Depressive Disorder Assignment Essay
Assignment 1- “Captain of the Ship” Project – Depressive Disorder –WK2
As nurse practitioners strive to achieve full-autonomous practice across the country, it should be noted that many states grant this ability to practice independently to psychiatric mental health nurse practitioners. To that end, you will be engaging in projects this semester that assume that you are practicing in a state that allows full-practice authority for NPs, meaning that the PMHNP may be the “captain of the ship” concerning caring for a patient population. The “captain of the ship” is the one who makes referrals to specialists, coordinates care for their patients/clients, and is responsible and accountable for patient/client outcomes overall. This is a decided change from a few decades ago when physicians were the “captain of the ship” and NPs played a peripheral role.
In this Assignment, you will become the “captain of the ship” as you provide treatment recommendations and identify medical management, community support resources, and follow-up plans for a client with a depression disorder.Depressive Disorder Assignment Essay
Learning Objectives
Students will:
• Recommend psychopharmacology treatments based on therapeutic endpoints for clients with depression disorders
• Recommend psychotherapy based on therapeutic endpoints for clients with depression disorders
• Identify medical management needs for clients with depression disorders
• Identify community support resources for clients with depression disorders
• Recommend follow-up plans for clients with depression disorders
To prepare for this Assignment:
• Select an adult or older adult client with a depressive disorder you have seen in your practicum.
In 3–4 pages, write a treatment plan for your client in which you do the following:
• Describe the HPI and clinical impression for the client.
• Recommend psycho pharmacologic treatments and describe specific and therapeutic endpoints for your psycho pharmacologic agent. (This should relate to HPI and clinical impression.)
• Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
• Identify medical management needs, including primary care needs, specific to this client.Depressive Disorder Assignment Essay
• Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
• Recommend a plan for follow-up intensity and frequency and collaboration with other providers.
History of Presenting Illness and Clinical Impression for the Client
A 28-year-old African American SK presented to the clinic with complaints of chronic fatigue and frequent headaches. She also reported disturbed sleep which forced her to wake up very early. SK described her headache as being dull, generalized and aching and had lasted for approximately two weeks before presentation. She also reported lacking interest in daily activities and how she frequently missed work due to inability to concentrate and generalized fatigue. Despite the fact that both her children were in school, she was concerned that she rarely spent quality time with them. Apart from losing appetite, SK noted that she had lost up to 10 pounds in a month. SK acknowledged to take ibuprofen for her headaches but denied using any drugs or alcohol.
The physical exam revealed an alert and a cooperative patient who neither had delusions nor hallucinations. She had logical and goal-oriented thoughts. During the interview, she could burst into tears and acknowledged to feel sad most of the times. She admitted the fact that her thoughts were often full of worries, being worthless and hopeless but denied suicidal ideation. The laboratory values were within the normal ranges. Based on the DSM for diagnosing mental health disorders, a clinical impression that was made for SK was major depressive disorder which is primarily characterized by sleep disturbance, lost interest in activities of daily life, excess worry, fatigue, loss of appetite, feelings of being worthless and hopeless for two weeks and inability to concentrate (Zimmerman et al., 2015).
Psychopharmacologic Treatments with Therapeutic Endpoints
Among patients with depressive disorders, recommendations for treatment are often made if a patient’s symptoms impair their physical and social functioning or lead to significant distress. SK reported that she missed a lot of days at work due to difficulty concentrating and that her relationship with her children was gradually being torn apart. This evidence reveals that her symptoms impaired her social functioning and occupational life. Therefore, she will be prescribed Zoloft, 50mg PO qDay. Zoloft, also known as sertraline is an antidepressant which belongs to the class of selective serotonin reuptake inhibitors. It acts by inhibiting the neuronal uptake of serotonin (Gautam, 2017). She will be informed to expect a number of side effects which are primarily side effects of antidepressants and SSRIs. In this case, the goal of pharmacotherapy will be to ensure that SK’s depressive symptoms which interfere with her social and occupational life are minimized.
Psychotherapy Choices and Therapeutic Endpoints
There is a lot of scientific evidence that supports the use of psychotherapy in the management of depressive disorders together with medications. Clearly, this client has a cognitive disturbance, high levels of social stress, affective disturbance and somatic manifestations whose likelihood is that they are related to her current depressed state (Zimmerman et al., 2015). Therefore, group cognitive behavioral therapy will be the most effective form of psychotherapy for the management of this client.Depressive Disorder Assignment Essay