ANSWER
Weekly Clinical Communication: Major Depressive Disorder in a 16-Year-Old Patient
Overview of the Patient:
Major Depressive Disorder (MDD) has been diagnosed in the 16-year-old patient, who exhibits symptoms such as a persistently low mood, feelings of worthlessness, difficulties concentrating, and irregular sleep patterns. The DSM-5-TR’s diagnostic criteria are met by this evaluation (American Psychiatric Association, 2022).
Assessment: A biopsychosocial approach was incorporated into a thorough mental evaluation. The patient’s medical history indicates a familial history of mood disorders, intellectual difficulties, and social disengagement. The patient also reported that interpersonal disputes at school were exacerbating their emotional anguish. Although the patient displayed passive suicidal thinking, no imminent concerns were found when the Columbia-Suicide Severity Rating Scale (C-SSRS) was employed to assess suicide risk.
Diagnosis: The DSM-5-TR criteria were used to confirm the diagnosis of major depressive disorder. The patient exhibits the necessary symptoms, including a notable impairment in social and academic performance that has persisted for longer than two weeks. Depending on how severe and persistent the symptoms were, differential diagnoses including dysthymia and adjustment disorder were excluded.
Treatment Strategy: Pharmacological Intervention: Start with a low daily dose of fluoxetine (10 mg), increasing as necessary. Fluoxetine has a good side effect profile and is FDA-approved for treating depression in children (Stahl, 2022).
Psychotherapy: To address negative thought patterns and develop coping skills, suggest cognitive-behavioral therapy (CBT). A licensed therapist will be scheduled for weekly sessions.
Family Involvement: To enhance communication and offer support, promote family therapy sessions.
Lifestyle Changes: Introduce mindfulness exercises, create regular sleep schedules, and encourage regular physical activity.
Monitoring & Follow-Up: Throughout the first phase of treatment, the patient will get biweekly follow-ups to track fluoxetine response, therapy compliance, and symptomatology changes. We’ll keep a careful eye out for side effects including stomach distress or behavioral activity. The Patient Health Questionnaire for Adolescents (PHQ-A) will be used to gauge progress.
Ethical and Cultural Considerations: The course of treatment is customized based on the patient’s preferences, cultural background, and developmental stage. Discussions focused on confidentiality and the value of team-based care, and consent and assent were acquired.
Citations:
Psychiatric Association of America, 2022. Text revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychological Association.
S. M. Stahl (2022). The neuroscientific foundation and real-world applications of Stahl’s basic psychopharmacology (5th ed.). Cambridge University Press.
D. J. Carlat (2023). The Interview in Psychiatry, Fifth Edition. Kluwer Wolters.
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QUESTION
NU674 Psychiatric Mental Healthcare II-Unit 6 Weekly Clinical Communication Due 10-9. 400w and 3 references. Week 6 Patient is 16 y/o with depression/ major depressive disorder . Must Use the attached template and sample. Please use course resource/ textbook and DSM5 as reference.
Course information
NU674 Psychiatric Mental Healthcare II
Course Description
This purpose of this course is to provide students further studies related psychiatric/mental health care management of patients across the life span to include underlying acute and chronic psychiatric/mental health disorders. Clinical opportunities will be utilized to apply concepts in primary and acute care settings with adults and families.
Program: Graduate Nursing
Semester Credit Hours: 4.0
Contact Hours: 30/0/90/120 (Lecture Hours/Lab Hours/Clinical Hours/Total Hours)
Program Outcomes
Students are expected to meet all the core MSN program outcomes as well as the Psychiatric Mental Health program outcomes.
Upon completion of their program, the student should be able to:
1. Demonstrate critical thinking and holistic caring as an advanced practice
2. Analyze scientific literature for application to selected diagnoses and treatment
3. Synthesize ethical principles into the management and evaluation of healthcare delivery concerns in culturally diverse care settings.
4. Articulate a personal philosophy and framework acknowledging professional and accrediting agency competencies relating to the role and scope of practice of the psychiatric mental health nurse practitioner.
5. Implement the role of the psychiatric mental health nurse practitioner in selected clinical settings
Course Learning Objectives
By the end of this course, you will be able to:
3. Apply knowledge, with mentor supervision and minimal prompting, of chronic and acute psychiatric mental health disorders using the current edition of the Diagnostic and Statistical Manual for Mental Disorders diagnostic criteria to assess, diagnose and manage the patient populations across the lifespan including a focus on vulnerable populations at risk for mental health disorders.
4. Integrate, with mentor supervision and minimal prompting, complete mental health assessment, interview, history and physical exam data collection with the knowledge of pathophysiology and psychopathology of psychiatric mental health disorders across the life span to form differential diagnoses and implement therapeutic, patient-centered treatment plans and interventions for patient populations across the lifespan.
5. Merge, with mentor supervision and minimal prompting, traditional and complementary pharmacological/non-pharmaceutical interventions into the treatment and management of psychiatric mental health disorders for patient populations across the lifespan.
6. Examine, evaluate, and demonstrate, with mentor supervision and minimal prompting, professional development in the role of the nurse practitioner in the diagnosis and management of health and wellness as well as acute and chronic psychiatric mental health disorders illnesses for patient populations across the lifespan as a member of an interprofessional team.
7. Integrate, with mentor supervision and minimal prompting, cultural, spiritual, and social competencies into therapeutic patient-centered treatment plans in connection with evidence-based findings to the diagnosis and management of individuals, groups and families across the lifespan with acute, complex, and chronic psychiatric mental health disorders illnesses for patient populations across the lifespan as a member of an interprofessional team.
8. Analyze, with mentor supervision and minimal prompting, professional values and core ethical/legal standards into the practice of the Psychiatric Mental Health Nurse Practitioner role with relation to patient/staff safety, quality indicators, and health outcome improvement in the delivery of quality psychiatric mental health care to patients.
9. Identifies, with mentor supervision and minimal prompting, the highest level of professionalism and accountability for the PMHNP role for transition into clinical practice.
Resources
Required
American Psychological Association. (2019). Publication manual of the American Psychological Association (7th ed.). Washington, DC: APA Press. ISBN 9781433832161
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders text revision (5th ed. -TR) (DSM-5 -TR). APA. ISBN: 978-0-89042-576-3
Carlat, D. J. (2023). The psychiatric interview (5th ed.). Philadelphia, PA: Wolters Kluwer. ISBN: 9781975212971
Johnson, K., & Vanderhoef, D. (2016). Psychiatric mental health nurse practitioner review manual (4th ed.). Silver Spring, MD: American Nurses Association. ISBN: 978-1-935213- 79-6
Joseph Boland, Verduin, M. L., Ruiz, P., Arya Shah, & Sadock, B. J. (2021). Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (12th ed.). Philadelphia, PA: Lippincott Williams, and Wilkins. ISBN: 9781975145569
Recommended
Dulcan’s Textbook of Child and Adolescent Psychiatry (3rd ed.) by Dulcan, Mina K. M.D. ISBN 9781615373277, 1615373276
Stahl, S. M. (2022). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press. ISBN: 978-1-108-97163-8
Stahl, S. M. (2021). Prescriber’s guide: Stahl’s essential psychopharmacology (7th ed.). Cambridge University Press. ISBN: 978-1-108-97163-8