Name
Capella University
NURS-FPX4015 Pathophysiology, Pharmacology, and Physical Assessment: A Holistic Approach to Patient-Centered Care
Prof. Name
Date
Obsessive-Compulsive Disorder (OCD) is a psychiatric condition defined by persistent intrusive thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) intended to reduce anxiety. The disorder often manifests during adolescence, affecting approximately 1–3% of young individuals (Brock et al., 2024). In the case of Wesley Blanco, a 13-year-old non-binary Filipino-White adolescent, symptoms included excessive guilt, repetitive praying, and ritualistic behaviors such as chewing food a specific number of times. These compulsions intensified during stressful periods, negatively affecting Wesley’s academic performance and social engagement. Following diagnosis, Wesley was prescribed fluoxetine, resulting in significant improvements in mood, sleep, and anxiety during follow-up.
Wesley Blanco, a 13-year-old non-binary Filipino-White adolescent, exhibited profound guilt, anxiety, and compulsive behaviors. Observations by Wesley’s mother indicated frequent crying, excessive apologies, and compulsive praying. Wesley reported intrusive thoughts (obsessions) about minor past events, such as breaking a mug, and performed repetitive rituals, including chewing food exactly 15 times or rehearsing phrases to prevent perceived harm.
Symptoms tended to worsen during stressful situations, particularly school-related tasks, consistent with research linking OCD symptom exacerbation to stressors (Cui et al., 2023). Although Wesley had no personal psychiatric history, a paternal history of Tourette’s syndrome suggested potential genetic predisposition. Physical health was stable, and suicidal ideation was denied. Clinical assessment confirmed OCD, a neuropsychiatric disorder characterized by repetitive, anxiety-driven behaviors. Treatment included fluoxetine, a selective serotonin reuptake inhibitor (SSRI), alongside ongoing therapy (Sohel et al., 2024). After one month, there was noticeable improvement in obsessive thoughts, mood, and school functioning. Inclusive communication and culturally sensitive family involvement were emphasized as part of a comprehensive recovery plan.
OCD arises from an imbalance in neurotransmitters, particularly serotonin, which regulates thoughts and behaviors. Dysregulation in brain regions such as the frontal lobe and basal ganglia leads to heightened anxiety and repetitive behaviors. Genetic predisposition further increases vulnerability (Majdari et al., 2021).
Wesley’s treatment involves fluoxetine, an SSRI that restores serotonin balance, thereby reducing intrusive thoughts and compulsive behaviors. The treatment begins with a low dose to minimize side effects, with gradual adjustments as needed. Concurrent psychotherapy optimizes outcomes. Evidence supports fluoxetine as a safe and effective treatment for pediatric OCD (Sobel et al., 2024).
Wesley exhibited anxiety-related signs including restlessness, difficulty focusing, tension, sleep disturbances, and ritualistic behaviors such as chewing food 15 times and repetitive chanting. Stress amplified these behaviors, aligning with common adolescent OCD manifestations (Cui et al., 2023).
| Question | Answer |
|---|---|
| What is the nursing diagnosis for Wesley Blanco? | Anxiety related to intrusive thoughts and compulsive behaviors; ineffective coping due to reliance on rituals to alleviate anxiety. |
| How do symptoms present? | Distress occurs when unable to perform compulsions, leading to anxiety, sleep disturbances, and decreased daily functioning. |
| What is the nurse’s role? | Observe repetitive behaviors, excessive checking, and anxiety-driven actions; provide support and interventions to manage symptoms (Brock et al., 2024). |
Wesley Blanco meets criteria for Obsessive-Compulsive Disorder (OCD), characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) that disrupt daily life. Symptoms can include excessive checking, handwashing, or ritualistic mental actions, impacting school performance, social interactions, and family routines. Early identification and intervention significantly improve outcomes, with evidence-based therapies shown to reduce symptoms in children and adolescents (Yan et al., 2022).
| Factor | Description |
|---|---|
| Family history | Father has Tourette’s syndrome, increasing OCD susceptibility. |
| Stress | School-related pressures exacerbate symptoms. |
| Cultural background | Mixed Filipino-White identity may contribute to bicultural stress and differing beliefs about mental health. |
| Personality traits | Guilt and perfectionism increase risk of obsessive-compulsive behaviors (Cui et al., 2023). |
No laboratory tests were required for Wesley’s diagnosis; OCD is primarily identified through clinical evaluation. A structured interview and the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) were used to quantify symptom severity and monitor progress. The CY-BOCS is validated as a reliable measure for assessing OCD in pediatric populations (Yan et al., 2022).
Untreated OCD can result in severe anxiety, concentration difficulties, sleep problems, social withdrawal, and impaired daily functioning. Persistent guilt and compulsive behaviors may erode self-confidence, and prolonged untreated OCD can increase the risk of secondary conditions, including depression. Early SSRI intervention has been shown to reduce these risks effectively (Sobel et al., 2024).
Nursing strategies focus on alleviating anxiety, managing compulsions, and supporting daily life. Interventions include teaching coping techniques (deep breathing, mindfulness), promoting structured routines, and gradual exposure to feared situations in a controlled environment. Positive reinforcement and supportive communication strengthen confidence, while collaboration with family and mental health professionals ensures continuity of care. Nurses also monitor medication adherence, side effects, and therapeutic response to SSRIs like fluoxetine (Sobel et al., 2024).
Wesley Blanco’s case demonstrates the profound impact of OCD on adolescents’ academic, social, and family life. Early detection and evidence-based interventions, including fluoxetine and cognitive-behavioral therapy, are crucial to symptom management. Family involvement and culturally sensitive care enhance recovery, while ongoing monitoring reduces relapse risk. This case exemplifies the importance of individualized care for youth from diverse backgrounds.
Brock, H., Hany, M., & Rizvi, A. (2024). Obsessive-Compulsive Disorder (OCD). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK553162/
Cui, J., Zhu, K., Wen, J., Nie, W., & Wang, D. (2023). The relationship between moral judgment ability, parenting style, and perfectionism in obsessive–compulsive disorder patients: A mediating analysis. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1133880
Majdari, B., Bey, K., Boberg, J., & Burton, C. (2021). Genetics of obsessive-compulsive disorder. Psychological Medicine, 51(13), 1–13. https://doi.org/10.1017/s0033291721001744
Sohel, A. J., Shutter, M. C., & Molla, M. (2024). Fluoxetine. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459223/
Yan, J., Gu, Y., Wang, M., Cui, Y., & Li, Y. (2022). The obsessive–compulsive symptoms in tic disorders and the psychometric properties of children’s Yale–Brown–Compulsive Scale: An evidence-based survey in a Chinese sample. Frontiers in Pediatrics, 10. https://doi.org/10.3389/fped.2022.794188
