18-year-old female university residence student, enjoy outings with friends.

Grades are borderline on unsatisfied.

She complains of chest pain, palpitations, and unrealistic expectation of

Pathophysiological complication related to stress

school.

Psychosocial
complication
related
maladaption to life style change

to

Increased heart rate and

chest pain related to stress
and poor life style choices

Poor nutrition status related to

unhealthy eating habits

Risk of substance abuse

related to lack of coping skills

Stress overload related to

maladaption to university life

Impaired self-esteem related to

poor grades

Lack of emotional support

related to living on
residence

1. Assess pain, complete ECG

and lab work as prescribed.
2. Ensure pt. take prescribed
med on time. Not to take OTC
medication.
3. Monitor temperature. Report
to doctor if it is above 38.
Encourage Pt. to drink fluid.
4. Avoid caffeine, alcohol and
energy drinks.
5. Educate Pt. not to smoke or
quit smoking. Provide
information to help Pt. quitting.
6. Not to hang over too much.

1. Eat 3 meals a day on regular

time. Educate Pt. about balance
and healthy diet.
2 Avoid Over or Under Eating.
3. Reduce frequency of dining out.
4. Consult with dietician discuss
about proper diet.
5. Avoid fried fast food, caffeine
and alcohol.
6. Encourage Pt. to cook food by
herself and avoid oily/ salty food.
7. Report weight gain or lose
>2kg/week.

1. Avoid drug or alcohol abuse.

2. Avoid overeating, drinking,
using drugs, or OTC medication.
3. Educate Pt. the risk of smoking.
Provide resources of quitting
smoking.
4. Avoid the temptation to use illicit
drugs, alcohol, or OTC med as
means of coping.
5. Call on an inter-professional
meeting of addictions counselor,
mental health therapist, PT and SW
about substance abuse concern.
6. Communicate and get family
involved to support Patient.

1. Confirm Pt. to believe that stress

is inevitable and she can reduce it.
2. Take part in physical exercise. 30
minutes per day to help reduce
anxiety.
3. Get a part time job at campus or
outside campus to be financially
independent.
4. Communicate with PT. about her
thoughts, beliefs, and worries.
5. Educate her to get help as soon
as she begins to feel overwhelmed.
Provide resources to patient..
6. Consult with social worker,
psychologist RE: Stress.

1. Attempt to cope with stressful

events, break the problems down
into small goals and tasks that can
be accomplished.
2. Learn time-managing skills,
dealing with problems and begin to
restore a feeling of control
3. Seek for help from professor,,
tutor, mentor from school.
4. Study harder, join a study group
get a tutor, or drop the course.
5. Develop a system of rewards for
small accomplishments.
6. Building Links with teachers and
professors.

1. Provides the feeling of being

loved, valued, and cared for.
2. Enhance Pt. the feeling of
obligation.
Reduce
the
likelihood of unhealthy coping
methods, such as smoking and
drinking.
3. Seek supports. Help may be
available from family, friends,
support or religious group, etc.
4. Encourage family to visit and
communicate with Patient.
5.
Seek
help
from
psychologists,
school
counselors, and other sources.

getting enough sleep

and relaxation time

Take
medications
as prescribed

Dont
blame
yourself for your
feelings or see
them
as
a
weakness

such
as
workshops and
seminars
encouraged to
develop
connections
with classmates
and
peers
personal

enable
students to talk
through their
problems in a
nonjudgemental
and
anonymous
unable to cope,