ANTON CASE STUDY 1

ANTON CASE STUDY

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ANTON CASE STUDY

Case notes with Management Plan

Due to the fact that Anton suffers from depression, the nurse has to establish very precise

goals for his care. The fundamental objective is to establish a connection of empathy and trust with

the patient as quickly as possible. It is the responsibility of the nurse to assist the patient in

cultivating positive attitudes towards oneself as well as realistic coping skills for challenging

circumstances (Curtis et al., 2018). The responsibility of the nurse also involves encouraging the

patient to adopt healthy behaviours, such as taking medicines exactly as recommended and

establishing a schedule that is high in energy but low in stress. A secondary duty of the registered

nurse is to facilitate the patient's access to social support and other types of services (Hong et al.,

2021). It is also essential for the nurse to be able to successfully build and maintain productive

professional ties and channels of communication in order for the nurse to successfully coordinate

care with other relevant healthcare providers. Last but not least, the nurse will promote and enable

the patient's engagement in self-care, as well as providing aid to the patient's loved ones when

necessary (Chand et al., 2021).

When I look back on it, it was difficult to form a relationship with a patient who was hesitant to

maintain eye contact or to engage in conversation. For this reason, the primary goal of nursing

interventions will be to reduce social disengagement as well as isolation. It is commonly known that

the patient is depressed, and he or he receives very little in the way of social support (Spino et al.,

2016). As a result, the most important nursing intervention in this circumstance will be to assist the

patient in catharsis that they are capable of on their own. When a patient is able to candidly disclose

concerns linked to his or his mental health, the patient may feel a sense of catharsis (Dorrance et al.,

2019).

The objective of this intervention for Anton's mental health on the part of the nurse is to persuade

Anton to talk about how he is feeling in general and how it pertains to his health. If a patient is
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having a catharsis, the nurse should listen carefully and ensure that the patient is treated with

respect during the process. If a patient brings up self-defeating beliefs or acts, the nurse shouldn't

support them by agreeing with them or making similar comments. This might make the patient feel

worse about themselves (Ghamari et al., 2016). It is the responsibility of the nurse to gently

challenge the patient's negative perceptions while also presenting the patient with other points of

view. The nurse may enquire, "What would you advise a close family or a trusted friend if they

were in a similar situation?" if they were in the same predicament as the patient.

The second step in the process that the mental health nurse will do is to educate the patient. Anton

was a difficult patient for the mental health nurse to get to know, and as a result, he need a lot of

chances to initiate discussion with the mental health nurse (Franck et al., 2016). The nurse could do

this by initiating dialogues regarding the patient's recovery and the patient's adherence to

medication. By monitoring the patient's vital signs, weight, and nutrition, the nurse is able to

maintain track of the patient's general physical health and make appropriate adjustments as

necessary. Anton's nurse may assist his in overcoming the adverse effects of the medications he

takes by informing his about the likelihood of those effects occurring and collaborating with his to

develop strategies for addressing those effects (Franck et al., 2016).

There was a lack of social and familial support, which manifested as feelings of loneliness,

difficulty making and keeping friends, frequent outbursts of tears, a persistently negative outlook,

and sporadic displays of eye contact. All of these symptoms can be traced back to the absence of

social and familial support. According to Gariépy et al. (2016), the primary focus of nursing care in

this scenario should be on assisting the patient in developing new social relationships and putting in

place new support systems in the new environment. The nurse may assist the patient in compiling a

list of persons for the patient to contact for emotional support, or the nurse may decide whether or

not it would be beneficial for the patient to participate in a support group (Liu et al., 2016).
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The second nursing intervention that should be performed in this scenario is to work on boosting the

patient's confidence. In order to do this, the nurse will demonstrate an exceptional amount of

compassion for the patient and will give the tools for the client to demonstrate the same level of

compassion (Bajaj et al., 2016). It's possible that the nurse will assist the patient in establishing

goals that are both attainable and time-bound. If the patient is successful in achieving these goals,

they will feel a sense of accomplishment and pride, which will do wonders for the patient's capacity

for social interaction as well as their sense of self-worth (Orth et al., 2016).

Clinical Handover Using ISBAR

Introduction

This is Psychiatric Nurse X phoning from your preferred inpatient psychiatric facility in order to

provide you with an update on Anton, a 40-year-old Caucasian female who was admitted after

taking an excessive amount of the drug Sertraline for major depression. Due to the fact that the

patient is going through significant psychological anguish, I feel obligated to seek out to you for

assistance.

