Type responses to questions in the response boxes

28 Days
Overview

Gwen Cummings, from 28 Days, has been sent to your rehabilitation facility. Gwen uses
alcohol and Vicodin, a prescription analgesic. She wound up in your facility after she and
her boyfriend Jasper, already drunk, arrived late to her sister’s wedding. Gwen fell into
the wedding cake at the reception, then stole a limousine and drove it into a house. In lieu
of jail, she has been sent to rehab for 28 days.

Client name: Gwen Cummings

Psychiatric diagnosis: Alcohol Use Disorder; In a controlled environment; Severe

*For the criteria supporting this diagnosis, please refer to the Diagnostic and Statistical
Manual of Mental Disorders, 5th edition, by the American Psychiatric Association,
and/or your mental health nursing textbook.

Date: 11/28/2019

Your name: Jaime Romero

Name of the client you are assessing: Gwen Cummings

Name of the movie: 28 Days

What is the chief complaint? (In the client’s own words, and report of others)

Response:
At first the client was in denial about her alcoholism but later in the movie realized that it
was a real problem and admitted it. The clients sister was very vocal about the client
being an alcoholic and stated, “You make it impossible to love you.” Toward the end of
the movie the sisters made up.

Based on the above information and a close viewing of the movie, what 6 questions
would you raise during history taking? What are the possible answers to these questions?
(Use a dialog format with the questions and answers). You might base your questions on
the:
 History of the client’s illness, problems encountered due to drinking.
 Family history of substance dependence.
 Psychosocial history.

Response:
When did you start drinking/using drugs? Gwen: “As a teenager, after struggling
with the death of my mother and having lived with her alcohol abuse my whole life.
It helped dull the pain from all of that.”
Why do you think you drink and abuse drugs? Gwen: “To numb the pain from my
childhood. To escape from reality.”

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28 Days - 1
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 Type responses to questions in the response boxes

Is there any one life even that you believe led to your habits? Gwen: “The death of
my mother.”
Have you ever tried to stop drinking/using drugs on your own? Gwen: “I haven’t
ever tried to stop on my own because I haven’t ever felt that I had a problem.”
Does your drug and alcohol abuse make you feel guilty? Gwen: “No, not really.
Sometimes I feel bad but I just drink more.”
Do you feel that there are consequences to drinking and using drugs? Gwen: “I
know that people get mad about it but I don’t think it’s a big deal. They are all
overreacting.”

What other observations do you have about the client’s behavior?

Response:
In the beginning of the movie, Gwen was wreckless and didn’t care what other
people thought about her drug and alcohol use. When arriving at rehab, Gwen was
very judgmental towards the other clients at the center. I believe that she felt that
this would be the easy way to stay out of jail. While outside, Gwen was
manipulative with her councilor before she knew who he was. She was also very
selfish.
In your opinion, is the diagnosis above accurate?

Response:
Yes. In my opinion, this is the correct diagnosis for Gwen.

What requirements does the client meet that support this diagnosis, based on DSM-5
criteria?

Response:
For the severe diagnosis of alcohol use disorder, Gwen would need to meet 6
symptoms. 1) Craving, or strong urge to use alcohol. 2) Recurrent alcohol use
resulting in a failure to fulfill major role obligations. 3) Continued alcohol use
despite havingpersistent or recurrent social or interpersonal problems caued or
exacerbated by the effects of alcohol. 4) Recurrent alcohol use in situations in which
it is physically hazardous. 5) Important social, occupational, or recreational
activities are given up or reduced because of alcohol use. 6) A need for markedly
diminished effect with continued use of the same amount of alchol.

What 5 things would you implement in the treatment plan?

Response:
1) Provide education on the effects of the substances on the mind and body. 2)
Discuss importance of following the treatment plan. 3) Encourage client to talk
about her past and what future goals she may have. 4) Teach problem solving skills.
5) Help the client set realistic goals.

With what 5 expected outcomes?

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 Type responses to questions in the response boxes

Response:
1)Promote safety and protection of the client. 2) Promote and maintain fluid and
electrolyte balance. 3) promote a restful sleep pattern. 4) Client will identify their alcohol
as a problem and take ownership of the problem. 5) Identifies changes in lifestyle that are
necessary.

Womble, D. M., Kincheloe, C. A. (2020) Introductory Mental Health

Nursing, Fourth Edition. Wolters Kluwer, Philadelphia, Pennsylvania

Anonymous writer (Updated 9/2019) What an Alcohol Use Disorder Diagnosis Means.
Retrieved from https://www.verywellmind.com/diagnosis-alcohol-use-disorder-67880

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