Background li na was diagnosed with depression 3

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Background: Li Na was diagnosed with depression 3 years ago, and she has had two suicide attempts with drug overdose over the past 3 years, requiring hospitalization both times. Her last attempt was 1 year ago. She sees a psychiatric nurse practitioner with prescriptive authority. Her treatment plan includes pharmacologic antidepressant therapy and biweekly counseling sessions. Her usual dose of sertraline was 100 mg, but 2 weeks ago, the nurse practitioner recommended tapering her sertraline and beginning a trial of venlafaxine. Since then, the nurse practitioner has been on vacation, and Li Na is scheduled for a follow-up upon her return from vacation. During the past 2 weeks, Li Na has made three visits to the community clinic with varying complaints of low back pain and headaches with increasing difficulty sleeping through the night. She has been prescribed extra-strength ibuprofen (600 mg) 4 times a day and as- needed extra-strength acetaminophen (500 mg). These are the drugs she overdosed on in her suicide attempt. Her husband also reports that she has lost 10 lb in the past month due to lack of appetite. Assessment: The pill bottles for her recently prescribed acetaminophen and ibuprofen accompanying her appear empty. Mrs. Chen claims to have been using the medications as prescribed by the community clinic. Her husband reports that she may have taken approximately 6000 mg of acetaminophen and 4800 mg of ibuprofen. Acetylcysteine 7000 mg in 200 mL of 5% dextrose in water was given in the ER, and she underwent a gastric lavage; many recognizable pills were identified in the contents. Her vital signs are being monitored; the last set of vitals done at 1500 are as follows: temperature, 37°C (98.6°F); heart rate, 80 beats/min; respiratory rate, 16 breaths/min; and blood pressure, 112/70 mmHg. Blood for laboratory tests was obtained in the ER. The results are available in the chart. The acetaminophen level was 80 mcg/mL, and the ibuprofen level was 150 mcg/mL. They also assessed her depression in the ER using the Hamilton Depression Scale. The result is in her chart. I performed a Mental Health Status Examination. The result is in her chart. Any potentially dangerous objects were removed from Mrs. Chen belongings. From vSim for Nursing | Mental Health. © Wolters Kluwer.
Recommendation: Maintain safety precautions and safety checks. Continue monitoring vital signs. Perform Mental Health Status Examination in five days to compare to baseline. From vSim for Nursing | Mental Health. © Wolters Kluwer.

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