Situation

Anton was found unconscious in his yard by a neighbor, who immediately dialed 911 and arranged

for an ambulance to transport him to the hospital. After receiving treatment for an overdose of

sertraline, Anton had a comprehensive examination of his mental condition and was subsequently

diagnosed with severe depressive disorder F32.2.

Background

Conditions like as hypertension and mild obesity are examples of significant prior conditions. Anton

is a chain smoker who goes through forty packs of eight milligram cigarettes in a short period of

time. he consumes alcohol in moderation and always has done so. When he was thirty years old,

shortly after the birth of his second child, he received a diagnosis of depression from his mental

history. he has been admitted to the hospital several times for treatment of depression ranging from
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moderate to severe. Both of the mother's sisters struggled with depression, and there is a family

history of nervousness in the mother's father. In addition, the second sister of the father passed away

at the age of 35 after being diagnosed with borderline personality disorder and committing suicide.

Before Anton's wife died away a few of months ago, the couple had been married for a combined

total of 10 years. The two people uprooted their lives and moved to the seaside town, where they

would begin a new chapter of their lives away from their friends and family. wife's unexpected

death occurred after he had successfully adopted the healthy lifestyle changes that he anticipated

would ease his depression. This is a tragic turn of events since he had hoped that these changes

would help his. The relocation will cause a disruption in the social support network that Anton and

wife have established in the city, which is one of the reasons why Anton's children do not want to

leave the city in the first place. Due to the nature of Anton's current predicament, he has to take a

combination of sertraline (100 mg) and coversyl (10 mg).

Assessment

The patient's mental capacity was appropriate for his age, and the fact that he had wrinkled skin

suggested that he had been a smoker for a significant portion of his life. It was challenging to

connect with the patient since he or she was reluctant to participate in discussion. Despite being

mainly cooperative, the patient sometimes broke down in tears, but overall they were cooperative.

The volume and tone of the conversation are both low and clear. A time of melancholy and

despondency has set in as a direct result of the recent death of a spouse. The patron revealed that

they were in such a state of misery that they were considering ending their lives. In addition to that,

the patient exhibits signs consistent with anhedonia. The patient is reasonable, and there is no

indication that he is hostile, and he has an affect that is reactive. The patient's mood is consistent

with his affect. The patient's active want to pass away is reflected in a number of symptoms, just

two of which are a lack of sleep and an inability to keep food down. Even though he has problems
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with his ability to remember things over the long term, he is not lost. Insight at the level 2 level

Recommendations

I have reason to suspect that the patient is capable of doing damage on themselves, and as a result,

they need rapid psychological measures. As a result, I would want to get a review from a

psychologist as soon as it is feasible.

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References

Bajaj, B., Robins, R. W., & Pande, N. (2016). Mediating role of self-esteem on the

relationship between mindfulness, anxiety, and depression. Personality and Individual

Differences, 96, 127-131. https://doi.org/10.1016/j.paid.2016.02.085

Chand SP, Arif H, Kutlenios RM. Depression (Nursing) [Updated 2021 Jul 26]. In: StatPearls

[Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from:

https://www.ncbi.nlm.nih.gov/books/NBK568733/

Curtis, J. R., Downey, L., Back, A. L., Nielsen, E. L., Paul, S., Lahdya, A. Z., Treece, P. D.,

Armstrong, P., Peck, R., & Engelberg, R. A. (2018). Effect of a patient and clinician

communication-priming intervention on patient-reported goals-of-Care discussions

between patients with serious illness and clinicians. JAMA Internal Medicine, 178(7),930.

https://doi.org/10.1001/jamainternmed.2018.2317

Dorrance Hall, E., Meng, J., & Reynolds, R. M. (2019). Confidant network and interpersonal

communication associations with depression in older adulthood. Health Communication, 35(7),

872-881. https://doi.org/10.1080/10410236.2019.1598616

Franck, L., Molyneux, N., & Parkinson, L. (2015). Systematic review of interventions addressing

social isolation and depression in aged care clients. Quality of Life Research, 25(6), 1395-1407.

https://doi.org/10.1007/s11136-015-1197-y
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Gariépy, G., Honkaniemi, H., & Quesnel-Vallée, A. (2016). Social support and protection

from depression: Systematic review of current findings in western countries. British

Journal of Psychiatry, 209(4), 284-293. https://doi.org/10.1192/bjp.bp.115.169094

Ghamari Givi, H., Zahed, A., & Fathi, D. (2016). Effectiveness of group cognitive-behavioral

therapy on depression among the mournful elderly. Journal of Geriatric Nursing, 2(3), 22-31.

https://doi.org/10.21859/jgn.2.3.22