TINA ET CELIA PRESENTATION.docx

Case study : Sarah, a 32-year-old woman, has been experiencing a mix of symptoms suggestive of both bipolar disorder and major depression. Over the past few weeks, she has been feeling intensely sad and hopeless, with a significant decrease in energy and interest in activities she once enjoyed. She...

Case study : Sarah, a 32-year-old woman, has been experiencing a mix of symptoms suggestive of both bipolar disorder and major depression. Over the past few weeks, she has been feeling intensely sad and hopeless, with a significant decrease in energy and interest in activities she once enjoyed. She has trouble sleeping, often lying awake for hours, and struggles to concentrate on tasks at work. Sarah's appetite has diminished, resulting in significant weight loss, and she frequently experiences feelings of worthlessness and guilt. However, Sarah's symptoms are not solely indicative of depression. She also goes through periods of heightened energy and irritability, during which she engages in impulsive behaviors such as excessive spending sprees and reckless driving. Sarah experiences racing thoughts and feels like her mind is constantly racing. She talks rapidly and jumps from one topic to another, making it difficult for others to keep up with her. These episodes are followed by periods of extreme fatigue and lethargy, during which Sarah struggles to get out of bed and lacks motivation to perform even the simplest tasks. Sarah's family has noticed these mood swings and are concerned about her well-being. They have observed that she cycles between periods of elation and deep sadness, often without any apparent trigger. Sarah herself feels overwhelmed by these mood fluctuations and is unsure of what to do. She recognizes that her symptoms are impacting her ability to function effectively in her daily life and is desperate for help and support. After a thorough evaluation by her psychiatrist, Sarah was diagnosed with bipolar disorder type II with mixed features and major depressive disorder. Nursing intervention As nurses our interventions encompass a comprehensive approach aimed at promoting the well-being and stability of patients , like SARAH, with mood disorder, ensuring their safety, and providing effective care throughout their treatment journey. ESTABLISH A RAPPORT, AND A GOOD OPPORTUNITY IN EVALUATING THE MENTAL STATE OF THE PATIENT TO BUILT A PRIMARY CARE PLAN ESTABLISHING RAPPORT AND THERAPEUTIC RELATIONSHIP: By building a trusting and supportive relationship with the patient, it facilitates effective communication and patient engagement in their treatment. Effective communication is characterized by openness and transparency, it enables nurses to establish a therapeutic relationship and foster a collaborative partnership between the nurse and the patient in the decision-making regarding their care. ASSESSING THE MENTAL STATE OF THE PATIENT : While establishing a therapeutic rapport, one essential aspect of our assessments involves both non-verbal and verbal evaluations. When dealing with clients who have bipolar disorder, including unipolar major depression, it's crucial to pay attention to cues beyond just their spoken words. These individuals may exhibit intense or unusual emotions, erratic changes in sleep patterns, and impulsive behaviors. By assessing both verbal and nonverbal cues, we can screen for potential mood disorders and identify any harmful effects that the patient may not recognize. One approach that we can use during the interview include conducting a comprehensive Mental Status Examination (MSE) to observe various manifestations of a manic or depressive episode. We can use other tools Utilizing screening tools such as the Mood Disorder Questionnaire (MDQ) which can further aids in assessing manic symptoms and determining appropriate interventions. SCREENING FOR SEVERE DEPRESSION During these assessments, we strictly adhere to safety guidelines to ensure the well-being of our patients. Therefore, we must do a suicide risk assessment as it is an essential component to our evaluation process, especially when dealing with severe depression. It is essential to assess whether the patient is at risk of harming themselves, including considering the possibility of suicidal ideation. Below is a comprehensive outline of the suicide risk assessment protocol which is PH-9 Questionnaire that we follow to assess depression, and based on the score given the following criteria, we can intervene : Identify Behavioral Manifestations: Look for signs such as decreased investment and motivation in work or daily activities. Pay attention to direct verbal messages indicating suicidal thoughts, such as expressions like "I want to die." Identify Risk Factors: Assess if the patient has a history of mental illness, substance abuse, or alcohol misuse, as these are significant risk factors for suicide. Identify