Mr. X, a 68-year-old married Chinese man who is a retired cook, reports sleep disturbances with irritability and loss of appetite for the past 6 months. He has frequent headaches, dizziness, and a sensation of tightness in the chest.
Three weeks before this visit, he had several episodes of chest pain and went to the local hospital, where he was admitted for a medical evaluation. Results of all investigations, including tests for ischemic heart disease, were normal. He was referred for a psychiatric consultation.
Despite sensitive probing by the psychiatrist, Mr. X denies symptoms of anxiety and depression. He has no history of psychiatric or physical illness.
When asked about his family, Mr. X reports that his wife had worked for many years as a nanny in a distant town and they were accustomed to living apart. She retired 6 months ago and returned to live with him. He became animated and agitated when talking about his wife and described her as a headstrong woman who always did things her way. The psychiatrist pointed out to him that his symptoms may be related to his recent life changes because they started when his wife rejoined him.
Mr. X was later able to tell the psychiatrist that his symptoms got worse when his wife aggravated him. They fought frequently about everything from how to set up a monthly budget to arranging their furniture, to what gifts to send to their children. He remembered that before he went to the emergency department at the hospital, he was angry with his wife because “she put wet dishes in the wrong place and messed up the kitchen.”
formulate a care plan for Mr. X using one nursing diagnosis from NANDA and upload to blackboard.
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