Depressive Disorder Assignment Paper
Depressive Disorder Assignment Paper
As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role Depressive Disorder Assignment Paper.
In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.
Learning Objectives
Students will:
Recommend psychopharmacologic treatments based on therapeutic endpoints for clients with depression disorders
Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders
Identify medical management needs for clients with depression disorders
Identify community support resources for clients with depression disorders
Recommend follow-up plans for clients with depression disorders
To prepare for this Assignment:
Select an adult or older adult client with a depressive disorder you have seen in your practicum.
In 3–4 pages, write a treatment plan for your client in which you do the following:
Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
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Recommend a plan for follow-up intensity and frequency and collaboration with other providers.
Introduction
A depressive disorder is a psychological condition whereby the patient expresses feelings of sadness and worthlessness. This is accompanied by a lack of interest in enjoyable activities. Other symptoms of the condition include the individual being excessively sad, dejected, empty and hopeless, as well as feeling worthless and melancholy. Depression typically ensues after a traumatic event with the individual being unable to express the negative feelings characterizing the traumatic events resulting in a general feeling of lethargy in all activities. Treatment for depression requires long-term care that addresses the psychological, environmental, biochemical and genetic causes of the condition (Sadock, B., Sadock, V. & Ruiz, 2014). The present paper explores the management of depression using a case study approach Depressive Disorder Assignment Paper.
Discussion
Describe the HPI and clinical impression for the client
Patient’s Name: Peter
Sex: Male
CC: “I have been feeling down since I lost my job. I do not want to get out of the house or even get up in the morning. In fact, I do not want to meet any of my friends or relatives.”
HPI: Peter is a 40-year-old Caucasian who reports that he has been fatigued in recent weeks. Since he lost his job eight months ago, he has lacked the motivation to look for a new job or even get out of the house. He would rather spend time lounging in bed. He believes that losing the income from work has been very stressful with the situation worsening since his savings are dwindling.
Psychosocial: Peter is divorced has a daughter who stays with his wife for whom he pays child support. He does not exercise and moderately drinks alcohol at social events.
Neurological: Peter is alert and oriented x 3. He has clear and coherent speech.
Psychiatry: Flat affect
Psych: Reports lethargy.
Labs: CBC-Normal, TSH-Normal, and BMP-Normal.
Differential Diagnosis: Depression, hypothyroidism, and vitamin D deficiency
Assessment: Depression
Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent
Peter should be started on a prescription of 20 mg of oral Prozac taken once daily. Prozac has been selected because it is recommended for treatment of depression and does not have significant side effects. His next appointment should be four weeks after starting the medication during which time he will be assessed for drug effectiveness and side effects. If the symptoms ease slightly with no major side effects then the dosage will be increased to 60 mg daily with 30 mg taken in the morning and 30 mg taken at night. If the level of improvement is still not acceptable, then the dose will be increased to a maximum of 80 mg daily with 40 mg taken in the morning and 40 mg taken at night (Acton, 2013) Depressive Disorder Assignment Paper.
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices
Other than the psychopharmacological treatment, the patient should be subjected to psychotherapy. In this case, the treatment would entail the use of interpersonal therapy that encourages the patient to improve interpersonal relationships and be more outgoing to relieve the feelings of lethargy. For that matter, the therapy would encourage the patient to open up in social settings, discuss his depression, and find strategies on how best to address the condition. Through personal expression in a social setting supervised by a qualified therapist, the patient would be able to explore the causes of the depression, its effects and how best to address them so that the feelings of lethargy are resolved (Cautin & Lilienfeld, 2015).
Identify medical management needs, including primary care needs, specific to this client
Peter’s needs during the treatment period would include engaging in social interactions to allow him explore his feelings. In this case, he would be encouraged to attend social events and other activities that can enhance his mood and eliminate the feelings of lethargy. In fact, any activity that would improve cognition and mood would be encouraged, particularly if they include social activities such as looking for and attending work, and attending social functions such as weddings and birthday parties. Besides that, his motivations for seeking treatment would be maximized by conducting regular assessments that evaluate the treatment progression while addressing any concerns he may have (Wheeler, 2014). For instance, there may be a need to review the treatment approach and change the dose, medication, or therapist if he expresses reservations about the current modalities.
Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client
There is a range of community support resources available to Peter as a person with depression. Firstly, he can access financial counseling services. These services would offer him advice on how to get credit and affordable housing. Secondly, he can access mental health services that help him to better manage and live with his depression within the community. Thirdly, legal aid that could address any concerns about victimization given his condition. Finally, he can access pharmacological hotlines that present immediate emergency advice on medication Depressive Disorder Assignment Paper.
Recommend a plan for follow-up intensity and frequency and collaboration with other providers
Peter should be encouraged to take the prescribed medication along with attending psychotherapy. This is a two-pronged approach that has additive effects without any contraindications. In using the two complementary approaches, the chances of the patient’s condition being wholly managed are increased thereby offering the best treatment approaches. Besides that, the [patient should be encouraged to express any reservations with the treatment approach to include serious side effects, need to change medication, and any desire to change the therapist if the approach is not producing the desired results.
Conclusion
It is evident the depression is characterized by feelings of sadness and worthlessness after a traumatic event. In the present case, the patient reports that he has been feeling lethargic for the last eight months after losing his job. A review of clinical review of his symptoms shows that he has depression. To address the condition, Prozac has been prescribed with provisions to adjust the dose based on how the patient responds to treatment. In addition, the patient should be subjected to psychotherapy that has an additive effect in relieving his depression symptoms. Besides that, he should be informed of the community resources that are available for his use to facilitate the treatment.
References
Acton, A. (2013). Major depressive disorders: new insights for the healthcare professional. Atlanta, GA: Scholarly Editions.
Cautin, R. & Lilienfeld, S. (2015). The encyclopedia of clinical psychology, volume II Cli-E. Hoboken, NJ: John Wiley & Sons.
Sadock, B. J., Sadock, V. A. & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.
Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company Depressive Disorder Assignment Paper.
