24TH CASE SCENARIO. (NURSING) DEPRESSION.

Age/Sex 65years Male.

Patient name: Butler,David.

Admitted 06/12/2004.

MR : Q000099923236

Admitting Doctor: Abraim ,Jesus.

Location: 2West

CODE STATUS Full code.

Height :5ft 9inches.

Weight: 125lbs.

Admitting Diagnosis: Depression.

Signs and symptoms of depression are withdrawn, regressive behavior, Obsessive thoughts, unkempt appearance, insomnia, psychomotor retardation.

NURSING RESPONSIBILITIES:

Check for possible suicide, report behavioral changes, meet physical needs, structured,simple routines, use touch judiciously, encourage expression 0f feeling.

TREATMENT:

Antidepressant, group therapy, individual and family therapy.

A 65years old man recently retired salesman is brought in Psychiatric Hospital by his wife.His wife said that since her husband retired, he is listless, and roams around the house totally out of control. He complains that he has nothing to do.The patient said that without a job,I have no purpose in life.What is my reason to be living?.His wife said that he eats very little, has lost 10lbs and sleep for only three hours every night. In order to prioritize the patient’s nursing care plan ,the nurse should assess patient for Suicidal Ideation. By asking patient to see if the patient has ever thought of hurting himself.

Allergy : NKDA

Room air.

Medications:

Seroquel 100mg po 09am.

Seroquel 50mg po 2100.

Tylenol 650mg po Q6hours Temperature >100.4.

Risperdal 3mg po daily.

Zyprexa 2.5mg po daily anxiety .

QUESTIONS:

What is depression?.

What causes depression?.

Do the patient need nutrition consult?.

Should his wife be afraid of her life?.

Why is the patient turning his retirement inward?.

Can he change his life and stop the anger?.

Questions:

When planning care for a 56years old man hospitalized with depression, the nurse include measures to increase his self esteem. Which of the following actions should the nurse take to meet this goal.

Answer: Set simple realistic goals with him to help him experience success.

Question:

After two weeks of receiving lithium therapy a patient in the Psychological unit becomes depressed. Which of the following evaluations of the patient’s behavior by the nurse would be most accurate.

Answer: This is normal response to lithium therapy, the patient should be monitored for suicidal behavior.

Question:

Several days after being admitted for depression, a man is observed sitting alone in the patient’s dining room. The nurse notes that the patient has not finished his meal. What will be the most appropriate nursing measures.

Answer: Order small frequent meals and sit with the patient while he eats in the dining room.

ECT:Electroconvulsive Therapy.

Stimulation for convulsions similar to grand mal seizures as treatment for depression.

Requires 6 – 12 treatment.

Preparation.

NPO 4hours,informed consent,encourage patient to avoid before starting procedure, remove jewelry, atropine 30minutes before to reduce secretions.

During Treatment:Short acting IV anesthesia and muscle relexant,Oxygen,Suction available.

After Treatment: Confusion, and memory loss for recent events, stay with patient, reorient and check vital signs.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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