Case
NUR 355 Depression Case Study
- Course
- NURS MISC
- Institution
- California Baptist University
This is a comprehensive and detailed case study on; Depression/overdose with psychosis. *Essential Study Material!! *Contains valuable info!!
[Show more]
Content preview
Depression/Overdose with PsychosisUNFOLDING Reasoning
Jenna Taylor, 18 years old
Primary Concept
Mood and Affect
Interrelated Concepts (In order of emphasis)
1. Safety
2. Psychosis
3. Clinical Judgment
4. Communication
5. Collaboration
© 2016 Keith Rischer/www.KeithRN.com
, Depression/Overdose with Psychosis
History of Present Problem:
Jenna Taylor is an 18-year-old woman who is brought to the emergency department by ambulance after she admitted to
her mother that she had taken a “handful” of dextroamphetamine/amphetamine (Adderall) this morning. Mom noted that
there are 20 tablets missing. Jenna admits that she has been hearing voices telling her that she is worthless and would be
better off dead. She denies visual hallucinations.
As the primary nurse explores these comments further, Jenna states, “The devil is in the place! I can feel it! The
voices are telling me that I am going to hell forever.” Jenna appears fearful, anxious and does not maintain eye contact.
When she briefly glances and looks your way, she appears to be looking through you.
Personal/Social History:
She was hospitalized three weeks ago for depression and suicidal ideation and was discharged ten days ago. Jenna lives
with her mother. Her parents were divorced 12 years ago. She graduated from high school, has few close friends, and has
no current plans for her future.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Problem: Clinical Significance:
Patient!took!a!“handful”!of!dextroamph Patient!is!a!danger!to!herself,!because!she!intended!to!harm/
etamine/!amphetamine!(Adderall)!this! kill!herself!when!she!took!the!drugs.!The!drug!used,!amount!
morning!and!mom!noted!20!tablets!mi of!drug!used,!and!time!it!was!consumed!are!important!to!trea
ssing.!Patient’s!symptoms!include;!fea ting!the!patient.!The!patient's!symptoms!are!important!for!tre
rful,!anxious,!she!doesn't!make!eye!co atment!and!diagnosis.!Auditory!command!hallucinations!are!
ntact,!and!she!is!hearing!voices!telling serious!and!need!to!be!handled!immediately,!because!they!p
!her!she!is!“worthless!and!would!be!be ut!the!patient!at!risk!for!harming!others!or!themselves.!Patien
tter!off!dead”!also!voices!telling!her!sh t!is!also!fearful,!anxious,!and!doesn't!make!eye!contact!which
e!is!“going!to!hell!forever”" !could!mean!the!patient!is!in!a!psychotic!state.!
RELEVANT Data from Social History: Clinical Significance:
Patient!was!hospitalized!3!weeks!ago! Patient!had!a!history!of!depression!and!suicidal!ideatiom!whi
for!depression!and!suicidal!ideation!an ch!put!the!patient!an!increased!risk!for!suicide.!Patient!was!di
d!was!discharged!10!days!ago.!Patien scharged!10!days!ago,!and!a!readmission!within!30!days!afte
t’s!parents!were!divorced!12yrs!ago.!P r!discharge!calls!for!observation.!The!divorce!could!be!a!caus
atient!has!few!close!friends.!Patient!liv e!of!depression.!Patient!seems!to!be!isolating!herself!for!soci
es!with!mom!and!has!no!current!plans ety,!because!she!has!few!close!friends!and!has!no!future!goa
!for!her!future. ls.!Isolation!can!make!depression!worse.!!!"
What is the RELATIONSHIP of your patient’s past medical history (PMH) and current meds?
(Which medication treats which condition? Draw lines to connect.)
PMH: Home Meds: Pharm. Classification: Expected Outcome:
x Attention deficit 1. Dextroamphetamine/amphetamine XR 1.!CNS!stimulants" 1.!Patient!will!have!i
hyperactivity 20 mg PO daily 2.!Benzodiazepines!" ncreased!attention!s
disorder (ADHD) 2. Clonazepam 0.5 mg PO BID 3.!Antidepressants!" pan"
x Depression with 3. Bupropion HCL SR 100 mg PO BID 2.!Patient!will!have!d
psychosis ecreased!anxiety!"
x Anxiety 3.!Patient!will!have!d
One disease process often influences the development of other illnesses. Based on your knowledge of
pathophysiology, (if applicable), which disease likely developed FIRST, then initiated a “domino effect” in Jenna’s
life?
x Circle the PMH problem that likely started FIRST.
x Underline at PMH problem(s) FOLLOWED as domino(s).
© 2016 Keith Rischer/www.KeithRN.com
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67163 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now