NURS 6630 Assignment Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders

NURS 6630 Assignment Study Guide for Medication Treatment Schizophrenia Spectrum and Other Psychosis Disorders

Introduction

Major depressive disorder (MDD), sometimes referred to as clinical depression, lasts for at least two weeks and is characterized by a persistently depressed mood, low self-esteem, and a lack of interest in or enjoyment from typically enjoyable activities (Sartorius et al., 2022). A person’s work or school life, eating and sleeping patterns, general health, and family and personal relationships are all significantly impacted by significant depression (National Institute of Mental Health (2021). A major depressive episode typically manifests as an all-encompassing low mood and the inability to derive pleasure from previously enjoyable activities (American Psychiatric Association, 2013). People who are depressed may obsess over or dwell on thoughts and feelings of worthlessness, unwarranted guilt or regret, hopelessness, or helplessness (American Psychiatric Association, 2013). Poor memory and concentration, withdrawal from social interactions and activities decreased sex drive, irritability, and suicidal thoughts are some additional symptoms of depression (Everaert et al., 2022). Commonly, insomnia causes a person to wake up very early and find it difficult to fall back asleep.

Assessment Questions & Rationale

The patient’s health history reveals been diagnosed with a serious mental health illness, and the daily intake of medication Zoloft 100 mg daily. Despite this medical history, it is vital to re-examine the mental health of the patient using the Geriatric Depression Scale (GDS). The Geriatric Depression Scale is a self-report tool for assessing depression in older adults (American Psychological Association, 2020). Users of GDS reply using a binary system (Yes/No). This tool, which was initially designed as a 30-item instrument, can be completed in 5–7 minutes, making it perfect for individuals who find it difficult to focus for extended periods of time or who are easily fatigued (American Psychological Association, 2020). Repeating the mental status examination is necessary because it is essential to the diagnosis of mental health illness (Andreas et al., 2017).

After re-examining the patient’s mental health, I will ask her the following three questions:

1. Are you taking your drugs as directed by your doctor?

Rationale: Treatment for depression disorders is challenging because it takes weeks to assess the therapeutic effects of prescribed drugs, determine whether dosage modifications are necessary, or switch to a different medication, and this necessitates additional time to assess potential side effects. When non-compliance is involved, managing depression can be difficult. Research has indicated that there is a correlation between “lower adherence and higher medication costs, medications not covered by insurance, patient perceptions of medication not being necessary, and patient fears of side effects (Lee et al., 2010).

1. Which of your regular medications are new?

• Rationale: Losartan is linked to “decreased REM and daytime sedation—and insomnia can occur since the proportion of REM sleep declines noticeably with age” (Lie et al., 2015). Research reveals that 10-20% of users of SSRI (Zoloft) experience agitation, insomnia, mild tremor, and impulsivity (Lie et al., 2013). Depression has also been connected to thiazide diuretics (Calati et al 2013). It is crucial to determine whether the drugs listed above or their dosage have recently changed.

1. Have you made any dietary or environmental changes that may be causing you to sleep less?

Caffeine is commonly consumed in care homes; however, excessive consumption or exposure to the elderly or those with psychiatric disorders can exacerbate or cause anxiety and insomnia. Hence, caffeine consumption should be evaluated (Bélanger et al., 2012). Elderly people are more likely than the general population to experience nocturnal awakenings and sleep fragmentation, so it’s critical to evaluate the patient’s sleeping environment and habits (Bélanger et al., 2012). For example, modifications to the patient’s living space brought on by her husband’s passing should be assessed.

Apart from gathering the patient’s subjective input, it’s crucial to communicate with the patient’s guardians, siblings, children, and primary care physician, and inquire about the following matters:

1. Has the patient’s mood changed at all?
2. Are there any indications of worry?
3. Has the patient’s living situation changed in any way since losing her husband? If yes, what kind of surroundings does she live in?

The aforementioned questions aid