Pharmacologic Antidepressant Therapy Essay Example
Question
1. Julia, age 62 years, became severely depressed 6 years ago when her son experienced a traumatic brain injury sustained in an automobile accident. She has been nonadherent with pharmacologic antidepressant therapy, which has led to her admission to an acute care psychiatric setting. During the assessment interview, she reports becoming increasingly forgetful and now has difficulty sleeping and concentrating. A physical assessment shows that she has lost 30 pounds during the last year as a result of “not being interested in eating.” Her home needs repairs, and she feels overwhelmed with completing the maintenance required. Julia reports “feeling helpless and alone,” adding that she “is alone and no one cares.”
a. Determine three nursing diagnoses that would apply to Julia, and list them in order of priority.
b. What are some nursing interventions to each of the nursing diagnoses listed?
Step 1/2
a. Based on the information provided, three nursing diagnoses that would apply to Julia are:
1: Risk for suicide related to severe depression and feelings of hopelessness and helplessness.
Explanation:
Depression can increase the risk of suicidal thoughts or behaviors. In this case, Julia has been experiencing severe depression for six years and has reported feeling helpless and alone. Therefore, a nursing diagnosis of “Risk for suicide related to severe depression and feelings of hopelessness and helplessness” is appropriate. Pharmacologic Antidepressant Therapy Essay Example
As a priority, the nursing staff should conduct a suicide risk assessment to identify potential risk factors and develop a suicide prevention plan to ensure Julia’s safety.
It is important to involve the interdisciplinary team, including mental health professionals, to provide appropriate treatment and support.
2: Impaired memory and concentration related to depression.
Explanation:
Julia has reported a decreased appetite and difficulty in completing activities of daily living. She has lost 30 pounds over the past year and feels overwhelmed with completing the maintenance required in her home. Therefore, a nursing diagnosis of “Self-care deficit related to decreased appetite and lack of interest in completing activities of daily living” is appropriate.
As a priority, nursing staff should encourage and assist Julia with activities of daily living, such as bathing and grooming. They can provide small, frequent meals and snacks to increase calorie intake and collaborate with the healthcare provider to develop a nutrition plan. They should also refer Julia to community resources for home maintenance and repair assistance.
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3: Self-care deficit related to decreased appetite and lack of interest in completing activities of daily living.
Explanation:
Julia has reported difficulty in sleeping and concentrating. She also reports becoming increasingly forgetful. Therefore, a nursing diagnosis of “Impaired memory and concentration related to depression” is appropriate.
As a priority, nursing staff should use simple and clear communication techniques with Julia to help her understand information. They can provide written information and visual aids to aid in memory retention.
Encouraging Julia to engage in mental stimulation activities, such as crossword puzzles or reading, can also be helpful. The nursing staff should collaborate with the healthcare provider to assess for potential medication side effects that may contribute to memory impairment.
The order of priority would be:
- Risk for suicide
- Self-care deficit
- Impaired memory and concentration
Explanation:
The order of priority is based on the potential impact on Julia’s immediate health and safety. The first nursing diagnosis, “Risk for suicide,” is the highest priority because it addresses the immediate threat to Julia’s life.
The second nursing diagnosis, “Self-care deficit,” is important to address Julia’s physical needs.
The third nursing diagnosis, “Impaired memory and concentration,” is important for Julia’s overall cognitive functioning and quality of life, but it is not as immediately life-threatening as the first two diagnoses.
Step 2/2
b. The following are some nursing interventions for each nursing diagnosis:
1: Risk for suicide:
- Establish rapport and trust with Julia: This helps build a therapeutic relationship with Julia, which can increase her engagement in care and reduce her risk of suicide.
- Conduct a suicide risk assessment to identify potential risk factors: This helps identify specific risk factors and develop a targeted suicide prevention plan.
- Develop and implement a suicide prevention plan: This may include interventions such as increased observation, limiting access to means of suicide, and involving mental health professionals in the treatment.
- Involve the interdisciplinary team, including mental health professionals, to provide appropriate treatment and support: Collaboration with the interdisciplinary team is essential in ensuring that Julia receives comprehensive care.
2:- Self-care deficit:
- Encourage and assist with activities of daily living, such as bathing and grooming: This helps ensure that Julia’s basic needs are met and can improve her sense of well-being.
- Provide small, frequent meals and snacks to increase calorie intake: This helps address Julia’s decreased appetite and prevent further weight loss.
- Collaborate with the healthcare provider to develop a nutrition plan: A nutrition plan can help ensure that Julia is getting the appropriate nutrients and may address any underlying medical issues.
- Refer Julia to community resources for home maintenance and repair assistance: This can help alleviate some of the stress and burden of managing her home.
3: Impaired memory and concentration:
- Use simple and clear communication techniques: This helps Julia understand and retain information more effectively.
- Provide written information and visual aids to aid in memory retention: This can provide Julia with additional cues and reminders to help her retain information.
- Encourage Julia to engage in mental stimulation activities, such as crossword puzzles or reading: These activities can help improve her cognitive function and may improve her mood.
Final answer
a. Nursing diagnoses for Julia and their order of priority:
- Risk for suicide
- Self-care deficit
- Impaired memory and concentration
b. Nursing interventions for each nursing diagnosis:
Risk for suicide:
- Establish rapport and trust
- Conduct suicide risk assessment
- Develop and implement suicide prevention plan
- Involve interdisciplinary team
Self-care deficit:
- Encourage and assist with activities of daily living
- Provide small, frequent meals and snacks
- Collaborate with healthcare provider for nutrition plan
- Refer to community resources for home maintenance and repair assistance
Impaired memory and concentration:
- Use simple and clear communication techniques
- Provide written information and visual aids
- Encourage mental stimulation activities
- Collaborate with healthcare provider to assess for medication side effects. Pharmacologic Antidepressant Therapy Essay Example