Protective Factors: Evaluate the presence of strong social support networks, such as supportive friends or family members, which can mitigate the risk of suicide. Conduct Suicide Inquiry: Engage in direct communication by asking the patient directly, "Are you thinking about suicide?" This open and direct approach allows for honest communication about suicidal ideation. Assess Level of Risk: Based on the gathered information, determine the level of suicide risk, considering factors such as the severity of depressive symptoms, presence of protective factors, and history of suicide attempts. By systematically following these assessment steps, we can effectively evaluate the risk of suicide in our patients and take appropriate measures to ensure their safety and well-being. C. NURSING ROLE IN HOLISTIC CARE – EVALUATION OF THE PRIMARY CARE PLAN: As nurses, it's crucial to educate Sarah and her family about her mood disorder, as well as her prescribed medication, including potential side effects and the importance of adherence. We closely monitor her response to the given medications, document any side effects, and evaluate changes in her symptoms and overall functioning. This ensures patient safety and promotes comfort during treatment. By closely tracking these changes, nurses can provide feedback to the healthcare team to allow for adjustments to the treatment plan as needed. Additionally, promoting treatment plan adherence and addressing any barriers to adherence are essential aspects of our role. Continuous evaluation of the implemented care plan is essential. We continuously assess its effectiveness based on the patient's unique needs. We adjust interventions as necessary to stabilize the client's needs during acute manic and depressive episodes and ensure their safety, medication management, rest, nutrition, and personal care. PROMOTION OF SELF-CARE IN COMBINATION TO THE PRIMARY CARE PLAN In addition to medication, promoting self-care activities is crucial as it can help alleviate depression symptoms and improve overall well-being. We can recommend relaxation techniques like progressive muscle relaxation or visualization of peaceful places, autogenic training for inducing a state of warmth and heaviness, and positive activities to relieve depression symptoms. Exercise, such as brisk walking, running, or cycling along with resistance training, for 60 minutes, 3-5 times a week, is also recommended for overall well-being. UTILIZING DAILY MOOD RECORDS TO ENHANCE TREATMENT AND RISK REDUCTION We can recommend the patient to keep a life chart to record daily mood symptoms, treatments (sides effects of meds.) , sleep pattern and life events that van trigger some depressive or manic phases. By asking patients to maintain a journal tracking their mood and activities, we can identify triggers for hypomanic or manic phases, enabling us to adjust treatment plans accordingly and reduce the risk of relapse. ENSURE TO GIVE THE AVAILABLE SERVICES OFFERED It's crucial to acknowledge that help and support are available for those dealing with depression, whether it's associated with bipolar disorder or unipolar depression, especially during depressive episodes, which can be very challenging. Knowing about these available resources is essential, as this can be a risky time for individuals affected: 9-8-8 suicide crisis helpline– this service is available for anyone in Canada 24/7 who is thinking of suicide, they can call or even text, and talk to someone directly. It is a confidential service, they will not attempt to send help unless they believe you are in immediate danger. In case of emergency, call 911. This service is a trauma-informed and culturally appropriate 811 info-social – they provide support 24/7 and it is a free confidential telephone consultation service in Quebec to connect with a psychosocial worker quickly. This service is available in French and English For additional mental health services and information, you can consult the Canadian website for mental health support for additional mental health services. https://www.canada.ca/en/public-health/services/mental-health-services/mental-health-get-help.html By providing comprehensive care, support, and access to resources, we can help Sarah navigate her journey towards recovery and improved mental well-being. CANVA CONTENT Just copy past and adjust if needed ! INFORMATION TO ADD ON EACH DIPO DIAPO 1 CASE SCNERIO Sarah, a 32-year-old woman, has been experiencing a mix of symptoms suggestive of both bipolar disorder and major depression. Over the past few weeks, she has been feeling intensely sad and hopeless, with a significant decrease in energy and interest in activities she once enjoyed. She has trouble sleeping, often lying awake for hours, and struggles to concentrate on tasks at work. Sarah's appetite has diminished, resulting in significant weight loss, and she frequently experiences feelings