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Psychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and\/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients\u2019 lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse\u2019s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.<\/p>\n
For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient\u2019s pathophysiology.<\/p>\n
To Prepare<\/p>\n
Review this week\u2019s interactive media pieces and select one to focus on for this Discussion.
\nReflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient\u2019s pathophysiology.
\nINTERACTIVE MEDIA: Hispanic Male with major depressive disorder (MDD)<\/p>\n
BACKGROUND INFORMATION<\/p>\n
The client is a 70 year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to your office for an initial appointment for complaints of depression. The client was referred by his PCP after \u201croutine\u201d medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and \u201cstiff\u201d shoulders which he attributes to his current work as a laborer in a warehouse.<\/p>\n
SUBJECTIVE<\/p>\n
During today\u2019s clinical interview, client reports that he always felt like an outsider as he was \u201cteased\u201d a lot for being \u201cblack\u201d in high school. States that he had few friends, and basically kept to himself. He describes his home life as \u201cgood.\u201d Stating \u201cDad did what he could for us, there were 8 of us.\u201d He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in \u201ctrouble\u201d at work.<\/p>\n
MENTAL STATUS EXAM<\/p>\n
The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. You administer the \u201cMontgomery- Asberg Depression Rating Scale (MADRS)\u201d and obtained a score of 51 (indicating severe depression).<\/p>\n
RESOURCES<\/p>\n
\u00a7 Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.<\/p>\n
Assignment: Write a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient\u2019s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.<\/p>\n
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