In current times, nursing practice is becoming a highly demanding and challenging profession. With the change of dynamics in the adult healthcare setup, several vital principles are underpinning the nursing practices, which include that:
The nurse should be accountable for treating every patient, specifically elderly individuals with dignity and respect
Nurses should be accountable to take responsibility for the care they are providing
The nurse will be responsible for promoting ethical healthcare practices to prevent ill health and will provide care that is safe and of the highest quality
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Mr Smith from the Caribbean has suddenly started to feel pain in his chest and back, along with breathlessness and dizziness. He thought that his illness might be related to sickle cell anemia and after a week these symptoms had not been resolved. Therefore, he went to the A& E where he went through a thorough examination regarding to check the current status of his respiration, cardiac and muscular system in upper body along with the identification of any vital signs of sickle cell anemia and full blood count. Mr. Smith has a prior case history of onset suffered from sickle cell anemia and for further diagnosis, his doctor suggested hospital admission. During the hospital admission, the SATS levels of Mr Smith dropped significantly, and he started to feel tremendous pain in his chest.
Pathophysiological processes of tissue destruction, carcinogenesis, degeneration, and trauma and deviance for (mental health) nursing care
In the case of SCD or sickle cell disease, understanding the pathophysiological processes of tissue destruction, carcinogenesis, trauma, and cell degeneration is crucial to comprehending fir providing proper mental health nursing care
Tissue Destruction:
A sickle cell crisis triggers the cascades of events that cause tissue damage. Red blood cells with aberrant hemoglobin S grow stiff and take on a sickle form, which obstructs blood flow in small arteries. This causes severe pain and tissue damage due to ischemia, infarction, and tissue hypoxia, especially in areas with high metabolic demand like the arms, back, and chest.
Carcinogenesis:
Sickle cell disease does not directly predispose individuals to the onset of carcinoma. However, chronic inflammation, repeated tissue damage, and oxidative stress related to SCD can trigger the damage of DNA which in turn can increase the risk of certain growth of cells or the onset of carcinoma. In mental health nursing care, the nurse should make the patient aware of the importance of regular screening and adopting a healthy lifestyle to mitigate the risk of both SCD and carcinoma
Chronic Vaso-occlusion and tissue hypoxia in Sickle Cell Disease cause tissue degeneration of vital organs, specifically organs like the liver, spleen, and bone. This degeneration facilitates organ dysfunction, avascular necrosis, and chronic pain which can impact the physical health and mental well-being of the patient.
Trauma:
The recurrent episodes of Vaso occultation, ischemia, and infarction cause a form of chronic cellular injury in the patient suffering from Sickle cell anemia. The onset of trauma can result in an acute pain crisis, which further exacerbates the psychological distress, depression, and anxiety among the affected individuals. In mental health nursing care nurses should provide holistic pain management and psychosocial support to individuals to address the issues
Deviance (Degeneration)
Deviance in the context of Sickle cell disease refers to the abnormal cellular and tissue changes that result from chronic Vaso-occlusion and tissue damage. The ongoing degeneration impacts on the patient’s social image, mental health, and social interaction. In mental health nursing care, the nurse should focus on developing and facilitating coping strategies, resilience, and addressing the emotional impact of chronic illness.
Justification of the contribution of genetics in disease etiology and the role of screening
Contribution of genetics in disease etiology:
In some case, genetic disorders used to associated with locus heterogeneity- which mean that the deleterious mutation in any of the gene can increase the risk and vulnerability of that disease. According to () genetic predisposition or genetic susceptibility can increase the likelihood of developing any particular disorder which based on the individual’s genetic makeup. Therefore, the contribution of genetics in disease aetilogy refers to the role that genetic factors play in the manifestation and development of any particular disease or condition
Considering the case scenario of Mr. Smith, who is suffering from sickle cell anemia, genetic mapping plays a fundamental role in the onset of SCD. More specifically, it can be stated that Sickle Cell disease is a genetic disorder inherited from parents, and mutation in the hemoglobin gene causes the increased production of abnormal hemoglobin. This genetic predisposition results in red blood cells taking the sickle shape. The Sickle-shaped RBC in turn causes vaso-occlusion, facilitates tissue damage, and triggers the pain crisis.
Considering the principle of mental health nursing for adult care, understanding the role of genetic mutation in the onset of sickle cell disease is important to provide mental health care and support by the nurses. It can also enable nurses to provide holistic care along with psychoeducation and psychological support to individuals suffering from chronic illness and often experiencing emotional distress and mental health issues.
Screening in the mental health care approach should focus on the patient’s mental health and well-being at the time when Mr. Smit was admitted to the hospital with the onset of sickle cell. Nurses can implement screening tools and assessment techniques to identify the degree of depression and anxiety, Mr Smith is going through due to the onset of the disease. By recognizing the mental health status at an early stage, it will be easier for the nurse to provide tailored and patient-centric intervention, carry out counseling, and provide support to Mr. Smith to enhance his overall well-being
Outline the processes and features of death and dying and mental health nursing priorities
The process of death and dying encompasses:
Physical aspect
Emotional aspect
Social aspect
According to Elisabeth Kubler-Ross, The process of death includes the following stages like:
Denial
Anger
Bargaining
Depression
Acceptance
Mental health nursing for the adult care should prioritise end-of-life care which will involve the provision of holistic support to individuals with specific needs. This includes the following:
To address the psychological distress
To facilitate open communication between nurses and older people
To offer emotional support to the individual and his family for managing their symptoms by ensuring dignity and comfort
Prioritising pain management, supporting spiritual needs, and promoting a sense of closure are important aspects of the mental health nursing care approach when it comes to providing treatment to individuals who are at a sensitive and profound phase of their livelihood.
Conclusion
References
Morrison, J., (2023). Diagnosis made easier: Principles and techniques for mental health clinicians. Guilford Publications.
Kavanagh, P.L., Fasipe, T.A. and Wun, T., (2022). Sickle cell disease: a review. Jama, 328(1), pp.57-68.
Young, J., Taylor, J., Paterson, B., Smith, I. and McComish, S., (2023). Trauma-informed practice: a paradigm shift in the education of mental health nurses. Mental Health Practice, 26(4).
