Halter: Varcarolis' Foundations of Psychiatric Mental Health Nursing, 7th EditionChapter 14: Depressive Disorders
Case Studies and Nursing Care Plans: Depression
Daniel, a 20-year-old college student, has been attending the university for 2 years. He is brought to the emergency department (ED) by his roommate, who found Daniel lying on the floor, unconscious, with an open bottle of Benadryl near his hand. The roommate states that he doesn't know Daniel very well, because Daniel spends a great deal of time studying in the library. The roommate says that Daniel has lots of friends, but over the past couple of weeks, Daniel has seen very few of them. He also has not gone to any of his classes. In addition, although Daniel has been very active in the college band, he has not gone to any rehearsals for 2 weeks. The roommate states that a month ago, Daniel learned that his girlfriend was breaking up with him. After that, Daniel appeared quiet and withdrawn and started to sleep poorly. After receiving treatment in the ED, Daniel is transferred to the intensive care unit (ICU) for observation and from there to the psychiatric ward.
In the psychiatric ward, Daniel admits to Hallie, a nurse, that he has "feelings of sadness." He says that he feels as if "his life is over" since his girlfriend left. He feels that because she left him, he must be unworthy of love and must be a worthless individual. "No one could ever love me," he states. He says this also is true because although his parents spent a lot of money providing him with music lessons and musical instruments over the years, he is failing his music theory class. "Nothing goes right, and it never will," he says. "I only fail." He is ashamed to tell his parents about the class. He feels that he has let them down and that he should be able to pass the class. He says that since he can't pass the class, he should just give up music because he's so lousy. He feels sad that he woke up. "Everyone would be happier without me," he states.
Daniel appears sad and has poor eye contact. His clothes are dirty, and his speech is low and slow. During the assessment he slumps in the chair.
Objective Data: (10 Points)
Subjective Data: (10 Points)
Nurse's Personal Perspective
Hallie is amazed at the thought processes of this young man. He has a supportive family, is succeeding in college except for his music theory class, and has friends and activities. She wonders how his thoughts had become so distorted, to the point where he now believes that he is worthless and better off dead. She thinks that Daniel is a good example of how serious the disease of depression can be. She also remains hopeful that he can recover, because many of his distorted cognitive thoughts can be corrected with therapy.
Diagnosis (list out the as evidence by) 10 points
Risk for suicide related to breakup with his girlfriend and distorted cognitive thinking
Situational low self-esteem related to breakup with girlfriend and distorted cognitive thinking
Outcomes Identification (10 points) (what as a nurse would you expect will happen with your interventions)
Planning: (10 points) (what plan do you have as a nurse to put in place to keep patient safe in acute phase).
Implementation: Give me 2-3 short term goals with 5-7 interventions per short term goal. The rationale on why you choose that intervention. Evaluate what the outcome of your interventions should do for the patient. (40 points)
Write out an SBAR, as you would be giving report to an on-coming nurse with what you did for this patient (10 points):
Category of paper
Short term goals 2 with 5-7 interventions
100 points possible
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