Sample Nursing Paper on Depression

1.  Identify the pathology involved with Depression

Over the last two decades, there have been varieties of mental disorders that have been affecting a people in various ways. As indicated, majorities of these disorders have a significant impact on multiple life areas; subsequently, such ailments have the ability to cause major distress when experiencing symptoms. One of the most common mental disorders is depression and as narrated by Richards and O’Hara (2014), it is a disease that is described than merely feeling sad or grief but prolonged periods of moody emotions. As indicated by Barlow (2008), “Depression most common disorders encountered by mental health professionals” (p.250). Additionally, Barlow (2008) states that although depression does not kill as other diseases such as Cancer or heart attacks it augments the chances of such ailments affecting a patient.

Symptoms

Depression has several symptoms that vary from one individual to another as presented below.

Emotional Symptoms. As explained by Leahy, Holland, and McGinn, (2012), individuals who suffer from depression often go through episodes of humiliation, emptiness, and misery without direct causes. In such instances, they experience anxiety, agitation, which may be coupled with frequent sobbing and may lose their sense of humor. Other than the aforementioned emotions, most individuals suffering from depression lack the drive or spontaneity to maintain an active life. As told by Barlow (2014), depression patients may find completing the simplest tasks impossible to perform at times.

Behavioral Symptoms. A patient suffering from depression may remain inactive for prolonged periods showing no will to eat, clean up, or even have suicidal thoughts (Culebras and Culebras, 1996).

Cognitive Symptoms. Commonly, persons suffering from depression are likely to consider themselves inadequate, undesirable, or inferior to their peers Leahy, Holland, and McGinn, (2012), The seldom take credit for their achievements but quick to assign themselves blame in case of a failure.

Over the years, there have been numerous attempts to find solutions for depression. As indicated by Barlow (2014), the earliest written accounts of depression as it is described today appeared in Mesopotamia during the second millennium B.C. form then the known treatment for the ailment was Psychotherapy

 

 

Initial Focused Assessment:
2.  Identify priority areas for assessment and why:

Currently, it is estimated that 7% of the U.S population suffers from some form of clinical depression. Additionally, about over the last decade, the annual visits by adults seen by primary care physicians has gone up by 30%. Depression in its different forms is a social menace.

 

 

 

       
3.  Identify 3 commonly administered medications for patients with depression
Medication Dose, Route, Frequency Side Effect Nursing Implications
Amitriptyline

(Elavil®)

Starting dose 10mg, increase by 10mg q for 3-7days.

 

Therapeutic dose for pain25-75mg for 3 days.

 

Antidepressant target dose 150-300mg 0under the physicians recommendations

The medication has two types of side effects

The high risk include Anticholinergic, drowsiness, weight gain as well as sexual dysfunction.

The moderate risk include Orthostatic hypotension, and QTc prolongation

For outpatients 75 mg of amitriptyline HCl a day in divided doses is usually satisfactory. If necessary, this may be increased to a total of 150 mg per day. Increases are made preferably in the late afternoon and/or bedtime doses. A sedative effect may be apparent before the antidepressant effect is noted, but an adequate therapeutic effect may take as long as 30 days to develop.

As a nurse the use of has a variety of side effects as indicated and some are short terms. Nevertheless, the existence of blurred vision, constipation, urinary retention, as well as orthostatic hypotension need closer and higher attention because they may cause permanent or serious damage to the patient.

Medication Dose, Route Frequency Side Effect Nursing Implications
Clomipramine

(Anafranil®)

 

 

 

 

 

 

 

Starting dose 25mg, increase by 25mg q for 3-7days.

 

Therapeutic dose for pain 50-100mg 3 days.

 

Antidepressant target dose 100-300mg under the physicians recommendations

The medication has two types of side effects

The moderate risk include Anticholinergic, drowsiness, weight gain as well as sexual dysfunction.

The low risk include Orthostatic hypotension as well as QTc prolongation.

As a Tertiary Amines Clomipramine

(Anafranil®) does not have life threatening side effects; however, this does not mean that as a nurse one should overlook the drugs reaction to a patient.

In short-term studies, antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults (under 24 years of age) taking antidepressants for major depressive disorders and other psychiatric illnesses.

Medication Dose, Route Frequency Side Effect Nursing Implications
Nortriptyline

(Pamelor®)

Starting dose 10mg, increase by 10mg q3-7d

Therapeutic dose for pain 25-75mg 3 days.

 

Antidepressant target dose 50-150mg under the physicians recommendations

The medication has two types of side effects

 

The drug’s moderate risk is QTc prolongation

The drug’s Low risk includes Anticholinergic and drowsiness

The dosage for Adults suffering from depression is 25 mg orally every 6-8 hours; the daily dosage should not exceed more than 150 mg per day.

For Children between the ages of 6-12 years the dosage is 1-3 mg/kg per day orally every 6-8 hours, or 10-20 mg per day orally divided 6-8 hours.

4.  Identify 2 Initial  Nursing Diagnoses for a patient with depression
Assessment Data Priority Diagnosis Intervention Expected outcomes
1. Sadness or depressed mood most of the day or almost every day coupled by the loss of pleasure in things that were once enjoyable. When a patient suffers from depression they are likely to adopt a demotivate lifestyle that may lead to other ailments. Identifying a lack of drive and will helps the practitioner to find the source of depression Re-introduction of the emotional stimuli in order to trigger different moods. When the practitioner identifies things that trigger happiness and enjoyment the patient may be able to overcome part of their depression
2. Exhaustion or loss of energy on a daily basis. Patients suffering from depression have a hard time working through the day. They feel exhausted without actually working thus become less productive which feeds their emotion of worthlessness. Re-introducing simple to do task that lifts their esteem. Positive motivation plays a significant role in lifting an individual from a depressed state. It gives them something they know they can do well thus improving their sense of activity.
Potential Complication(s) Assessment Findings to Indicate Complications Interventions When Complications Occur
 

A lack of positive response

 

 

 

 

 

 

 

 

From the aforementioned diagnoses and expected outcomes, it is clear that practitioners endeavor to change the patient’s state of mind. In some cases, the patients may develop a negative reaction to the treatment. For instance, if they realize the tasks they are working on are easy then they become worse as they think the nurses do not have faith in them working on complex tasks. The nurse should always communicate with the patient. Practitioners are always advised to explain their treatment processes to their patients so that when one falls into a mental breakdown they are able to communicate.
5. Identify treatments and management of Depression
The best way to manage digression begins with a psych-evaluation. This helps the nurse understand the level of depression they are dealing with before administering any form of medication. Patients should be checked for changes on a regular basis in order to make sure the treatment taken is effective. It is not wise to have a patient take antidepressants before an in-depth analysis of what they are going through. Any form of side effect on drugs or a procedure should be reported to the doctors immediately.

 

 

References

Barlow, D. H. (Ed.). (2014). Clinical handbook of psychological disorders: A step-by-step treatment manual. Guilford publications.

Culebras, A., & Culebras, A. (1996). Clinical handbook of sleep disorders (pp. 187-188). Boston: Butterworth-Heinemann.

Leahy, R. L., Holland, S. J., & McGinn, L. K. (2012). Treatment plans and interventions for depression and anxiety disorders. New York : Guilford Press

Richards, C. S., & O’Hara, M. W. (2014). The Oxford handbook of depression and comorbidity. Oxford : Oxford University Press