In this case study you will review a client who is suffering with major depression and develop a plan of care based on the case study. Review the case study and answer the questions. Place the questions in a Word document to be submitted via the Dropbox.

A title page or a running head are not needed. However, the document should adhere to APA format guidelines including font size, grammar and format. Response is clearly written using Standard English including correct grammar, spelling, punctuation, and complete sentences and paragraphs, and be free of typographical errors.

Your end document should be at least three pages in length (with the supplied questions) and not including the reference page. All questions should be answered, and responses should be on topic and demonstrate understanding of material covered by the case study.

You should make at least one direct reference to the unit’s material to support this plan of care. You should use a journal article retrieved from the library to support your paper as well as at least one reference to this unit’s assigned reading. Please review the rubric for point distribution.

How to Submit

When you are ready to submit your Assignment, click the Dropbox, then attach your Word document file. Make sure to save a copy of the Assignment you submit.

Depression Case Study

Assessment

K.S. is a 45 year old woman complaining of insomnia. Initial impression is a fatigued and tearful woman. She is being seen by the nurse practitioner and you are doing an intake assessment in her office. K.S. checks in and is smelling heavily of alcohol. Breathalyzer reveals an alcohol level of 0.25% or over three times the legal limit. Her primary complaint, “I just need something to help me sleep.”

K.S. reports a recent move from a neighboring state after obtaining a bachelor’s degree in elementary education. She reports an unintentional 20 pound weight loss since starting the job. She has only been here for 3 months after being hired by the local school system. She is unmarried, and has no local friends. She broke up with her long-time fiancé two months ago, since he did not want to follow her to her new job.

K.S. reports, “My boss is not supportive, it’s either sink or swim here…I can’t sleep, I feel nauseated all of the time…I just spent my life’s savings on four years of college and I just don’t think I can be a teacher…I just wasted four years of my life. I don’t think I can stand it anymore.”

How do you respond therapeutically to K.S.? (1 point)

K.S. has no pertinent medical or psychiatric history and is not taking any medications at the time of her admission. K.S. is diagnosed with major depression and feels she is a danger to herself at this time. K.S. is admitted to the inpatient psychiatric unit for major depression. She is assigned to Dr. Akey-Heart.

What symptoms support a diagnosis of major depression? What are you trying to prevent or promote when she is admitted? (1 point)

What three criteria would make K.S. a priority for admission for inpatient psychiatric care? (1 point)

List two nursing diagnoses in the order of priority that apply to K.S. (one should address safety). Include two SMART goals (1 point).

List 3 nursing interventions for each nursing diagnosis to help K.S. meet these goals (1 point).

Dr. Akey-Heart prescribes sertraline 50 mg po daily x5 days then increases to 100 mg po daily.

During initiation of a new selective serotonin reuptake inhibitor (SSRI), it’s important to monitor for serotonin syndrome, what are the symptoms of serotonin syndrome? What is the black box warning for teens and young adults who take this medication? What other adverse effects do medications in this class include? (1 point)

Why is the first week on antidepressants the most dangerous time? (1 point)

What benefits do SSRI’s have over tricyclic antidepressants? What advantages does this medication have over MAO inhibitors? (1 point)

How to Submit

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.