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Adult\/Geriatric Depression<\/strong><\/p>\n \u00a0<\/p>\n BACKGROUND INFORMATION<\/p>\n The client is a 32-year-old Hispanic (the best nursing writing service, a studybay for your papers) American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to the PMHNPs office for an initial appointment for complaints of depression. The client was referred by his PCP after \u201croutine\u201d medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and \u201cstiff\u201d shoulders which he attributes to his current work as a laborer in a warehouse.<\/p>\n \u00a0 SUBJECTIVE<\/p>\n During today\u2019s clinical interview, client reports that he always felt like an outsider as he was \u201cteased\u201d a lot for being \u201cblack\u201d in high school. States that he had few friends, and basically kept to himself. He describes his home life as \u201cgood.\u201d Stating \u201cDad did what he could for us, there were 8 of us.\u201d He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in \u201ctrouble\u201d at work.<\/p>\n \u00a0 MENTAL STATUS EXAM<\/p>\n The client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. The PMHNP administers the \u201cMontgomery- Asberg Depression Rating Scale (MADRS)\u201d<\/strong> and obtained a score of 51 (indicating severe depression)<\/em>.<\/p>\n To prepare for this Assignment:<\/strong><\/p>\n \u00b7 Review this week\u2019s Learning Resources. Consider how to assess and treat adult and geriatric clients requiring antidepressant therapy( Use laureate media interactive media below to make treatment decisions)<\/strong><\/p>\n \u00b7 \u00a0<\/p>\n The Assignment<\/strong><\/p>\n Examine Case Study: An Elderly Hispanic (the best nursing writing service, a studybay for your papers) Man With Major Depressive Disorder<\/em>. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client\u2019s pharmacokinetic and pharmacodynamic processes.<\/p>\n \u00b7 At each decision point stop to complete the following:<\/p>\n o Decision #1<\/strong><\/p>\n \u00a7 Which decision did you select?<\/p>\n \u00a7 Why did you select this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?<\/p>\n o Decision #2<\/strong><\/p>\n \u00a7 Why did you select this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?<\/p>\n o Decision #3<\/strong><\/p>\n \u00a7 Why did you select this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.<\/p>\n \u00a7 Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?<\/p>\n \u00b7 Also include how ethical considerations might impact your treatment plan and communication with clients.<\/p>\n RESOURCES<\/p>\n \u00a7 Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.<\/p>\n d Readings<\/p>\n Note: All Stahl resources can be accessed through this link provided.<\/strong><\/a><\/p>\n Stahl, S. M. (2013). Stahl\u2019s essential psychopharmacology: Neuroscientific basis and practical applications <\/em>(4th ed.). New York, NY: Cambridge University Press.<\/p>\n Note: <\/strong>To access the following chapters, click on the Essential Psychopharmacology, 4th ed<\/strong><\/em> tab on the Stahl Online website and select the appropriate chapter. Be sure to read all sections on the left navigation bar for each chapter.<\/p>\n Stahl, S. M. (2014b). The prescriber\u2019s guide <\/em>(5th ed.). New York, NY: Cambridge University Press.<\/p>\n \u00a0<\/p>\n American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders<\/em> (5th ed.). Washington, DC: Author.<\/p>\n Note: <\/strong>Retrieved from Walden Library databases.<\/p>\n Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134<\/em>, 382-389. Retrieved from https:\/\/www.researchgate.net\/profile\/Marie_Asberg\/publication\/22697065_A_New_Depression_Scale_Designed_to_be_Sensitive_to_Change\/links\/09e41513f85c708fee000000.pdf<\/a><\/p>\n Required Media\u00a0<\/p>\n
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