Psychiatric Nursing care analysis - Research Paper Example

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Client Care Analysis The patient in this study is a 76-year-old Caucasian female. This patient recently underwent surgery for an open colon resection, which has left her with obvious physical deformities of the abdomen. As a result, she is being carefully observed for signs of clinical depression in her behavior and attitude…
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Psychiatric Nursing care analysis
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Download file to see previous pages At the end, a discussion of nursing management techniques for patients experiencing symptoms of depression will be examined. Current Theories in the Etiology, Presentation, and Prognosis of Depression The causes of depression are complex, but are generally understood to be a combination of environmental and genetic factors, such as a traumatic life event combined with a genetic susceptibility to hormone disruption in seratonin levels, though such a connection has not been conclusively proven (Abela & Hankin, 2008; Risch et al., 2009). There is, however, a definitive correlation between “stressful” or otherwise disruptive events and the beginnings of depressive symptoms (Risch, et al., 2009). Depression is often co-morbid to an anxiety disorder or attention deficit disorder (Luby, Belden, Pautsch, Si, & Spitznagel, 2009;Goldberg, et al., 2010). When presenting independently, these disorders are also generally risk factors for depression. Depression is also often seen as a precursor to the development of senility or dementia in older adults (Brommelhoff et al., 2009). Additionally, as well as being a symptom, insomnia in older adults is considered a risk factor for depression, though this is still controversial (Fiske, et al., 2009). Depression has two core symptoms used in diagnosis which must be experienced for at least a two week period: feelings of sadness or misery without a specific reason for such feelings, and a loss of interest in previous-enjoyed activities (Goldberg, Kendler, & Sirovatka, 2010). In older adults such as the client in this report, insomnia is a widely noted symptom, which is a converse to the hypersomnia usually noted in younger adults with depression (Nutt, Wilson, & Paterson, 2008). Other symptoms include difficulty concentrating and impaired decision-making, change in appetite or eating habits, feelings of worthlessness, and thoughts of suicide (Keenan et al., 2008). Older adults, however, are less likely to display emotional symptoms, and instead present with cognitive decline, motor skills impairment, and a wider range of somatic symptoms (Fiske, Wetherell, & Gatz, 2009). The prognosis of major depressive disorder is highly variable against the length of time the initial depressive episode was present. More minor presentations of the disorder behave similarly to major depressive disorder, but the patients are likely to worsen before they improve. In one study, patients with a previous history of depressive episodes lasting longer than one year were more likely to suffer from a relapse episode that would last longer than six months. This was true even if the initial episode experienced was only minor or sub-threshold depression (Gilchrist & Gunn, 2007). Sub-threshold symptoms in older adults will generally persist for at least a year and makes the person seven times more likely to develop major depression in that time frame than those who do not exhibit such symptoms (Lyness, Chapman, McGriff, Drayer, & Duberstein, 2009). Relationship of Theories to Client Behavior Given that the client has recently undergone major surgery, she is at a higher risk for depression than most of the population. Any surgery could be considered a major life event, but an open colon resection especially would be a very stressful and possibly traumatic experience for the patient, resulting in major physical changes to ...Download file to see next pagesRead More
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