchers will need to overcome challenges of participant selection and attrition. These factors are especially relevant within hospital settings because high patient turnover rates and changes in medical status may contribute to changes in treatment plans that affect group participation (L. Plum, personal communication, March 17, 2019). Despite these challenges, continued research examining guided imagery and progressive muscle relaxation interventions within group psychotherapy is warranted (Scherwitz et al., 2005). The results thus far are promising, and further investigation has the potential to make relaxation techniques that can improve people’s lives more effective and widely available.
References
Achterberg, J. (1985). Imagery in healing. Shambhala Publications.
American Psychological Association. (2017). Stress in America: The state of our nation.
https://www.apa.org/news/press/releases/stress/2017/state-nation
Baider, L., Uziely, B., & Kaplan De-Nour, A. (1994). Progressive muscle relaxation and guided imagery in cancer patients. General Hospital Psychiatry, 16(5), 340–347.
https://doi.org/10.1016/0163-8343(94)90021-3
Ball, T. M., Shapiro, D. E., Monheim, C. J., & Weydert, J. A. (2003). A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children. Clinical Pediatrics, 42(6), 527–532.
https://doi.org/10.1177/000992280304200607
Bernstein, D. A., & Borkovec, T. D. (1973). Progressive relaxation training: A manual for the helping professions. Research Press.
Bottomley, A. (1996). Group cognitive behavioural therapy interventions with cancer patients: A review of the literature. European Journal of Cancer Cure, 5(3), 143–146.
https://doi.org/10.1111/j.1365-2354.1996.tb00225.x
Cohen, M., & Fried, G. (2007). Comparing relaxation training and cognitive-behavioral group therapy for women with breast cancer. Research on Social Work Practice, 17(3), 313–323.
https://doi.org/10.1177/1049731506293741
Cunningham, A. J., & Tocco, E. K. (1989). A randomized trial of group psychoeducational therapy for cancer patients. Patient Education and Counseling, 14(2), 101–114.
https://doi.org/10.1016/0738-3991(89)90046-3
Freebird Meditations. (2012, June 17). Progressive muscle relaxation guided meditation [Video]. YouTube.
Hardy, K. (2017, October 8). Mindfulness is plentiful in “The post-traumatic insomnia workbook.” Veterans Training Support Center.
http://bit.ly/2D6ux8U
Hashim, H. A., & Zainol, N. A. (2015). Changes in emotional distress, short term memory, and sustained attention following 6 and 12 sessions of progressive muscle relaxation training in 10–11 years old primary school children. Psychology, Health & Medicine, 20(5), 623–628.
https://doi.org/10.1080/13548506.2014.1002851
Holden-Lund, C. (1988). Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing & Health, 11(4), 235–244.
http://doi.org/dztcdf
Jacobson, E. (1938). Progressive relaxation (2nd ed.). University of Chicago Press.
Lange, S. (1982, August 23–27). A realistic look at guided fantasy [Paper presentation]. American Psychological Association 90th Annual Convention, Washington, DC.
McCallie, M. S., Blum, C. M., & Hood, C. J. (2006). Progressive muscle relaxation. Journal of Human Behavior in the Social Environment, 13(3), 51–66.
http://doi.org/b54qm3
McGuigan, F. J., & Lehrer, P. M. (2007). Progressive relaxation: Origins, principles, and clinical applications. In P. M. Lehrer, R. L. Woolfolk, & W. E. Sime (Eds.), Principles and practice of stress management (3rd ed., pp. 57–87). Guilford Press.
Menzies, V., Lyon, D. E., Elswick, R. K., Jr., McCain, N. L., & Gray, D. P. (2014). Effects of guided imagery on biobehavioral factors in women with fibromyalgia. Journal of Behavioral Medicine, 37(1), 70–80.
https://doi.org/10.1007/s10865-012-9464-7
Peterson, A. L., Hatch, J. P., Hryshko-Mullen, A. S., & Cigrang, J. A. (2011). Relaxation training with and without muscle contraction in subjects with psychophysiological disorders. Journal of Applied Biobehavioral Research, 16(3–4), 138–147.
https://doi.org/10.1111/j.1751-9861.2011.00070.x
Rausch, S. M., Gramling, S. E., & Auerbach, S. M. (2006). Effects of a single session of large-group meditation and progressive muscle relaxation training on stress reduction, reactivity, and recovery. International Journal of Stress Management, 13(3), 273–290.
https://doi.org/10.1037/1072-5245.13.3.273
Scherwitz, L. W., McHenry, P., & Herrero, R. (2005). Interactive guided imagery therapy with medical patients: Predictors of health outcomes. The Journal of Alternative and Complementary Medicine, 11(1), 69–83.
