The given case study presents the case of an individual who is constantly under pressure to perform. By going through the case study, it can be said that Mr. Jones is demonstrating denial about his illness.

The given case study presents the case of an individual who is constantly under pressure to perform. By going through the case study, it can be said that Mr. Jones is demonstrating denial about his illness.
The fact that his hypertensive state is chronic means that he knows the prevalent dangers of failing to take medication for his condition. The fact that he refused to take medication for his condition is a clear indication that Mr. Jones is at a stage where he does not think that the illness poses any danger to his wellbeing. Ideally, there can never be any other reason that would explain his refusal to take the medication as he had always done. Given the much emphasis that clinicians place on diseases such as high blood pressure, there is a very low possibility that Mr. Jones was not aware of the dangers that he posed to himself for skipping his medication for days before the accident (Gallo, & Matthews, 2012). Given the high cost of medication in the United States, there is also the possibility that Mr. Jones was trying to cut down on cost for him to be able to take care of his family in a better way.
Ideally, the manner in which Mr. Jones had behaved in the past can be used as a pointer of how he would react to the medication in the hospital. According to research, Native Americans place much emphasis on the family unit. This would explain why Mr. Jones has been pushing himself beyond the limit in his endeavor to provide for his family. One thing that Mr. Jones knows very well is that his family will suffer while he is in the hospital. In an effort to ensure that he gets back to caring for his family, there is a very high possibility that he would refuse to disclose his pain status for fear that he would continue being held at the hospital (Gallo, & Matthews, 2012).
Since the nurses are trained to realize when a patient is trying to create the wrong impression, there is a very high possibility that they would refuse to advocate for his discharge despite the wrong impression that he tries to give to them. This will without a doubt make him feel that he is being held against his will and will therefore do every human thing possible to compel them to discharge him. This would include refusing to take medication as prescribed as a protest measure. Apart from thinking about the welfare of his family, the intense stress that he is going through at the moment can be used to explain his actions. Stress is known to cause people to behave irrationally and for Mr. Jones his high stress levels can be used to predict his future actions. Actually, the high stress levels that he has been subjected to can be a good way of explaining why he failed to take his medications a few days before the accident. According to research, stress leads to constant worry and impairs ones ability to make decisions. Stress can also lead to forgetfulness of important things and this can as well explain why Mr. Jones failed to take his medication despite knowing very well the detrimental effects that his actions had on his health (White, Wilkes, & Barbato, 2013).
Anxiety is usually a reaction to stress that can be triggered by both physical and psychological factors. For Mr. Jones, the accident will most likely exacerbate his anxiety levels to unmanageable levels. In the event that the anxiety is not contained, his condition might degenerate to levels that would make it unmanageable. In addition to this, there is a high possibility that his anxiety will worsen his hypertension. Apart from the generalized anxiety disorder that has been brought about by his inability to provide for his family, Mr. Jones also seems to be suffering from post-traumatic stress disorder as a result of the accident that he just had. It is critical for the nurses to help him deal with the disorder to ensure that it does not degenerate into something worse. One intervention that they can take is to administer a cognitive-behavioral therapy to help him in the location and avoidance of thought that bring about the anxiety. The nurses can also administer a psychodynamic physiotherapy to help him confront the emotional conflict that has brought about the anxiety in his life. Lastly they can also administer anti-anxiety drugs or antidepressants to help him in dealing with the condition (Murphy, 2009).

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