Published Jun 14, 2011
KristeyK
285 Posts
So my latest med-surg clinical rotation has a psychosocial focus. I have been peeling my brain apart for a couple hours now trying to figure out a psych DX for a patient who has ZERO psych issues at the time. Background to help you:
81 yo male, had a Nephroureterectomy d/t finding transitional cell cancer in his kidney. His recovery is going remarkably well, he was up and out of bed several times during the day, keeps his pain under control, and states that he refuses to allow this to "rule his life." He even said that he has lead a blessed life, and wants to be discharged so he is able to continue living it. (With a few extra visits to the Dr. now....his words...lol.) I spent HOURS with this man trying to find SOMETHING that I could use and about the only thing I can come up with is Risk for Anxiety. However I don't like that as he is really quite good at coping with any anxiety he starts to feel. He has a VERY strong family support system, and excellent mental capacity.
Do any of you know of a DX that states something is going RIGHT with a patient? (I've poured through my book a few times and cannot find anything.) In your opinions, is something along the lines of "effective coping" something I could use?
Thanks!!!
Rob72, ASN, RN
685 Posts
Is his assessment of his personal condition realistic, or is he pushing his limits? Is he ready for information about necessary modifications to his lifestyle?
It may(probably will) depend on your instructor. In similar circumstances, I had, "Effective transitional coping r/_________", and you may insert whatever you feel to be significant in his process.
rogueninja
4 Posts
I don't know about a diagnosis to describe things going right.
Could he be in denial of his situation? I say that because you said that he is good at coping with any anxiety that he begins to feel, could he be just dismissing those feelings, without actually coping?
Maybe, Risk for ineffective coping related to related expressive mood as evidenced by euphoria, elation, cheerfulness (an exaggerated sense of well being).
He could have been genuinely happy (you know him better!), just a thought.