https://doi.org/10.1089/acm.2005.11.69
Skovholt, T. M., & Thoen, G. A. (1987). Mental imagery and parenthood decision making. Journal of Counseling & Development, 65(6), 315–316.
http://doi.org/fzmtjd
Trakhtenberg, E. C. (2008). The effects of guided imagery on the immune system: A critical review. International Journal of Neuroscience, 118(6), 839–855.
http://doi.org/fxfsbq
Utay, J., & Miller, M. (2006). Guided imagery as an effective therapeutic technique: A brief review of its history and efficacy research. Journal of Instructional Psychology, 33(1), 40–43.
White, J. R. (2000). Introduction. In J. R. White & A. S. Freeman (Eds.), Cognitive-behavioral group therapy: For specific problems and populations (pp. 3–25). American Psychological Association.
https://doi.org/10.1037/10352-001
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). Basic Books.
Yu, S. F. (2004). Effects of progressive muscle relaxation training on psychological and health-related quality of life outcomes in elderly patients with heart failure (Publication No. 3182156) [Doctoral dissertation, The Chinese University of Hong Kong]. ProQuest Dissertations and Theses Global.
Submission Ide: c7f559e7-1bf4-4a9a-aa0a-65aed22d18af
18% SIMILARITY SCORE 6 CITATION ITEMS 22 GRAMMAR ISSUES 0 FEEDBACK COMMENT
Internet Source 0%
Institution 18%
Jane Chima
Mr.C-CaseStudy x
Summary
1111 Words
Potentially missing comma: 2020 2020,
Running head: MR. C CASE STUDY 1
CASE STUDY MR. C
Jane Chima
Grand Canyon University
NRS-410V Pathophysiology and Nursing Management of Clients Health.
Lisa Arends
November 8, 2020
MR. C CASE STUDY 2
Describe the clinical manifestations present in Mr. C.
Mr. C is a 32-year-old single man described in this scenario who presents with clinical
Spelling mistake: dl do
Student: Submitted to Grand Canyon University
Spelling mistake: bariatric barbaric
Spelling mistake: bariatric barbaric
Spelling mistake: bariatric barbaric
Spelling mistake: Genser Gender
Spelling mistake: Barrat Barr at
Student: Submitted to Grand Canyon University
Spelling mistake: unbeneficial beneficial
Three successive sentences begin wit…: The
Three successive sentences begin wit…: The
Student: Submitted to Grand Canyon University
manifestations that expose him to developing life-threatening conditions linked to obesity. If
appropriate measures are not taken to alleviate the condition, the probability of Mr. C developing
this disease is high though it has not been confirmed through clinical diagnosis. The client has a
high blood pressure of 172/96, which is yet to seek medical attention. Besides suffering sleep
apnea, his HR and RR are high, indicating an accretion of surfeit fat around his neck. Furthermore,
an average person has a fasting glucose level ranging between 70-115, but with our patient in
question, it is 146. A healthy person has a lofty cholesterol level below 200, but for Mr. C, it is
250. In addition, the patient in the study has an idyllic HDL level of 30, which is far below the
healthy person expected to 50 and above. Lastly, Mr. C’s triglycerides are at 312 mg/dl, which
above the desired normal level of 150.
Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether
bariatric surgery is an appropriate intervention.
There are several potential health risks that Mr. C should observe due to her overweight
condition. They include cardiovascular diseases, cancer, osteoarthritis, type 2 diabetes, kidney
failure, HBP, and sleep apnea. The patient in this scenario should undergo bariatric surgery
because he is presented with most of these potential health risks. The patient will control her body
weight once he is given serious intervention like bariatric surgery (Genser & Barrat, 2017). Having
a BMI of 40, this patient has class 3 obesity, thus qualifying for the surgery. Also, there no further
complications like psychological problems or medical issues that would be altered by the surgery
process.
MR. C CASE STUDY 3
Assess each of Mr. C.’s functional health patterns using the information given. Discuss at
least five actual or potential problems that can you identify from the functional health
patterns and provide the rationale for each. (Functional health patterns include health-
perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-
rest, cognitive-perceptual, self-perception/self-concept, role-relationship,
sexuality/reproductive, coping-stress tolerance.)
