Lee Arthur
Depression/Overdose with Psychosis
UNFOLDING Reasoning
Jenna Taylor, 18-years-old
,Lee Arthur
, Lee Arthur
Depression/Overdose with Psychosis
History of Present Problem: Jenna Taylor is an 18-year-old woman who is brought to the
emergency department by ambulance after she admitted to her mother that she had taken a
“handful” of dextroamphetamine/amphetamine (Adderall) this morning. Mom noted that there
are 20 tablets missing. Jenna admits that she has been hearing voices telling her that she is
worthless and would be better off dead. She denies visual hallucinations. As the primary nurse
explores these comments further, Jenna states, “The devil is in the place! I can feel it! The voices
are telling me that I am going to hell forever.” Jenna appears fearful, anxious and does not
maintain eye contact. When she briefly glances and looks your way, she appears to be looking
through you.
Personal/Social History: She was hospitalized three weeks ago for depression and suicidal
ideation and was discharged ten days ago. Jenna lives with her mother. Her parents were
divorced 12 years ago. She graduated from high school, has few close friends, and has no current
plans for her future.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Clinical Significance:
Problem:
• 18-year-old female • Young adults and females are at higher risk for
• Took up to 20 Adderall mental health problems such as depression and
• Auditory hallucinations personality disorders.
• Anxious, fearful • Adderall is a stimulant and when taken in high doses
• Does not maintain eye contact will cause severe cardiovascular complications and
can cause sudden death.
• Could be caused from the high dose of Adderall; if
she were hearing voices prior to OD this could be
sign of psychosis. Patient should be monitored at
ALL times
• Anxiety and fearfulness are side effects of
amphetamine toxicity; calming down patient should
be priority
• No eye contact signifies that the patient may be
disconnected with reality, making it hard to
effectively communicate with the patient.
RELEVANT Data from Social Clinical Significance:
History:
• Very recent hospitalization for • Recent hospitalization for SI and depression indicate
SI and depression that she did not get better after discharge.
• Lives with mother • Mom can help monitor patient’s behavior at home
• Divorced parents • Divorced parents during early childhood can cause
• Few Close Friends childhood trauma
• No current plans for future • Few close friends – indicates that she may be at risk
for loneliness, maybe at risk for social withdrawal.
• Plans for future will help patient have something to
Depression/Overdose with Psychosis
UNFOLDING Reasoning
Jenna Taylor, 18-years-old
,Lee Arthur
, Lee Arthur
Depression/Overdose with Psychosis
History of Present Problem: Jenna Taylor is an 18-year-old woman who is brought to the
emergency department by ambulance after she admitted to her mother that she had taken a
“handful” of dextroamphetamine/amphetamine (Adderall) this morning. Mom noted that there
are 20 tablets missing. Jenna admits that she has been hearing voices telling her that she is
worthless and would be better off dead. She denies visual hallucinations. As the primary nurse
explores these comments further, Jenna states, “The devil is in the place! I can feel it! The voices
are telling me that I am going to hell forever.” Jenna appears fearful, anxious and does not
maintain eye contact. When she briefly glances and looks your way, she appears to be looking
through you.
Personal/Social History: She was hospitalized three weeks ago for depression and suicidal
ideation and was discharged ten days ago. Jenna lives with her mother. Her parents were
divorced 12 years ago. She graduated from high school, has few close friends, and has no current
plans for her future.
What data from the histories is RELEVANT and has clinical significance to the nurse?
RELEVANT Data from Present Clinical Significance:
Problem:
• 18-year-old female • Young adults and females are at higher risk for
• Took up to 20 Adderall mental health problems such as depression and
• Auditory hallucinations personality disorders.
• Anxious, fearful • Adderall is a stimulant and when taken in high doses
• Does not maintain eye contact will cause severe cardiovascular complications and
can cause sudden death.
• Could be caused from the high dose of Adderall; if
she were hearing voices prior to OD this could be
sign of psychosis. Patient should be monitored at
ALL times
• Anxiety and fearfulness are side effects of
amphetamine toxicity; calming down patient should
be priority
• No eye contact signifies that the patient may be
disconnected with reality, making it hard to
effectively communicate with the patient.
RELEVANT Data from Social Clinical Significance:
History:
• Very recent hospitalization for • Recent hospitalization for SI and depression indicate
SI and depression that she did not get better after discharge.
• Lives with mother • Mom can help monitor patient’s behavior at home
• Divorced parents • Divorced parents during early childhood can cause
• Few Close Friends childhood trauma
• No current plans for future • Few close friends – indicates that she may be at risk
for loneliness, maybe at risk for social withdrawal.
• Plans for future will help patient have something to
