Case Study 142 Depressed Patient with Suicidal Thoughts (Complete 100% ) Latest Version

Case Study 142 Depressed Patient with Suicidal Thoughts 1. What other information should you ask J.B. regarding his thoughts of suicide? o Do you have a plan to carry through with your thoughts of suicide? If so, when do you plan on carrying out the plan? o Have you attempted suicide in the past? o What are some coping mechanisms you have tried using? 2. What characteristics of J.B. put him at a high risk for suicide? o Characteristics of J.B. that put him at a high risk for suicide are the occurrence of his wife dying recently, feelings of loss and loneliness, feelings of sadness most of the time, interruption in his normal activities, loss of interaction with friends and family, and thoughts of suicide. 3. Which psychiatric disorders can result in suicidal ideations or gestures? Name at least three. o Depression o Anxiety o post-traumatic disorder 4. What questions should you ask J.B. to determine whether he his clinically depressed? Name at least six. 1. Are you have difficulty sleeping or sleeping more than usual? 2. How have your eating habits been? Are you eating more or less than usual? 3. How long have you been having these feelings of sadness? 4. Do you know of any family being diagnosed with depression? 5. Has it been more difficult for you to concentrate or make decisions? 6. How often do you have feelings of sadness, hopelessness, or worthlessness? 5. Ill people often have trouble sleeping, experience change in appetite, reduce their level of activity, and have thoughts of death. How can you tell the difference between old age with illness and depression? o Old age can cause fatigue and decreased level of activity but it should not cause a loss of desire or interest in activities or thoughts of death. To determine the determine, the characteristics and risk factors of the illness should be assessed to determine the differences between the illness and depression. 6. List five of the most common signs of depression in the older adult. 1. Depressed mood 2. Difficulty sleeping or excessive sleeping 3. Suicidal ideation 4. Indecisiveness 5. Change in sleep pattern 7. Which of these would be considered soft methods of suicide? Select all that apply. o Slashing one’s wrist o Ingesting pills o Inhaling natural gas 8. What immediate interventions would you carry out for J.B.? o Immediate interventions for J.B. would include assessing suicide risk and plan, implement safety precautions or one-to-one observation as needed, monitor the client’s ability to perform activities of daily living, and include individual counseling 9. Identify two treatments that are available for depression. 1. Electroconvulsive therapy (ECT) is an available treatment for depression. ECT uses electrical current to introduce brief seizure activity while the client is anesthetized. This is thought to enhance the effects of neurotransmitters in the brain 2. Transcranial magnetic stimulation (TMS) is another available treatment for depression. TMS is a noninvasive therapy that uses magnetic pulsations to stimulate the cerebral cortex of the brain, 10. Would J.B. be a candidate for electroconvulsive therapy (ECT)? Why or why not? o J.B. would not be a candidate for ECT because ECT is indicated for clients who have major depressive disorder and are not responsive to pharmacological treatment and who are experiencing psychotic manifestations. J.B. has not started pharmacological therapy and he is not portraying psychotic manifestations. Another reason J.B. is not a candidate for ECT is because cardiovascular disorders are a contraindication for ECT because it places the client at a higher risk for adverse effects 11. What special instructions will you give him regarding the Lexapro? Select all that apply. o The medication may cause nausea, dry mouth, sedation, and insomnia. o The herbal product St. John’s wort will enhance the action of the Lexapro. 12. Why do you think that a drug in the SSRI class was chosen over a tricyclic antidepressant or a monoamine oxidase inhibitor (MAOI)? o SSRIs have less side effects than MAOIs o More food interactions to be aware of with MAOI such as aged cheese, cured meat, sauerkraut, fermented soy products, raisins, dates, or other dried fruits, nuts, and other foods and drinks with tyramine o MAOIs can take up to six weeks to work while SSRIs can work within four weeks. 13. What important information needs to be conveyed to J.B.’s daughter about the first few weeks of therapy with the SSRI? o Do not stop medication abruptly o Teach that therapeutic effect may tale 1-4 weeks and that he may have increased anxiety for the first 5-7 days, but do not abruptly discontinue the medication, o If he has symptoms of nausea, vomiting, sedation, dizziness, sweating, facial flushing, mental changes, and shivering, to report it immediately because it could be serotonin syndrome o He should avoid alcohol ingestion, other CNS depressants, and over the counter drugs unless cleared by doctor o He should avoid operating vehicles and heavy machinery due to the side effects of drowsiness, dizziness, and blurred vision