Posted: October 12th, 2022

Week 4 : Assessing, Diagnosing, and Treating Adults With Moo

Week 4 : Assessing, Diagnosing, and Treating Adults With Mood Disorders Walden University NRNP  6665

Week 4: Assessing, Diagnosing, and Treating Mood Disorders in Adults
Subjective:
CC (chief complaint): I have a history of taking and then discontinuing medications. I don’t believe I require them. The medication suffocates me.
Petunia Park, a 25-year-old female patient, arrives at the clinic complaining about her inability to finish the drug dose. She complains about sleeping fewer hours and engaging in sex exploration to alleviate her symptoms. She puffs on a pack of cigarettes. The patient denies having depression or bipolar disorder.
Substance She currently smokes a pack of cigarettes every day. She has a history of taking too much Benadryl. She does not consume alcohol, illegal drugs, or opiates.
Her medical history includes four hospitalizations and a history of sleepless nights.
Current Medications: There are no current medications.
Allergies: Zoloft, risperidone, Seroquel, and Klonopin cause reactions.
She has multiple sexual partners and is sexually active. There has been no previous pregnancy or childbirth. She uses birth control pills to prevent pregnancy.
ROS:
• GENERAL: There will be no unintended weight gain or loss, fever, nausea, vomiting, or chills. She has had suicidal thoughts and hallucinations in the past. She is alert and aware of time and place.
• HEENT: No history of vision or hearing loss, sore throat, or running nose.
• SKIN: No rashes, bruises, or lesions on the skin.
• CARDIOVASCULAR: No history of heart palpitations, pressure, or pain.
• RESPIRATORY: There is no history of breathing problems such as asthma.
• GASTROINTESTINAL: Adverse effects include nausea, abnormal bowel sounds, and reflux.
• GENITOURINARY: There are no abnormal urine patterns like polyuria or dysuria.
• NEUROLOGICAL: There have been no reports of falls, dizziness, or stumbling.
• MUSCULOSKELETAL: There is no history of gout or joint pain.
• HEMATOLOGIC: A blood disorder is ruled out.
• LYMPHATICS: This test is negative for enlarged lymph nodes.
• ENDOCRINOLOGIC: Harmful to the endocrine system.
Objective:

