Peggy Bell is a 40-year-old white Caucasian female who presents to the FNP clini

Question

Peggy Bell is a 40-year-old white Caucasian female who presents to the FNP clinic in the company of her elderly mother. Patient is emaciated, has fingers that are severely nicotine stained, smells strongly of alcohol, answers questions in monologues with no eye contact, and appears to be nodding off between coughing episodes. The mother reports that the patient:

Has been having increased cough with blood-tinged sputum, has "blackouts" almost every night after "drinking spells" and has been losing weight.

Mother states: "Peggy and I live alone. Her kids live out of state and don't like to see Peggy like this. I guess Peggy just hasn't been able to stop drinking since her husband divorced her 10 years ago. He just didn't love her like I do." Patient has no health insurance. The mother appears attentive and loving, and anticipates all needs patient may have in relation to mobility and communication with FNP.

Discuss your initial impression of this patient's presentation.

Discuss two questions you would ask in relation to the alcohol and drug misuse of this patient.

According to developmental and family cycle theory, discuss two strengths this family demonstrates.

Discuss one referral you would suggest to facilitate this family's progress in relation to alcohol and drug misuse interventions.

Explanation / Answer

1). The initial impression of patient's presentation is, the patient is an alcoholic and nicotine dependence, lungs are damaged as indicated by increased cough with blood-tinged sputum. The patient might also be depressed as she was divorced from her husband.

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