Sarah Connor is a 42-year-old client who reports difficulty concentrating, insomnia, fatigue, constant worrying,
and an inability to perform 'daily tasks at work and at home.
Sarah states she has been feeling this way for the last 8 months.
She reports that she filed for divorce 4 months ago and currently lives in a townhouse with her 2 high school age children.
Sarah works full-time in an office for a large corporation but states that her employer has been having layoffs recently.
She voices concerns about her current finances. She also reports that her mother was recently diagnosed with dementia, and she is in process of moving her to a long-term care facility.
Her father is deceased. Sarah states that she is experiencing frequent headaches and neck tension and has also had a poor appetite with episodes of nausea and diarrhea.
A nurse in an emergency department notes that Sarah is alert and oriented, but appears restless and guarded.
She is talking fast and rocking back and forth while sitting in a chair.
She appears pale and thin and has dry skin. Sarah states, "I feel like I have no control over my life.
I am anxious all the time. I have been calling in sick to work lately so I don't have to go."
She reports a headache that she rates a 4 on a 0 to 10 pain scale.
Her neck muscles are tense and Sarah reports neck pain on palpation, rating it a 5 on the pain scale.
She also tells the nurse that she hasn't eaten today due to continued poor appetite and episodes of nausea,
and that she has had 2 diarrhea stools today. She denies difficulty with rination.
Sarah's past medical history is unremarkable, and she has no known allergies.
She denies use of alcohol or illicit drugs. The nurse obtains her vital signs:
temperature is 37.1∘C(98.7∘F), blood pressure is 135/72 mmHg,
heart rate is 106/ minute, respiratory rate is 26/ minute, and oxygen saturation on room air is 96%.
The nurse auscultates Sarah's heart sounds and notes tachycardia but no murmurs.
Her lungs are clear to auscultation bilaterally and her bowel sounds are normoactive.
She has no dependent edema, and her pedal pulses are +2 . Sarah received lorazepam (Ativan) 1 mg IV bolus five minutes ago.
Which of the following concerns should the nurse plan to address?
(Select all that apply.)
A. Physiological: Pain .
B. Psychosocial: Stress and Coping
C. Physiological: Immunity
D. Psychosocial: Cognition
E. Physiological: Nutrition
F. Physiological: Fluid and .Electrolyte
G. Physiological: Infection
H. Physiological: Gas Exchange
I. Physiological: Intracranial regulation
J. Physiological: Clotting