Diagnosed with depression
Because the patient admits to having some experiences a few times a year, depression is most likely a condition. The symptoms of the encounter are similar to those of depression. For example, the patient claims that her experiences have caused her to sleep more hours and lose interest in daily activities (Soderholm et al., 2020). The episodes occur after the patient has completed his or her writing projects. Overworking and sleeping less are signs of depression.
Differential Diagnosis – UAE Best Dissertation Writing Help Service
Bipolar illness
Patients with bipolar disorder have manic episodes. The episodes include mood swings that range from highs to lows (Rowland & Marwaha, 2018). The symptoms include a decreased need for sleep as well as a loss of touch with reality.
Personality Disorder with Borderline Personality
BPD is characterized by low moods that impair one’s quality of life. BPD and depression can co-occur. It has an impact on how people perceive themselves and others (Chanen et al., 2020). It causes unstable relationships and makes it difficult to manage emotions.
Obsessive-Compulsive Syndrome (OCD)
Depression and OCD have a close relationship because either condition can lead to the other. It causes unwanted recurring thoughts. It causes irrational fearful thoughts (Robbins et al., 2019). OCD symptoms include agitation, irritability, panic attacks, social isolation, and depression.
Assessment:
28/30 on the Mental Status Examination. The assessment results show that the patient does not have any signs of mental damage or dementia. Patients with mild depression receive a score of 24.
Impression of Diagnosis: Depression
Reflections:
Depression is a common disorder among adolescents. The condition can reduce one’s quality of life and increase the risk of suicidal ideation. Depression necessitates both psychotherapy and medication (Robbins et al., 2019). I’ve discovered that combining psychotherapy and pharmacological approaches to treating the condition is effective. It is critical to encourage the client to avoid any form of drug abuse because drug abuse causes behavior to deteriorate (Robbins et al., 2019). Another lesson is that patients with depression often deny they have a mental illness and rarely seek help.
Patients suffering from depression may experience a variety of symptoms or episodes. Healthcare workers are responsible for gathering detailed information, such as in the current case study (Soderholm et al., 2020). The goal is to collect enough information to make an accurate diagnosis.
Background information about a patient is critical because it allows a healthcare worker to make connections between symptoms and family genes (Soderholm et al., 2020). For example, the client recognizes that some family members suffer from mental illnesses. The data Helps the healthcare worker in determining the patient’s health status.
Due to his depressive state, the patient requires a referral to a counselor. Psychotherapy is critical in the treatment of mental illnesses. Cognitive behavior therapy encourages patients to open up and share information that will help them improve their mental health (Chanen et al., 2020). Another reason for the referral is that the patient claims she smokes a pack of cigarettes every day and is not ready to quit. Smoking can lead to other health complications, such as cancer. It has the potential to be a gateway drug for other drugs such as marijuana.
To address the lost sexual behavior, a referral to a counselor is required. She appears to be working with multiple partners (Chanen et al., 2020). Sexually transmitted infections, pregnancy, and further depressive disorder can all result from this behavior.
Case Development and Treatment Strategy:
Depression is the case formulation. Specific personality traits, traumatic life events, chronic illness, a genetic link, and drug abuse are all risk factors (Stahl et al., 2017). Drug abuse and engaging in sexual behavior with multiple factors are among the precipitating factors. Unresolved relationship conflicts with family, boyfriend, and other sexual partners are examples of the Perpetuating. Reliable support, coping skills, emotional regulation, optimism, and self-sufficiency are all protective factors (Stahl et al., 2017).
Depression treatment necessitates both psychotherapeutic and pharmacological approaches. Talk therapy, such as cognitive behavior therapy, will be used in psychotherapy (Stahl et al., 2017). The goal is to Help the client in changing their behavior by identifying the distorted beliefs and behaviors that are affecting their quality of life. The patient should attend several sessions as recommended by the psychotherapeutic practitioner (Cheung et al., 2018). It is critical to emphasize the importance of sticking to the treatment plan.
Antidepressants will be used in the pharmacological treatment. Sertraline (Zoloft) 50mg tablet taken at bedtime can help the patient experience symptom relief (Cheung et al., 2018). The medication’s goal is to improve sleep patterns, appetite, and social interaction. Sertraline (Zoloft) is advised because it has few side effects and produces significant results.
To improve the quality of the results, the patient requires family support and other lifestyle changes. For example, the patient may require the Helpance of family members. Another approach is to make a daily schedule and set aside time for sleeping (Cheung et al., 2018). The patient should avoid working so hard that they forget to sleep. Another lifestyle change is to find a stress-relieving activity, such as meditating, going to the movies with a friend, or participating in sports.

References
A. M. Chanen, K. Nicol, J. K. Betts, and K. N. Thompson (2020). Borderline personality disorder in adolescents: diagnosis and treatment 1-8 in Current Psychiatry Reports, 22(5).
A. H. Cheung, R. A. Zuckerbrot, P. S. Jensen, D. Laraque, R. E. Stein, and the Glad-PC Steering Group. (2018). Part II of the Guidelines for Adolescent Depression in Primary Care (GLAD-PC). Treatment and ongoing supervision 141, Pediatrics (3).
T. W. Robbins, M. M. Vaghi, and P. Banca (2019). Obsessive-compulsive disorder: Questions and Answers Neuron, vol. 102(1), pp. 27-47.
T. A. Rowland and S. Marwaha (2018). Bipolar disorder epidemiology and risk factors 8(9), 251-269. Therapeutic Advances in Psychopharmacology.
J. J. Soderholm, J. L. Socada, T. Rosenström, J. Ekelund, and E. T. Isometsä (2020). A comparison study found that borderline personality disorder combined with depression increases the risk of suicidal behavior in mood disorder patients. Frontiers in Psychiatry, vol. 11, no. 290.
S. M. Stahl, D. A. Morrissette, G. Faedda, M. Fava, J. F. Goldberg, P. E. Keck,… and R. S. McIntyre (2017). Guidelines for recognizing and treating mixed depression. 22(2), pp. 203-219 in CNS Spectrums.

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