Running head: CASE STUDY 1

Case Study Depression mental health

Students Name

Institutional Affiliation

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 CASE 2

Introduction

Mental health as a state which affects how an individual thinks, act and feel includes

psychological, emotional and social well-being. Depression as a mental disorder usually causes

people to experience low self-worth, disturbed sleep and loss of interest as seen in K.S case. K.S

is a 45 years old woman, who is complaining of insomnia, and during the intake assessments she

checks in the office smelling heavily of alcohol which its level is three times the legal limit.

During the assessment K.S reports that she recently moved from a neighboring state to take a job

as a teacher, unintentionally lost 20 pounds after starting the job besides being unmarried and

having no friends. Her main complaints include she cannot sleep, feels nausea all the times and

wasted the four years she spent in college considering she doesn't want to be a teacher anymore.

The paper will discuss various issues pertaining to K.S case including her SAD PERSONS tool,

safety assessment questions, therapeutic response, medication, nursing diagnosis and

intervention.

SAD PERSONS tool

The SAD PERSONS tool in the case of K.S is D which stands for depression and the

scale is 3 to 4 indicating close follow-up will be required and hospitalization considered in

severe case (Quinlivan et al., 2017). The recent life changes including moving to a new state,

taking a new job as a teacher and breaking up with her long-time fiancé may have increased her

stress.

Question To Ask While Assessing Her Safety

After being admitted to the inpatient psychiatric unit, there are several questions which

Karen can be asked while assessing her safety. The questions include what is the nature and

level of her inner distress and pain, are suicidal thought and feelings present, has she harmed

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 CASE 3

herself before, what is the degree of her suicidal intent and if she possesses the capacity to enter

into a therapeutic partnership (Warner et al., 2013). Karen qualifies for immediate inpatient

hospitalization due to her depression level which has resulted in alcohol addiction, lack of sleep

besides having suicidal thoughts.

Therapeutic Response

Karen fear of losing her job and feeling embarrassed requires a therapeutic response. As a

healthcare provider, one can use the Socratic questioning technique as one of the therapeutic

response techniques. The Socratic response will contains series questions which one can ask her

in order to help her consider the new perspective of herself and place in the world (Gregoire,

2015). The technique will help to stop being embarrassed and reduce the depression. Another

therapeutic response may involve learning her preferences in order to promote her comfort

through active listening and observation. Taking time to listen to her and express her fears and

anxieties can help in determining the best medical prescription to help her cope with the

concerns besides assuring her that she will be well.

Medication

The prescribed Lexapro 10 mg drugs in essential in treating depression and anxiety. The

medication helps in restoring the balance of serotonin in the brain. Lexapro is in the class of

inhibitors drugs and has advantages over tricyclic antidepressants. The advantage is in terms

times it takes to start working. Regarding the time it takes to start working, Lexapro may take 1

to 2 weeks for the patient to feel the benefit of using the medication and four weeks for full

benefit (Web Med, 2018). Tricyclic antidepressant takes 2 to 6 weeks for patients to start feeling

the benefits (Knott, 2017). On matters about side effects, both tricyclic antidepressant and

Lexapro have severe side effects including vision changes, fainting, irregular heartbeat, and

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 CASE 4

tremor. Also, Lexapro has an advantage over MAO inhibitors regarding the time the medications

start working; MAO inhibitors takes 2 to 6 weeks for the patient to feel the benefit while

Lexapro takes 1 to 2 weeks (Marshall, 2013). On the issue of side effects, both medications have

severe ones including increased tremor, nausea, decreased sex drive, constipation and increased

anxiousness. The first weeks of the antidepressants are the most dangerous times because of the

increased side effects considering the antidepressants medication has not started to become

effective. Also, other individuals have violently adverse reactions to antidepressants during the

first weeks, but over the sides, effects will subdue as the drug start working more.

Nursing Diagnosis

Three-part nursing diagnosis is one of the most vital aspects of nursing, and there is two-

three parts diagnosis which can apply to K.S situation. The first three-part diagnosis is Problem

statement, Etiology and Symptoms or defining characteristics. Problem statement or diagnostic

label will describe K.S health problems or response for which nursing therapy is given. Etiology

will state the probable cause of her health problem including her behavior and interaction with

the environment (NANDA, 2018). Defining characteristics or symptoms involve the unusual

data items discovered during her assessment, the data items may include sign and symptoms and

response to the disease. Another three-part diagnosis may consist of the diagnostic label,

defining characteristics and related or risk factors. Diagnostic label involves a concise

description of the

M.S problem, defining characteristic can include a description of signs and symptoms associated

with the diagnosis while related and risk factor can involve the description of the elements which

causes or contribute to the M.S problem (NANDA, 2018).

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 CASE 5

Goals Which Apply To Nursing Diagnosis

Based on the patient assessment and diagnosis, a healthcare provider can set specific

measurable and achievable short and long-range goals for the patient. One applicable goal in

K.S situation is ensuring she uses the available resources and support systems to enhance her

recovery. Another goal is ensuring she verbalizes the feelings related to her emotional state as

she focuses on the present. In addition, other goals may include ensuring she communicates her

needs and remains safe without harming herself during hospitalization (Warner et al., 2013).

Nursing Interventions to Meeting the Goals

In order to meet the goals, there are certain interventions which must be carried out to

ensure K.S meets the goals. The interventions include the healthcare provider ensuring he or she

assess K.S mental status about suicidal thoughts during assessment sessions , discussing with her

regarding getting involved or setting up a network of people who she can consult and ask for

advice during emotional times and encouraging her to focus on her strengths and abilities. In

addition a healthcare provider can provide her with a chance to express her fears, feelings, and

concern besides encouraging her to make choices and get involved in a care plan.

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 CASE 6

References

Gregoire, C. (2015). This Simple Technique Can Instantly Reverse Negative Thoughts. HuffPost

UK. Retrieved 5 March 2018, from https://www.huffingtonpost.com/entry/socratic-

method-improve-depression_us_55ca2888e4b0f1cbf1e65731

Knott, L. (2017). Antidepressants | Tricyclic, SSRI and MAOI. Patient.info. Retrieved 5 March

2018, from https://patient.info/health/depression-leaflet/antidepressants

Marshall, H. (2013). Monoamine oxidase inhibitors. Netdoctor. Retrieved 5 March 2018, from

http://www.netdoctor.co.uk/medicines/depression/a630/monoamine-oxidase-inhibitors/

NANDA. (2018). NANDA International Nursing Diagnosis .Nanda.org. Retrieved 5 March

2018, from http://www.nanda.org/nanda-international-glossary-of-terms.html

Quinlivan, L., Cooper, J., Meehan, D., Longson, D., Potokar, J., Hulme, T., ... & Page, L. (2017).

Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort

study. The British Journal of Psychiatry, 210(6), 429-436.

Warner, C. H., Warner, C. M., Appenzeller, G. N., & Hoge, C. W. (2013). Identifying

and managing posttraumatic stress disorder. Am Fam Physician, 88(12), 827-34.

Web Med (2018). Drugs & Medications Lexapro . Webmd.com. Retrieved 5 March 2018, from

https://www.webmd.com/drugs/2/drug-63990/lexapro-oral/details

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