The different functional health patterns presented by Mr. C’s health status indicate
prevailing health issues. For example: The nutritional function can be used by caregivers to educate
on proper and healthy eating. Taking balanced diets and doing regular physical exercises will help
reduce excess weight. The metabolic patterns involve educating the client about the proper
selection of healthy food to help prevent the development of diabetes while addressing the issue
of HBP. The elimination function encompasses altering the patient’s unbeneficial behaviors in the
study and changing them with good habits like drinking plenty of water to change the bowel
pattern. The exercise function will help the patient in question deal with hyperlipidemia by
exercising regularly. The self-perception function allows the patient to have a positive outlook
about his condition. As a result, his self-esteem and image perception will change. The
sexuality/reproductive function is not covered in this assessment because the patient is single.
Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
functionality, and if the filtration process is low, it means there is a decrease in GFR. Therefore,
Kattah et al. (2017) says that the person is at the end-stage renal disease if his/her kidney cannot
perform above 10% of its standard capacity. Some of ESRD’s contributing factors are low
hemoglobin, high cholesterol, diabetes, and HBP (Collazo-Clavell, 2019).
Consider ESRD prevention and health promotion opportunities. Describe what type of
patient education should be provided to Mr. C. to prevent future events, health restoration,
and avoidance of deterioration of renal status.
It is vital to prevent and control critical health issues like ESRD. The first essential
prevention approach is to manage the ESRD contributing risk factor. The next health promotion
approach is to educate people on adopting healthy lifestyles like exercising regularly and eating
healthy diets. Lastly, individuals at high risk of developing ESRD should be identified and
screened often. In our case, Mr. C needs to be briefed by the nurse on the importance of treating
ESRD. First, a nurse should educate the client about some treatment methods such as dialysis and
kidney transplant. The patient should be educated using the teach-back method to allow him to
take charge of his condition because he will have relevant and comprehensive about their ailing
issue (Skelton et al., 2015). As a result, Mr. C will adapt to a better lifestyle, know the risk factors,
and take on appropriate measures to control the health issue (Skelton et al., 2015).
Explain the type of resources available for ESRD patients for nonacute care and the type of
multidisciplinary approach beneficial for these patients. Consider aspects such as devices,
transportation, living conditions, and return-to-employment issues.
There are numerous and accessible resources for ESRD patients. There are community
groups and multidisciplinary approaches that can offer support. Some of the stakeholders they can
contact are emergency resources, nutritionists, doctors, and nephrologists. They work in
collaboration to help provide appropriate treatment intervention to the patient. The patient must be
provided with adequate information about health promotion and necessary handling devices for
ESRD. An insured patient should require healthcare insurance to care for transport expenses as
well as living condition issues. The recovery process of patients mostly depends on the impact and
effort provided by social workers. As such, patients gain confidence in running their daily activities
(Kattah et al., 2017).
Student: Submitted to Grand Canyon University
Passive voice: development are measured …
Spelling mistake: Glomerular Globular
Spelling mistake: Kattah Attach
Spelling mistake: Kattah Attach
Student: Submitted to Grand Canyon University
type of (omit): type of
Statistically detect wrong use o…: know now
Student: Submitted to Grand Canyon University
type of (omit): type of
Spelling mistake: nonacute non acute
type of (omit): type of
Redundant phrase: Some of the Some
Spelling mista…: nephrologists neurologists
Spelling mistake: Kattah Attach
There are several stages involved when the chronic kidney disease is developing. Kidney
failure develops gradually until it permanently fails to function. Before the person is diagnosed
with kidney failure, it takes months to years. Kidney disease stages of development are measured
by Glomerular Filtration Rate (GFR). Kattah et al. (2017) allege that GFR estimates the kidney’s
MR. C CASE STUDY 4
MR. C CASE STUDY 5
MR. C CASE STUDY 6
References
Collazo-Clavell, M. L. (2019, June). Managing Obesity: Scaling the Pyramid to Success. In Mayo
Clinic Proceedings (Vol. 94, No. 6, pp. 933-935). Elsevier.
Genser, L., & Barrat, C. (2017). Bariatric surgery versus intensive medical therapy for diabetes-5-
year outcomes. Obésité, 12(1), 65-67.
Kattah, A. G., Scantlebury, D. C., Agarwal, S., Mielke, M. M., Rocca, W. A., Weaver, A. L., … &
Garovic, V. D. (2017). Preeclampsia and ESRD: the role of shared risk factors. American
Journal of Kidney Diseases, 69(4), 498-505.
Skelton, S. L., Waterman, A. D., Davis, L. A., Peipert, J. D., & Fish, A. F. (2015). Applying best
practices to designing patient education for patients with end-stage renal disease pursuing
kidney transplant. Progress in Transplantation, 25(1), 77-90.