of worthlessness and guilt. However, Sarah's symptoms are not solely indicative of depression. She also goes through periods of heightened energy and irritability, during which she engages in impulsive behaviors such as excessive spending sprees and reckless driving. Sarah experiences racing thoughts and feels like her mind is constantly racing. She talks rapidly and jumps from one topic to another, making it difficult for others to keep up with her. These episodes are followed by periods of extreme fatigue and lethargy, during which Sarah struggles to get out of bed and lacks motivation to perform even the simplest tasks. Sarah's family has noticed these mood swings and are concerned about her well-being. They have observed that she cycles between periods of elation and deep sadness, often without any apparent trigger. Sarah herself feels overwhelmed by these mood fluctuations and is unsure of what to do. She recognizes that her symptoms are impacting her ability to function effectively in her daily life and is desperate for help and support.. DIAPO 2 TITLE: NURING INTERVENTION – ESTABILISHING RAPPORT AND THERAPEUTIC RELATIONSHIP SUBTITBLE: IMPORTANCE OF RAPPORT IN NURSING CARE Importance of establishing rapport in nursing care to foster trust and enhance patient cooperation. Building a trusting and supportive relationship with the patient to facilitate effective communication and patient engagement in their treatment. Characteristics of effective communication in nursing care, characterized by openness and transparency, enabling nurses to establish a therapeutic relationship and foster a collaborative partnership between the nurse and the patient in decision-making regarding their care. DIAPO 3 NURSING INTERVENTION: ASSESSING THE MENTAL STATE OF THE PATIENT 2 SECTIONS SIGNIFICANCE OF MENTAL STATE ASSESSEMENT ASSESSING MENTAL STATE HELPS IN EARLY DETECTION OF MENTAL HEALTH ISSUE IT GUIDES TREATMENTS PLANS FOR PATIENT. TOOLS AND TECHNIQUES FOR EVALUATION: Observing Mental Status Examination (MSE) during the interview as a key approach in evaluating the mental state Utilizing screening tools such as the Mood Disorder Questionnaire (MDQ) and PHQ-9 Questionnaire for severe depression to aid in assessing manic symptoms and determining appropriate interventions. DIAPO 4 TITLE: NURSING INTERVENTION: NURSING ROLE IN HOLISTIC CARE - EVALUATION OF THE PRIMARY CARE PLAN SLIDE CONTENT: Patient Education: Educate Sarah about her mood disorder and prescribed medication. Emphasize potential side effects and the importance of medication adherence. Monitoring and Documentation: Closely monitor Sarah's response to the given medications. Document any side effects and evaluate changes in symptoms and overall functioning. Promote adherence to the treatment plan and address any barriers to adherence. Patient Safety and Comfort: Meticulously track changes to ensure patient safety and promote comfort during treatment. Feedback to Healthcare Team: Provide valuable feedback to the healthcare team based on observations and documentation. Allow for necessary adjustments to the treatment plan based on feedback. Continuous Evaluation and Adjustment: Continuously assess the effectiveness of the care plan based on Sarah's unique needs. Adjust interventions as necessary to stabilize Sarah's needs during acute episodes. DIAPO 5: TITLE: NURSING INTERVENTION: PROMOTION OF SELF-CARE IN COMBINATION WITH THE PRIMARY CARE PLAN SLIDE CONTENT: Recommending the patient to keep a life chart to record daily mood symptoms, treatments, sleep patterns, and life events that can trigger depressive or manic phases. Utilizing daily mood records to identify triggers for hypomanic or manic phases, enabling adjustments to treatment plans and reducing the risk of relapse. In addition to medication, promoting self-care activities is crucial as it can help alleviate depression symptoms and improve overall well-being. We can recommend relaxation techniques like progressive muscle relaxation or visualization of peaceful places, autogenic training for inducing a state of warmth and heaviness, and positive activities to relieve depression symptoms. Exercise, such as brisk walking, running, or cycling along with resistance training, for 60 minutes, 3-5 times a week, is also recommended for overall well-being. DIAPO 6 TITLE: NURSING INTERVENTION: ENSURE TO GIVE THE AVAILABLE SERVICES OFFERED SLIDE CONTENT : Highlighting the availability of support services for individuals dealing with depression, such as the 9-8-8 suicide crisis helpline and 811 info-social for immediate psychosocial support in Quebec Emphasizing the importance of acknowledging available resources for individuals affected by depression, especially during challenging depressive episodes. Providing comprehensive care, support, and access to resources to help patients navigate their journey towards recovery and improved mental well-being.